Overview of the ATLANTA Trial (from the Original Post)

The link shared points to a 2019 blog post from Prostate Cancer UK titled “New ATLANTA trial focuses on advanced prostate cancer” (published September 6, 2019).

The post announces the launch of the ATLANTA trial (also known as IP2-ATLANTA), a UK-based clinical trial investigating whether treating the primary prostate tumour can benefit men with advanced (metastatic) prostate cancer — even after the cancer has spread beyond the prostate and is no longer considered curable.

• Rationale: It builds on findings from the earlier STAMPEDE trial, which showed that adding radiotherapy to the prostate (alongside standard hormone therapy) improved 3-year survival in some men with metastatic disease. Researchers hypothesize that the original prostate tumour continues to send “growth signals” that fuel cancer spread elsewhere in the body. Targeting the prostate could disrupt this, slow disease progression, and extend life.
• Target Group: Men newly diagnosed with advanced prostate cancer that has spread (metastatic), who typically receive hormone deprivation therapy (ADT) plus chemotherapy, but not routine prostate-directed treatments like surgery or full radiotherapy.
• Interventions: The trial tests additional cytoreductive treatments to the prostate, including:
• Radiotherapy
• Surgery (e.g., prostatectomy)
• Focal therapies (e.g., minimally invasive ablation techniques like high-intensity focused ultrasound [HIFU] or cryotherapy)
• Scale and Leadership: A nationwide, multicentre trial led by Professor Hashim Ahmed at Imperial College London. It aimed to recruit 918 men.
• Funding and Support: Funded by Prostate Cancer UK, which also supported related work like the CHRONOS trial on focal therapy for localised disease and mpMRI improvements in diagnosis.
• Goals: To determine if these prostate-targeted treatments can keep cancer under control longer, potentially adding valuable time for patients and families. If successful, it could pave the way for larger studies and broader treatment changes.

The post includes a quote from Prostate Cancer UK emphasizing the trial’s potential to extend lives and thanks supporters for enabling such research. It links to related info on STAMPEDE results, focal therapies, and more.

Trial Updates and Current Status (as of early 2026)

The ATLANTA trial (full title: Additional Treatments to the Local Tumour for Metastatic Prostate Cancer: Assessment of Novel Treatment Algorithms) is registered on ClinicalTrials.gov as NCT03763253 and on ISRCTN as ISRCTN58401737.

• It began as a phase 2 randomised controlled trial (with an internal pilot phase) comparing standard systemic therapy (e.g., ADT ± chemotherapy) alone versus with added cytoreductive treatment to the prostate and/or metastases.
• The internal pilot (recruiting from 2019–2021) enrolled 81 patients across UK sites and demonstrated feasibility: randomisation was achievable, treatments were generally well-tolerated, and most patients received modern systemic therapies (e.g., doublet therapy).
• A 2025 publication (European Urology Oncology) reported results from this pilot: low rates of serious adverse events (grade 3+ in 7–18% across arms), some complete pathological responses in the prostate (around 11%), but many patients still had residual viable cancer after systemic therapy.
• It concluded that combining cytoreductive approaches (minimally invasive ablation ± lymph node dissection, prostatectomy, or radiotherapy) was feasible and warranted further evaluation.
• Recruitment and follow-up have progressed since the 2019 announcement, with the trial focusing on quality-of-life impacts, feasibility for a larger phase, and longer-term outcomes.
• As of 2026, it remains referenced in ongoing prostate cancer research discussions (e.g., in consensus conferences and related trials), but no final phase 3 results or major practice-changing outcomes have been widely reported yet. The trial is led from Imperial College London, where recruitment info is still listed on their site.

For the most current details (e.g., full results, eligibility, or participation), check:

• The official trial page at Imperial College: https://www.imperial.ac.uk/clinical-trials-unit/therapeutic/surgery-robotics-dev/atlanta-study
• ClinicalTrials.gov entry: https://clinicaltrials.gov/study/NCT03763253
• Prostate Cancer UK or Cancer Research UK pages on the trial.

This trial represents an important step in exploring whether “treating the primary” in metastatic prostate cancer — a concept gaining traction — can offer benefits beyond standard systemic approaches. If you have a specific aspect (e.g., eligibility, results, or related trials) you’d like more on, let me know!