A week in medicine: prostate cancer, knee arthritis, kidney cysts — 4 stories

A hormone-blocking pill added to radiotherapy delayed metastasis in high-risk prostate cancer

On 24 October 2026, interim results of the phase 3 DASL-HiCaP trial were presented as a late-breaking abstract at the ESMO Congress 2026. The double-blind trial enrolled about 1,100 patients with prostate cancer at high risk of recurrence in Australia, New Zealand, Canada, the United States, Ireland and the United Kingdom. All received standard hormone therapy (androgen deprivation) and radiotherapy to the prostate or prostate bed and the pelvic lymph nodes; half were randomly assigned to add darolutamide, an androgen receptor inhibitor, and half a placebo, for 96 weeks.

At a median follow-up of 3.8 years, metastasis or death occurred less often with darolutamide (hazard ratio 0.42; 95% CI 0.27–0.66). At four years, 95% of patients on darolutamide were free of metastases on standard imaging, against 88% on placebo. Overall survival has not separated so far: 97% versus 95% at four years, hazard ratio 0.88 (95% CI 0.49–1.59). Adverse events of grade 3 or higher occurred in 43% versus 36%.

Darolutamide is already approved for advanced prostate cancer in more than 85 markets, but not for this earlier, high-risk setting. These are interim results from a sponsor press release and a congress presentation, not yet a peer-reviewed paper. The trial is led by the University of Sydney and the ANZUP Clinical Trials Group, and follow-up for overall survival continues.

A standardised pathway around platelet-rich plasma injections helped knee arthritis more than usual care

On 26 October 2026, The American Journal of Sports Medicine published a randomised, double-blind trial from three hospitals in China. It enrolled 240 people with early knee osteoarthritis (Kellgren–Lawrence grade I or II), all of whom were treated with platelet-rich plasma (PRP) injections. Half followed a standardised pathway: set selection criteria, quality-controlled leukocyte-poor PRP, ultrasound-guided injections, staged rehabilitation and systematic follow-up. The other half received conventional PRP care directed by their physician.

At 12 months, the pathway group improved more: the difference was −2.98 points on the visual analogue pain scale (95% CI −3.64 to −2.32), −8.63 points on the WOMAC total score and +10.25 points on the IKDC knee function score. Adverse events occurred in 14.8% of patients (17 of 115) versus 31.9% (36 of 113). The pathway cost slightly more on average, about 15,200 versus 14,750 yuan.

The authors name the limit themselves: the components were bundled and there was no placebo group, so the trial does not show whether PRP itself works or which part of the pathway made the difference. Some well-designed earlier trials of PRP in knee osteoarthritis found no benefit.

In a small trial in polycystic kidney disease, empagliflozin was followed by faster kidney growth

On 24 October 2026, the Journal of the American Society of Nephrology published a 12-month pilot randomised trial of empagliflozin in autosomal dominant polycystic kidney disease (ADPKD), an inherited condition in which cysts gradually enlarge the kidneys. Drugs of this class, SGLT2 inhibitors, slow the progression of diabetic and non-diabetic kidney disease. The trial enrolled 50 adults aged 18 to 55 with ADPKD at high risk of progression who were not taking tolvaptan; they received empagliflozin or placebo.

The drug was well tolerated: 96% in each group tolerated the assigned treatment, and urinary tract infections occurred in 2 people on empagliflozin and none on placebo. But total kidney volume, adjusted for height, grew by 10.5% a year on empagliflozin against 5.1% on placebo. Kidney filtration (eGFR) dropped in the first month on the drug, as expected for this class, and its change from month 1 to month 12 did not differ between the groups.

Kidney volume was a secondary outcome of a feasibility trial with 50 participants, so this is a warning signal rather than proof of harm or benefit. It does show that results from other kidney diseases cannot simply be carried over to polycystic kidney disease. The PubMed record lists the US National Institutes of Health and the PKD Foundation among the funders.

Remote fine-tuning of brain stimulators after Parkinson's surgery held up against clinic visits

On 23 October 2026, Movement Disorders published a randomised trial from six German centres in adults with Parkinson's disease who had just had deep brain stimulation electrodes implanted in the subthalamic nucleus on both sides. After a first in-person programming session, 52 participants were randomly assigned to have their stimulators adjusted for the next 90 days either at clinic visits or remotely through a secure telemedicine platform.

At 90 days, motor symptoms on the standard MDS-UPDRS part III scale were no worse with remote programming: the median difference was −2.5 points (95% CI −9.0 to 2.0), within the prespecified non-inferiority margin of 5 points. Other clinical and patient-reported outcomes were broadly similar, serious adverse events occurred at similar rates, and no one died.

The trial was small (48 people in the per-protocol analysis), open-label and lasted three months, so it speaks to access to follow-up care rather than to the long-term results of stimulation. The PubMed record lists Abbott Laboratories among the funders.

This material is for information only and does not replace a consultation with a doctor. Nothing in it is a recommendation to start, stop or change treatment.

Sources

• Orion Corporation. Darolutamide plus ADT and radiation therapy reduces risk of metastasis or death by 58% in prostate cancer patients at high risk of recurrence. 24 October 2026. mfn.se

• DASL-HiCaP (ANZUP1801). ClinicalTrials.gov. NCT04136353

• Yang S, Wang H, Liu Y, et al. Clinical Pathway Management for Platelet-Rich Plasma Therapy in Kellgren-Lawrence Grade I and II Knee Osteoarthritis. Am J Sports Med. 2026. PMID 42929654, doi:10.1177/03635465261486945

• Seliger SL, Gitomer B, You Z, et al. Empagliflozin Therapy in Autosomal Dominant Polycystic Kidney Disease: A Feasibility Randomized Controlled Trial. J Am Soc Nephrol. 2026. PMID 42925875, doi:10.1681/ASN.0000001271

• Empagliflozin in ADPKD. ClinicalTrials.gov. NCT05510115

• Shaik J, Zhang W, Zentsch V, et al. Remote Versus In-Person Follow-up Programming After Subthalamic Deep Brain Stimulation for Parkinson's Disease. Mov Disord. 2026. PMID 42920097, doi:10.1002/mds.70575