Trends in Management of Oligometastatic Hormone-Sensitive Prostate Cancer

Purpose of Review Systemic therapy for patients with hormone-sensitive oligometastatic prostate cancer is non-curative and associated with toxicities. Meanwhile, this population presents unique clinical opportunities to improve outcomes, including the demonstrated benefits of radiotherapy to the pri...

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Bibliographic Details
Published in:Current oncology reports 2019-05, Vol.21 (5), p.43-13, Article 43
Main Authors: Kothari, Gargi, Ost, Piet, Cheung, Patrick, Blanchard, Pierre, Tree, Alison C., van As, Nicholas J., Lo, Simon S., Moghanaki, Drew, Loblaw, Andrew, Siva, Shankar
Format: Article
Language:English
Subjects:
Clinical trials
Genitourinary Cancers (DP Petrylak and JW Kim
Medicine
Medicine & Public Health
Metastases
Metastasis
Oncology
Prostate cancer
Radiation therapy
Section Editors
Topical Collection on Genitourinary Cancers
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Summary:Purpose of Review Systemic therapy for patients with hormone-sensitive oligometastatic prostate cancer is non-curative and associated with toxicities. Meanwhile, this population presents unique clinical opportunities to improve outcomes, including the demonstrated benefits of radiotherapy to the primary tumor or oligometastatic sites. Recent Findings Recently published randomized studies have demonstrated benefits with the addition of radiotherapy to the primary disease or metastatic lesions in patients with synchronous or metachronous disease. The introduction of novel PET imaging has improved the sensitivity and specificity for detecting metastatic disease and provides an opportunity to better select patients who will benefit from local therapy. Summary The data presented in this review supports revisiting practice guidelines for patients with hormone-sensitive metastatic prostate cancer, particularly in relation to the role of radiotherapy to the primary tumor and sites of oligometastatic disease. Future trials will aim to further establish the role of metastasis-directed therapies in metachronous, synchronous, and castrate-resistant disease.
ISSN:1523-3790
1534-6269
DOI:10.1007/s11912-019-0791-5