Peter Mac News

SABR shows unprecedented effectiveness in kidney cancer

27 February 2024

A precisely targeted and high-powered form of radiotherapy can provide long-term cancer control for patients with inoperable kidney tumours, a Peter Mac-led trial has shown.

The “FASTRACK II” trial involved 70 patients with high-risk tumours that were not suited for surgery and was the first multi-centre trial to test stereotactic body radiation (SABR) as a non-invasive treatment for kidney cancer.

The patients, with a median age of 77 years, received their SABR treatment at one of seven Australian sites or a hospital in the Netherlands, between 2016 and 2020. The average tumour size was relatively large at 4.6cms.

Each patient had a single tumour that was targeted with SABR either in a single dose (for tumours under 4cm) or across three doses (for larger tumours), and the results were tracked for a median of 3.5 years.

The SABR treatment effectively stopped kidney tumours from growing - with only modest side-effects and impairment of kidney function - in a group of patients with very limited curative treatment option. These results were published today in the journal Lancet Oncology.

“Our study demonstrated that a novel treatment delivered in an outpatient setting is able to achieve unprecedented efficacy for patients with inoperable kidney cancer,” says Peter Mac’s Professor Shankar Siva, who led the trial.

“There’s an unmet need for curing this type of cancer, and our findings point to the potential of radiation therapy to address that need.”  

None of the patients experienced a local progression of their tumour (100% control), or died from their cancer, during the trial period. Overall survival in this older cohort was 99% one year after SABR, and 82% at three years.

Prof Siva said the findings of this non-randomised phase II clinical trial justified designing a randomized, phase III trial to compare SABR to surgery for patients with operable kidney cancer.

“The prospect of comparing SABR to traditional surgery in a larger clinical trial holds immense potential in reshaping kidney cancer treatment strategies,” Prof Siva says.

“Surgery has been the standard-of-care for kidney cancer, either to remove tumour and a surrounding margin or removing the entire kidney. If shown to be similar, given a choice between the two, I believe a lot of patients would opt for non-invasive radiation.” 

SABR is a precisely-targeted form of radiotherapy which allows patients to receive much higher doses than conventional radiotherapy – ensuring SABR can be administered in a single or just several sessions, rather than many sessions.

Supporters of FASTRACK II include the TransTasman Radiation Oncology Group (TROG) and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP).

You can read the paper online - Stereotactic ablative body radiotherapy for primary kidney cancer (TROG 15.03 FASTRACK II): a non-randomised phase 2 trial


For more information contact the Peter Mac Communications team on 0417 123 048.

About Peter Mac

Peter MacCallum Cancer Centre (Peter Mac) is a world leading cancer research, education and treatment centre and Australia’s only public health service dedicated to caring for people affected by cancer.