{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:45:42Z","timestamp":1792010742214,"version":"4.4.0"},"reference-count":28,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Prospective data on the management of intraprostatic radiorecurrence (IPR) after definitive radiotherapy (RT) and use of genomic classifiers (GC) in this setting are limited. We hypothesized that dose-escalated focal salvage high-dose-rate brachytherapy (DE-fsHDR) would be safe and effective, and that GC would risk stratify patients who may benefit from treatment intensification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>F-SHARP is a multi-institutional phase I\/II trial of DE-fsHDR for IPR after any form of RT for localized prostate cancer. Patients received up to 30 Gy in 1-2 fractions. The primary objective was to determine the acute RT-related grade \u22653 CTCAE v4.03 genitourinary and GI toxicity rates. Secondary end points included all-grade toxicity, quality of life (QoL; EPIC-26 and International Prostate Symptom Score), disease control, and survival. GC analysis used a clinical-grade transcriptome assay (Veracyte, San Diego, CA). Time-to-event outcomes included biochemical progression-free survival (bPFS), radiographic progression-free survival (rPFS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-four participants received one fraction and 38 received two fractions (N = 62). The median follow-up was 39.4 months. No acute grade 3 toxicities occurred. Two patients (3.2%) had late grade 3 toxicity. QoL changes did not meet criteria for a minimal clinically important difference. Three-year survival rates were 62.7% (bPFS), 67.5% (rPFS), 73.0% (LRFS), and 85.9% (MFS); there were no differences between fractionation groups (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; .05). Among 31 patients with GC results, higher scores were associated with worse bPFS, rPFS, LRFS, and MFS. All patients with GC score &gt;0.85 (n = 4) experienced biochemical, local, and metastatic recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DE-fsHDR is a safe and effective salvage treatment for IPR. GC score is a promising prognostic tool in patients undergoing salvage local therapy for IPR and warrants further study to guide treatment intensification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-25-02730","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:59:57Z","timestamp":1792007997000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Dose-Escalated Focal Salvage High-Dose-Rate Brachytherapy and Genomic Classifier Risk Stratification in Radiorecurrent Prostate Cancer: The F-SHARP Phase I\/II Clinical Trial"],"prefix":"10.1200","clinical-trial-number":[{"clinical-trial-number":"nct03312972","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2186-2987","authenticated-orcid":false,"given":"Abhishek A.","family":"Solanki","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"},{"name":"Loyola University Medical Center, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5608-3808","authenticated-orcid":false,"given":"William","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Medicine, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Proudfoot","sequence":"additional","affiliation":[{"name":"Veracyte, Inc, San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Baldea","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center, Maywood, IL"},{"name":"Department of Urology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcliz A.","family":"Barkan","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center, Maywood, IL"},{"name":"Department of Pathology and Laboratory Medicine, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alec M.","family":"Block","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"},{"name":"Loyola University Medical Center, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6287-3427","authenticated-orcid":false,"given":"Neil B.","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Texas Southwestern, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmer","family":"Farooq","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center, Maywood, IL"},{"name":"Department of Urology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2886-0956","authenticated-orcid":false,"given":"Michael R.","family":"Folkert","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3835-0906","authenticated-orcid":false,"given":"Aurelie","family":"Garant","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Texas Southwestern, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Gorbonos","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center, Maywood, IL"},{"name":"Department of Urology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8502-708X","authenticated-orcid":false,"given":"Gopal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center, Maywood, IL"},{"name":"Department of Urology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4433-0939","authenticated-orcid":false,"given":"Hyejoo","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"},{"name":"Loyola University Medical Center, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Kelly","sequence":"additional","affiliation":[{"name":"Veracyte, Inc, San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0847-2657","authenticated-orcid":false,"given":"Steven","family":"Kregel","sequence":"additional","affiliation":[{"name":"Department of Cancer Biology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4701-2469","authenticated-orcid":false,"given":"Stanley L.","family":"Liauw","sequence":"additional","affiliation":[{"name":"Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Luminais","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Virginia, Charlottesville, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mysz","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus L.","family":"Quek","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center, Maywood, IL"},{"name":"Department of Urology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy N.","family":"Showalter","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Virginia, Charlottesville, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Welsh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Woods","sequence":"additional","affiliation":[{"name":"Loyola University Medical Center, Maywood, IL"},{"name":"Department of Urology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elai","family":"Davicioni","sequence":"additional","affiliation":[{"name":"Veracyte, Inc, San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1623-9863","authenticated-orcid":false,"suffix":"Jr","given":"William","family":"Small","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"},{"name":"Loyola University Medical Center, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8234-4234","authenticated-orcid":false,"given":"Matthew M.","family":"Harkenrider","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL"},{"name":"Loyola University Medical Center, Maywood, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_3_10_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.32900"},{"key":"e_1_3_10_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.02.039"},{"key":"e_1_3_10_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2022.07.011"},{"key":"e_1_3_10_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.73.9987"},{"key":"e_1_3_10_6_2","volume-title":"NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Prostate Cancer Version 2.2026","unstructured":"NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Prostate Cancer Version 2.2026. https:\/\/www.nccn.org"},{"key":"e_1_3_10_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)00107-8"},{"key":"e_1_3_10_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.11.010"},{"key":"e_1_3_10_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-024-05205-9"},{"key":"e_1_3_10_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.02.009"},{"key":"e_1_3_10_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.06.210"},{"key":"e_1_3_10_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2025.02.042"},{"key":"e_1_3_10_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.11.021"},{"key":"e_1_3_10_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16150"},{"key":"e_1_3_10_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(89)90015-9"},{"key":"e_1_3_10_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.10.011"},{"key":"e_1_3_10_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/80.3.557"},{"key":"e_1_3_10_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2014.08.044"},{"key":"e_1_3_10_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.12.035"},{"key":"e_1_3_10_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2021.10.138"},{"key":"e_1_3_10_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2022.05.018"},{"key":"e_1_3_10_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2023.109495"},{"key":"e_1_3_10_23_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01391"},{"key":"e_1_3_10_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2019.10.014"},{"key":"e_1_3_10_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2021.04.007"},{"key":"e_1_3_10_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2022.01.005"},{"key":"e_1_3_10_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.07.014"},{"key":"e_1_3_10_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2019.07.012"},{"key":"e_1_3_10_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.05.007"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO-25-02730","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:59:58Z","timestamp":1792007998000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO-25-02730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":28,"alternative-id":["10.1200\/JCO-25-02730"],"URL":"https:\/\/doi.org\/10.1200\/jco-25-02730","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"2025-11-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"JCO-25-02730"}}