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PROMPTS trial: Using screening MRI to reduce incidence of clinical spinal cord compression in mCRPC

David Dearnaley, MA, MD, FRCP, FRCR, The Institute of Cancer Reseach and The Royal Marsden NHS Foundation Trust, London, UK, discusses the Phase III PROMPTS trial (ISRCTN: 74112318) which investigated the use of screening MRI and pre-emptive treatment in patients with castration resistant prostate cancer (CRPC) who also had asymptomatic spinal metastases, with the aim of reducing rates of clinical spinal cord compression (SCC). Patients were randomised to either the control arm, in which they received standard of care, or the experimental arm, in which they underwent a screening MRI scan. If the MRI showed no radiological SCC, patients continued on standard of care. If the MRI was positive, patients received pre-emptive treatment for the radiological SCC, followed by another MRI scan at 6 months. Prof. Dearnaley discusses the results of the trial, the implications of these results, and the possible future directions for this research. This interview took place at the European Society for Radiotherapy and Oncology (ESTRO) 2022 annual congress in Copenhagen, Denmark, and online.