Timothy McClure, MD, on 2-year PRESERVE trial results for focal IRE

In this video, Timothy D. McClure, MD, of Weill Cornell Medicine, discusses updated 2-year data from the PRESERVE trial as well as findings on how prostate size may affect urinary symptom outcomes after focal irreversible electroporation (IRE).¹

The PRESERVE trial (NCT04972097) is a US-led, multicenter, prospective study evaluating focal IRE in patients with MRI-visible, Grade Group 2 or Grade Group 3 prostate cancer, enrolling 121 patients across 17 US centers. According to McClure, the trial represents one of the largest US studies of focal therapy, and specifically IRE, in patients with intermediate-risk disease. The initial results showed an 80% rate of freedom from treatment failure at 1 year.

At this year's American Urological Association (AUA) Annual Meeting, investigators discussed 2-year follow-up data from the same cohort. McClure noted that no additional treatment failures or device- or procedure-related adverse events emerged in the extended follow-up period. Additionally, at 24 months, 97% of patients (66 of 68) had a prostate-specific antigen level below their baseline value.

Twelve-month data also presented at AUA examined how baseline prostate size relates to functional outcomes,² showing that mean International Prostate Symptom Score (IPSS) improved from 8.1 to 6.1 by 12 months, with greater improvement observed in men with prostates smaller than 80 cm³.

McClure explained, "Because in large part, prostate volume does reflect IPSS scores, that volume reduction is what's improving their symptoms. In patients with an 80 g or larger prostate, despite doing a volume-reduction procedure like IRE, we're not bringing the volume down to a size that makes a notable improvement in their IPSS scores."

He added that this finding should factor into how clinicians identify ideal candidates for focal therapy going forward.

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