Given the recently published results of PEACE 2, under what scenario would you offer pelvic radiotherapy for high-risk/very high-risk prostate cancer?

Although PEACE-2 was presented at GU ASCO, to my knowledge it has not yet been published other than in abstract form, and the results of the arms in PEACE-2 comparing prostate only vs whole pelvic RT were not presented, so I don't think PEACE-2 sheds any light yet on the question of whether or not t...

PEACE-2 and RTOG 0924 should remind us that we do not have convincing data to support elective nodal irradiation (ENI) for intact prostate cancer. Personally, I find POP-RT very intriguing. But those two large, multicenter trials conducted in the US and Europe are humbling. I suspect there is a popu...

Dr. @Dr. First Last makes a great point about the "literature": POP-RT is published while PEACE-2 and NRG/RTOG 0924 have only been presented in abstract form at conferences. Hopefully, we will learn more from future meta-analyses and/or genomic stratifications.

The POP-RT signal came in men who were ...

We now have data from 4 RCTs that do not support a benefit from pelvic ENI for localized prostate cancer (GETUG-01), intermediate/high-risk disease (RTOG 9413), unselected favorable high-risk disease (RTOG 0924), and unselected very high-risk disease (PEACE-2). Although there was a trend for improve...

With PEACE-2 being negative for high-risk and very high-risk prostate cancer, the argument for ENI in any situation except patients with nodal disease (primary or recurrent) is weaker now.