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ESMO 2025 | ENZARAD: ADT, radiotherapy and radical prostatectomy in prostate cancer

Bertrand Tombal, MD, PhD, Université catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium, comments on the significance of the ENZARAD trial (NCT02446444), which investigated the treatment of high-risk localized prostate disease with radiotherapy, androgen deprivation therapy (ADT), and radical prostatectomy (RP), showing no benefit of RP. Despite the results being negative, the trial has high clinical significance, particularly in the context of the STAMPEDE trial (NCT00268476). This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.

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Transcript

My favorite trial is a negative one. It’s ENZARAD. ENZARAD is high-risk localized disease, treated with radiotherapy plus ADT and adding eventually an RP. That trial shows there is no benefit of RP. It’s very important. Why? Because following the STAMPEDE trial we saw high-risk patients not being in the very high risk receiving a combination of ADT and Abiraterone...

My favorite trial is a negative one. It’s ENZARAD. ENZARAD is high-risk localized disease, treated with radiotherapy plus ADT and adding eventually an RP. That trial shows there is no benefit of RP. It’s very important. Why? Because following the STAMPEDE trial we saw high-risk patients not being in the very high risk receiving a combination of ADT and Abiraterone. Today we have almost, I mean the ENZARAD has almost demonstrated that it’s wrong. That if you have a high-risk localized disease, negative lymph nodes, you’re going to be treated as well with radiotherapy and two years of standard hormone therapy. So that’s typically a negative, statistically negative trial with a very, very high clinical significance. So very important trial. I would even say going back tomorrow to my practice, that’s the most informative trial.

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