Top Line: The FASTRACK trials represent landmark prospective evidence establishing SABR as a safe and effective non-invasive treatment for RCC in patients who are not surgical candidates.
The Study: The final long-term results of FASTRACK II and a pooled analysis of both FASTRACK trials was recently published. The FASTRACK II analysis included 70 patients who were treated with either 26 Gy in 1 fraction (tumors 4cm or less) or 42 Gy in 3 fractions (tumors 4-10 cm). The median tumour size was 4.6 cm, 56% had T1b disease, and 9% had T2a disease meaning many tumors were larger than those typically treated with ablation. With a median follow up of 62 months, local control was a whopping 100% at 36, 60, and 84 months. There were no cancer related deaths, and adverse effects were mild. The pooled analysis included a total of 103 patients, and there was only one local recurrence (in the setting of metastatic progression) for a 5 year local control rate of 98%. The rate of grade 3 adverse events was 8% with no grade 4 events.
TBL: SABR is safe and effective with excellent long term local control for primary RCC in patients who are not candidates for or decline surgery. | Siva, Lancet Oncol 2026
The Study: The final long-term results of FASTRACK II and a pooled analysis of both FASTRACK trials was recently published. The FASTRACK II analysis included 70 patients who were treated with either 26 Gy in 1 fraction (tumors 4cm or less) or 42 Gy in 3 fractions (tumors 4-10 cm). The median tumour size was 4.6 cm, 56% had T1b disease, and 9% had T2a disease meaning many tumors were larger than those typically treated with ablation. With a median follow up of 62 months, local control was a whopping 100% at 36, 60, and 84 months. There were no cancer related deaths, and adverse effects were mild. The pooled analysis included a total of 103 patients, and there was only one local recurrence (in the setting of metastatic progression) for a 5 year local control rate of 98%. The rate of grade 3 adverse events was 8% with no grade 4 events.
TBL: SABR is safe and effective with excellent long term local control for primary RCC in patients who are not candidates for or decline surgery. | Siva, Lancet Oncol 2026