Combined Fixed-duration Systemic Treatment and Metastasis-directed Radiotherapy for Oligometastatic Hormone-sensitive...

Area of Science:

• Oncology
• Urology
• Medical Imaging

Background:

• Oligometastatic hormone-sensitive prostate cancer (omHSPC) presents a challenge in achieving long-term remission.
• The efficacy of
• total therapy
• (androgen deprivation therapy [ADT] with or without androgen receptor pathway inhibitors [ARPI], metastasis-directed therapy, and local therapy) in omHSPC is not well-defined.

Purpose of the Study:

• To evaluate the outcomes of
• total therapy
• in patients with omHSPC after treatment completion.
• To assess clinical progression-free survival (cPFS), eugonadal progression-free survival (PFS), and time to restart of ADT (TTrADT).

Main Methods:

• Retrospective analysis of 89 consecutive omHSPC patients treated with
• total therapy
• at a single institution.
• Utilized Kaplan-Meier and Cox regression models to analyze outcomes.
• Included patients with prostate-specific antigen ≤0.1 ng/ml post-systemic therapy.

Main Results:

• At a median follow-up of 37 months, 45% of patients remained progression-free at 3 years (3-yr cPFS rate).
• The median time to restart ADT (TTrADT) was 47 months, with 60% not restarting ADT by 3 years.
• Longer duration of systemic therapy (≥12 months) was the sole significant predictor of improved outcomes.

Conclusions:

• Total therapy
• can lead to long-term durable remission in a subset of omHSPC patients.
• Approximately 45% of patients remained progression-free at 3 years post-therapy.
• Prospective trials are warranted to further validate this therapeutic approach.