A New Option for Intermediate-Risk Prostate Cancer — and Why It Matters
By Stuart Jordan
A clinical trial exploring a new treatment option for intermediate-risk prostate cancer has produced a striking result. Across 42 patients enrolled in the RTIRE trial at Weill Cornell Medicine, none of the 12-month biopsies showed evidence of recurrent cancer. That outcome is now driving a major Phase III randomized trial — called IRRADIANT — launching at some of the top cancer centers in the country, including Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, Moffitt Cancer Center, Fox Chase Cancer Center, UT Southwestern, and Mayo Clinic (MN & AZ).
I was fortunate to be one of those 42 patients. And I want to tell you why I chose this trial, what the experience was like, and what it may mean for men in our community who have been diagnosed with intermediate-risk prostate cancer — Grade Group 2 or 3, or in Gleason terms, 3+4 or 4+3 — and are considering their treatment options.
The core problem RTIRE was designed to solve is one that AnCan knows well. Focal treatments are appealing — less invasive, fewer side effects, and faster recovery. But recurrence remains a significant concern, and RTIRE was designed specifically to address that challenge. It combines IRE, a precise nonthermal ablation of the dominant lesion, with reduced-dose MR-guided radiation to cover the entire prostate. Think of the IRE as a boost — targeting the most aggressive area with intensity — while the radiation handles the rest of the gland with less total dose than standard SBRT. The goal is to achieve cancer control comparable to whole-gland treatment while reducing side effects.
When I brought this to AnCan two years ago, the group was skeptical. The questions were fair: why take the risk of focal when standard SBRT has a strong track record? And if you were going focal, why add the complexity of a clinical trial? I had my reasons — the credentials of Drs. McClure and Nagar, the MRLinac technology at MSK, and frankly, the logic of addressing the risk of recurrence directly rather than accepting it as a given. The group respected my reasoning without necessarily agreeing with it.
Today, they are the ones asking me to share this story.
My own outcome has been encouraging: a clean 12-month biopsy, consistently low PSA readings, a clean MRI and PSMA scan, manageable urinary side effects controlled with medication, no bowel issues, and some sexual-function changes, which can occur with virtually any prostate cancer treatment. I am not cured. I remain under routine surveillance and am currently considered low risk, and I have no regrets about the path I chose.
IRRADIANT is now open and enrolling. The trial is randomized, so participants have a 50/50 chance of receiving either the IRE boost plus reduced-dose SBRT or standard SBRT radiation treatment alone. If you have been diagnosed with intermediate-risk prostate cancer and are weighing your treatment options, I am happy to discuss further. Reach out during our session or email me at stuart@ancan.org.
RTIRE – trial details and results‑related info
1. ClinicalTrials.gov – official RTIRE registry (Phase II)
Includes protocol, dose (32.5 Gy/5 or 22 Gy/2), eligibility, endpoints, and status.
https://clinicaltrials.gov/
2. BMC Urology protocol paper (PubMed)
Full write‑up of the RTIRE Phase II design, rationale, and planned outcomes; registered as NCT05345444.
https://pubmed.ncbi.nlm.nih.
3. ASCO JCO abstract – RTIRE trial overview (TPS403)
Short scientific abstract summarizing objectives, feasibility endpoint, expansion phase, and planned oncologic/QOL outcomes.
https://ascopubs.org/doi/10.
4. AUA Journal abstract – early RTIRE experience (MP04‑01)
Phase I proof‑of‑principle abstract on combining IRE with reduced‑dose MRgRT (feasibility, safety, preliminary efficacy).
https://www.auajournals.org/
5. Patient‑facing RTIRE explainer (PRIMR)
Plain‑language description of RTIRE, who it’s for, and what it’s testing.
https://www.primrmed.com/
IRRADIANT – new randomized trial information
1. IRRADIANT trial explainer (PRIMR blog)
Best lay summary of IRRADIANT: two‑arm design (standard radiation boost vs IRE boost + lower‑dose radiation), endpoints, and follow‑up.
https://www.primrmed.com/blog-
2. IRRADIANT trial listing (PRIMR clinical trials page)
Shorter listing with key eligibility and contact/info points.
https://www.primrmed.com/
3. IRRADIANT social/video teaser
Very brief description and link to a video overview of the study.
https://www.instagram.com/p/