Focal salvage HDR brachytherapy shows low acute toxicity in phase I/II trial for radiorecurrent prostate cancer

Phase 1-2 · J Clin Oncol · 2026-10-15. Number 1 in the UrologyWatch Top 5 for October 15, 2026.

In the 62-patient F-SHARP phase I/II trial of dose-escalated focal salvage HDR brachytherapy after prior radiotherapy, no acute grade 3 toxicity occurred (2 patients had late grade 3 toxicity) and 3-year biochemical PFS was 62.7%. Among 31 patients with genomic classifier data, all 4 with scores above 0.85 experienced recurrence, suggesting a possible biomarker for risk stratification.

Why it matters: Supports focal salvage HDR brachytherapy as a low-acute-toxicity option for intraprostatic radiorecurrence; a small genomic classifier subset hints at a biomarker for treatment intensification, pending larger validation.

Limitation: Single-arm phase I/II design with modest sample size (n=62) and surrogate biochemical/radiographic endpoints.

Source: J Clin Oncol · PubMed 42874014 · DOI 10.1200/jco-25-02730

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