[Metastasis-directed therapy in prostate cancer]

Area of Science:

• Oncology
• Radiotherapy
• Molecular Imaging

Context:

• Oligometastatic hormone-sensitive prostate cancer (omHSPC) management is evolving.
• Metastasis-directed therapy (MDT) is increasingly considered for omHSPC.
• Prostate-specific membrane antigen positron emission tomography (PSMA-PET) enhances metastasis detection.

Purpose:

• To evaluate the role and impact of metastasis-directed therapy (MDT) in oligometastatic hormone-sensitive prostate cancer (omHSPC).
• To explore the potential of PSMA-PET imaging in identifying omHSPC amenable to MDT.
• To assess the current evidence and future research directions for MDT in omHSPC.

Summary:

• MDT, often radiotherapy, may extend the androgen deprivation therapy (ADT)-free interval and progression-free survival (PFS) in metachronous omHSPC.
• Limited prospective data exist for synchronous omHSPC.
• Combining MDT with ADT and novel hormonal therapeutics (NHT) requires further investigation.

Impact:

• MDT is gaining importance in omHSPC despite limited evidence.
• Standardized definitions and larger prospective trials are needed for omHSPC.
• Clarifying the benefit of MDT, especially in synchronous omHSPC and with combined therapies, is crucial for improving patient outcomes.