Evidence map›Paper›PMID 42225101›Full record

Trial reportThe Lancet. Oncology2026

Aglatimagene besadenovec (CAN-2409) with radiotherapy for patients with localised prostate cancer: a phase 3, multicentre, randomised, double-blind, placebo-controlled trial.

Theodore L DeWeese, Andrea Manzanera, John Sylvester, Thomas Wheeler, Thomas Schroeder, Glen Gejerman, Gregory Chesnut, Thomas M Facelle, Mark G Garzotto, Christopher Pieczonka and 14 more

Abstract readRandomized Controlled TrialClinical Trial, Phase IIIMulticenter Study
In one paragraph

Trial report in The Lancet. Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. [Intraprostatic gene therapy with aglatimagene as an adjunct to radiotherapy].Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Theodore L DeWeeseDepartments of Radiation Oncology, Urology, and Oncology, Johns Hopkins School of Medicine, Baltimore MD, USA.
Andrea ManzaneraCandel Therapeutics, Needham, MA, USA.
John SylvesterAtlantic Urology Clinics, Myrtle Beach, SC, USA.
Thomas WheelerDepartment of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA.
Thomas SchroederUniversity of New Mexico, Albuquerque, NM, USA.
Glen GejermanNew Jersey Urology, Summit Health, Saddlebrook, NJ, USA.
Gregory ChesnutWalter Reed National Military Medical Center, Bethesda, MD, USA.
Thomas M FacelleColorado Clinical Research, Golden, CO, USA.
Mark G GarzottoVA Portland Health Care System/OHSU, Portland, OR, USA.
Christopher PieczonkaAssociated Medical Professionals of NY, US Urology Partners, Syracuse, NY, USA.
Nilay M GandhiPotomac Urology Center, Alexandria, VA, USA.
Steven SukinTexas Urology Specialists, Tomball, TX, USA.
Michael A LissUniversity of California San Diego, San Diego, CA, USA.
Ronald TutroneChesapeake Urology Research Associates, Towson, MD, USA.
Bryan MehlhaffOregon Urology Institute, Springfield, OR, USA.
Stephen J SavageRalph H Johnson VA Medical Center, Charleston, SC, USA.
Megan GoodyCandel Therapeutics, Needham, MA, USA.
Jenessa VogtCandel Therapeutics, Needham, MA, USA.
Shangbang RaoCandel Therapeutics, Needham, MA, USA.
Maria Lucia Silva PolancoCandel Therapeutics, Needham, MA, USA.
Francesca BaroneCandel Therapeutics, Needham, MA, USA.
W Garrett NicholsCandel Therapeutics, Needham, MA, USA.
Paul P TakCandel Therapeutics, Needham, MA, USA; Faculdade de Medicina, Universidade de Lisboa, Portugal. Electronic address: pptak@candeltx.com.
PrTK03 study team

Funding

Clinical and Immunologic Evaluation of ProstAtak for Prostate CancerR44CA124032 · NCI · ADVANTAGENE, INC · PI AGUILAR-CORDOVA, ESTUARDO · 2007 to 2013
$7.3M
NCI NIH HHS R44 CA124032
6 · The paper itself

Abstract

backgroundAbout 30% of men with localised prostate cancer undergoing radiotherapy with curative intent have disease recurrence associated with progression-related symptoms and substantial toxicity of salvage therapies. Previous studies with aglatimagene besadenovec (CAN-2409, hereafter referred to as aglatimagene) showed synergy with radiation and immune-mediated cytotoxicity in patients with prostate cancer. We aimed to assess whether addition of aglatimagene plus prodrug (valacyclovir) to standard-of-care external beam radiation therapy (EBRT) could improve disease-free survival in this population.

methodsWe conducted a phase 3, randomised, double-blind, placebo-controlled trial at 51 medical centres (26 community and 25 institutional or military) across the USA and Puerto Rico in patients with intermediate or high-risk prostate cancer. Patients aged at least 18 years who were planning to undergo EBRT and with an Eastern Cooperative Oncology Group score of 0-2 were eligible. Patients were randomly assigned (2:1) via central block-randomisation to receive either three courses of intraprostatic aglatimagene (5 × 10

findingsBetween Feb 21, 2012, and Sept 9, 2021, 745 men (591 [79%] White, 121 [16%] Black) were randomly assigned to receive aglatimagene plus valacyclovir (n=496) or placebo plus valacyclovir (n=249). After a median follow-up of 50·3 months (IQR 35·2-63·3), median disease-free survival was not reached (95% CI 121·78 to not reached) in the aglatimagene plus valacyclovir group versus 86·1 (IQR 29·7-143·0) months in the placebo plus valacyclovir group (hazard ratio 0·70, 95% CI 0·52-0·94; p=0·016). Treatment-emergent adverse events (TEAEs) of grade 3 or worse occurred in 40 (8%) of 479 patients in the aglatimagene group and 17 (7%)of 232 patients in the placebo group. The most common TEAE of grade 3 or worse was acute kidney injury in both the aglatimagene group (nine [2%] of 479 patients) and the placebo group (four [2%] of 232 patients). Serious adverse events occurred in 28 (6%) of 479 patients in the aglatimagene group and 17 (7%) of 232 in the placebo group. Treatment-related serious adverse events occurred in eight (2%) patients in the aglatimagene group (four acute kidney injury, two pyrexia, and one each influenza-like symptoms and urinary retention) and five (2%) in the placebo group (four acute kidney injury, and one each increased creatinine levels and skin rash; one patient reported two serious adverse events). No treatment-related deaths were reported.

interpretationAglatimagene plus valacyclovir was associated with longer disease-free survival than placebo plus valacyclovir when added to standard of radiotherapy for the treatment of localised prostate cancer, offering a meaningful benefit without increasing clinically significant toxicity.

fundingCandel Therapeutics and US National Institutes of Health.

Indexed as

ChemoradiotherapyProstatic NeoplasmsValacyclovirAgedDouble-Blind MethodHumansMaleMiddle AgedPuerto RicoUnited StatesValacyclovir

Identifiers

PMID42225101
PMCPMC13437160

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.