Insights into the Management of Oligometastatic Prostate Cancer

How best to treat oligometastatic prostate cancer is still not clear, but there are several on-going studies designed to determine what should be best practices.  Although not yet completed, these studies do indicate that metastasis-directed therapy (MDT) and local therapy targeted to the primary tumor (in the prostate gland) may be of benefit in the setting of oligometastatic disease. 

 Until we can develop robust evidence, we will remain challenged with knowing how to manage men with oligometastases best.

 In a comprehensive review aims to collate the currently available evidence evaluating the potential role of MDT and prostate-targeted therapy in the setting of oligometastatic Prostate cancer researchers searched PubMed and to identify relevant ongoing trials that could provide information about the best care for men with oligometastases.  In a review of over forty different completed and on-going studies the researchers concluded that the data suggest that although ADT plus either docetaxel or abiraterone remains the mainstay of treatment for metastatic prostate cancer, in oligometastatic prostate cancer, improved outcomes may be achieved with metastasis- and prostate-targeted therapies. 

The study authors pointed out that the studies included in this review are mainly retrospective in nature, limiting the strength of the evidence they provide. Prospective studies are ongoing, and their results are eagerly awaited.

 In summary, the authors said that they reviewed the treatment of patients with prostate cancer that has spread to five sites or fewer. “We conclude that while androgen deprivation plus either docetaxel or abiraterone should remain the standard of care, there is evidence that treatment targeted at the metastases and the primary tumor may improve the outcome for the patient and potentially delay the use of systemic treatment.”

European urology oncology. 2018 Oct 09 [Epub]

Antonino Battaglia, Gert De Meerleer, Lorenzo Tosco, Lisa Moris, Thomas Van den Broeck, Gaëtan Devos, Wouter Everaerts, Steven Joniau