Focal therapy use remains uncommon in nonmetastatic prostate cancer

06 Sep 2026, 16:00 · Medical Xpress

by Elana Gotkine

edited by Gaby Clark, reviewed by Andrew Zinin

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For patients with nonmetastatic prostate cancer, focal therapy use has remained uncommon across risk groups, and its use was defined as inappropriate in about half of recipients, according to a research letter published online Aug. 13 in the JAMA.

Andrea Cosenza, M.D., from the University of Pittsburgh Medical Center, and colleagues conducted a retrospective study using the National Cancer Database to examine patterns and temporal trends in focal therapy use among U.S. patients ages 50 and older with nonmetastatic prostate cancer diagnosed between 2010 and 2023. Focal therapy use in low-, high- or very high-risk disease was defined as inappropriate.

The study population included 1,179,384 participants. The researchers found that 1.3% of patients received focal therapy overall. Of these recipients, 51.0% had low-, high- or very high-risk disease, while 49.0% had intermediate-risk disease (2,786 and 4,901 with favorable and unfavorable intermediate-risk disease, respectively).

Among recipients with low-risk disease, the rate of focal therapy did not change significantly from 2010 to 2023 (1.8% to 2.2%; P = 0.46 for trend). A significant increase was observed among those with favorable intermediate-risk disease (2.1% to 2.9%), while decreases were seen among those with unfavorable intermediate-risk, high-risk and very high-risk disease (2.5% to 1.9%, 2.1% to 0.9%, and 1.8% to 0.5%, respectively; all P < 0.001 for trend).

"Our findings highlight the need to ensure that promising new treatments are adopted in ways that are supported by evidence and matched to the patients most likely to benefit," senior author Quoc-Dien Trinh, M.D., also from the University of Pittsburgh Medical Center, said in a statement.

Publication details

Andrea Cosenza et al, Focal Therapy for Prostate Cancer, JAMA (2026). DOI: 10.1001/jama.2026.12411

Journal information: Journal of the American Medical Association

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