[(accessed on 12 March 2022)]; {"type":"clinical-trial","attrs":{"text":"NCT03678025","term_id":"NCT03678025"}}. Sign up for the Nature Briefing newsletter what matters in science, free to your inbox daily. ); gro.dirdam.dulas@demamnas.aileon (S.S.N. Chi K.N., Agarwal N., Bjartell A., Chung B.H., Pereira de Santana Gomes A.J., Given R., Jurez Soto ., Merseburger A.S., zgrolu M., Uemura H., et al. Armstrong A.J., Szmulewitz R.Z., Petrylak D.P., Holzbeierlein J., Villers A., Azad A., Alcaraz A., Alekseev B., Iguchi T., Shore N.D., et al. Information about inherited (germline) or tumour-acquired (somatic) mutations is growing at an unstoppable rate. However, 63% of patients had >5 bone metastases with a median PSA prior to randomisation of 145 ng/mL, so there was a high percentage of patients with a high M1 burden. and JavaScript. OShaughnessy M.J., McBride S.M., Vargas H.A., Touijer K.A., Morris M.J., Danila D.C., Laudone V.P., Bochner B., Sheinfeld J., Dayan E.S., et al. Professor Barbara Alicja Jereczek-Fossa report grants from AIRC, grants from FIEO-CCM & FUV, grants from Accuray, personal fees from Janssen, personal fees from Ferring, personal fees from Bayer, personal fees from Roche, personal fees from Astellas, personal fees from Elekta, personal fees from Carl Zeiss, personal fees from Ipsen, personal fees from Accuray, personal fees from Iba, outside the submitted work. has received advisory board: Janssen, Bayer, MSD, honoraria for lectures/travel expenses: Janssen, Astellas, Recordati and research funding: Fundacin para la Investigacin en Urologa (FIU). (UroToday.com) In the session of the 2022 Advanced Prostate Cancer Consensus Conference focusing on the treatment of patients with oligometastatic and oligoprogressive prostate cancer, Dr. Ost examined whether we have predictors for the successful treatment of patients with oligometastatic prostate cancer. Treatment with ADT plus enzalutamide reduced the relative risk of death by 33% in the overall study patients. PSMA is not fully prostate-specific because it is also expressed in other solid tumours, but it has high specificity for patients with PC [23]. Pending results of ongoing prospective randomized trials, there is a clear need for more consistent treatment indications and radiotherapy practices. Gillessen S., Attard G., Beer T.M., Beltran H., Bossi A., Bristow R., Carver B., Castellano D., Chung B.H., Clarke N., et al. Outcomes of Observation vs Stereotactic Ablative Radiation for Oligometastatic Prostate Cancer. Thus far, CRP in M1 patients has not been contemplated outside of clinical trials and is not included in the Clinical Guidelines. This allows for a high dose in the tumour cells with low toxicity in normal tissues. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global cancer statistics 2018: GLO-BOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. PSMA is a potential target for theragnostic treatment due to the differential expression of PSMA between normal tissues and cancer cells and the ability of PSMA to be internalised upon binding of antibodies or targeted small molecules. The percentage of patients with treatment for the primary tumour was 26%, while the rest were M1 debut. All authors have read and agreed to the published version of the manuscript. Federal government websites often end in .gov or .mil. Lu-PSMA works by attaching to a surface protein on . Disclaimer. Epub 2020 Jul 2. Management of patients with advanced prostate cancer: Recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015. Kaplan-Meier Analysis of Biochemical Progression-Free Survival Among Patients in M1 and N1-Only Groups, Table. In STAMPEDE, the HR in the overall population (M1 and non-M1) and in the subgroup of M1 patients was 0.63 and 0.61, respectively. Other known mutations, with lower incidence but with therapeutic impact, include modifications in MMRd or MSI-H such as MLH1, MSH2 and MSH6, PMS2, which are less frequent (57% of patients). Clipboard, Search History, and several other advanced features are temporarily unavailable. official website and that any information you provide is encrypted The aim of this article is to review the role of radiotherapy in the management of oligometastatic hormone-sensitive prostate cancer (HSPC). 2022; 49 (4):1417 . Nature Reviews Urology It included seven trials with over 7000 patients and compared six therapeutic alternatives in terms of OS, radiological PFS and adverse events. PD-1 Blockade in Tumors with Mismatch-Repair Deficiency. , Ost This narrative review aims to summarise the current evidence regarding therapeutic options for patients with OMPC. However, these studies provide invaluable oncological benefits. Systemic and tumor-directed therapy for oligometastatic prostate cancer: study protocol for a phase II trial for veterans with de novo oligometastatic disease. PSA levels prior to NGI, number of metastases (5: oligometastatic vs > 5: polymetastatic) and their location (M1a: exclusive lymph node . All of them were in favour of combination therapy. official website and that any information you provide is encrypted Optimal Treatment for Patients with Oligometastatic Prostate Cancer The LATITUDE [74] and STAMPEDE (arm G) [75] trials are the higher evidence trials supporting the use of abiraterone plus ADT in patients undergoing multimodal therapy. A nonsignificant 20% reduction in the risk of death in the high-volume group was reported by adding docetaxel after a median follow-up of 83.9 months. However, the sub-analysis of OMPC done within this setting has methodological drawbacks, as it was not an objective of the studies. Single lesion on prostate-specific membrane antigen-ligand positron emission tomography and low prostate-specific antigen are prognostic factors for a favorable biochemical response to prostate-specific membrane antigen-targeted radioguided surgery in recurrent prostate cancer. So, I think that theres no question, at this juncture, that most patients who present with de novo metastatic disease should not just be receiving ADT alone. Nat. , Deek The patients were stratified according to tumour volume (according to the criteria defined in the CHAARTED study) and prior treatment with docetaxel. Published: October 7, 2022. doi:10.1001/jamanetworkopen.2022.35345. National Library of Medicine Accessibility A meta-analysis, which included four studies using docetaxel in this setting, demonstrated a 9% absolute improvement in 4-year survival [73]. Metastasis-directed RT plus hormone therapy shows benefit in They showed a benefit in PFS and CSS. We know that it may delay progression, but I think that's the million-dollar question that we have to resolve in the next few years. HHS Vulnerability Disclosure, Help 2019 Apr 1;19(1):291. doi: 10.1186/s12885-019-5496-5. Connor MJ, Smith A, Miah S, Shah TT, Winkler M, Khoo V, Ahmed HU. POSTCARD will determine the effect of durvalumab in addition to MDT [60] and another one, Stereotactic Body Radiotherapy With or Without darolutamide for OligoRecurrent Prostate Cancer (DART), which will study the combination of darolutamide with SBRT [61]. Progression-free survival following stereotactic body radiotherapy for oligometastatic prostate cancer treat-ment-naive recurrence: A multi-institutional analysis. To date, most clinical trials have focused on using PSMA-targeted radiopharmaceuticals for M1 CRPC. review we assess the available evidence for radiotherapy to the primary tumor in newly diagnosed mPC and for MDT in oligometastatic prostate cancer, as well as future directions in this clinical setting. and transmitted securely. ARCHES: A Randomized, Phase III Study of Androgen Deprivation Therapy With Enzalutamide or Placebo in Men With Metastatic Hormone-Sensitive Prostate Cancer. The aim of this article is to review the role of radiotherapy in the management of oligometastatic hormone-sensitive prostate cancer (HSPC). The primary endpoints were OS and radiological PFS, and secondary objectives were time to initiation of chemotherapy, time to worsening pain, time to initiation of chronic opioid therapy and time to the occurrence of a skeletal-related event (SRE). One side of the couple is specific for diagnostic imaging, and the other is specific for treatment purposes [63]. Nat Rev Urol. The https:// ensures that you are connecting to the In the meantime, to ensure continued support, we are displaying the site without styles Metastasis-directed therapy (MDT) is used as part of the treatment for oligometastatic patients in different tumor types. Article Tools. For example, should a patient with a certain kind of metastatic pattern receive certain kinds of therapies? Administrative, technical, or material support: Enke, Baine. Radiotherapy of oligometastatic prostate cancer: a systematic - PubMed A recent meta-analysis of 23 observational studies with SBRT for recurrent metastases concluded that the proportional rates of local control, PFS and androgen deprivation-free survival were 0.976 (95% confidence interval (CI): 0.960.98), 0.413 (95% CI: 0.3780.477), and 20.1 months (95% CI: 14.525.6), respectively. However, the half-life of choline is short (20 min) and requires a cyclotron. Heidenreich A., Fossati N., Pfister D., Suardi N., Montorsi F., Shariat S., Grubmller B., Gandaglia G., Briganti A., Karnes R.J. Cytoreductive Radical Prostatectomy in Men with Prostate Cancer and Skeletal Metastases. doi:10.1007/s11912-019-0791-5 In March 2022, the Food and Drug Administration (FDA) approved lutetium-177-PSMA-617 (Lu-PSMA for short, brand name Pluvicto), the first radioligand therapy for prostate cancer. Radiation Oncology Volume 12 - 2022 | https://doi.org/10.3389/fonc.2022.932637 This article is part of the Research Topic Advances in Radiotherapy for Prostate Cancer View all 14 Articles Radiotherapy in Oligometastatic, Oligorecurrent and Oligoprogressive Prostate Cancer: A Mini-Review Conceptualisation, G.R.J. Article Bethesda, MD 20894, Web Policies 62, 13631371 (2021). A large body of literature suggests that RT to the primary tumour for OMPC is a feasible therapeutic option. Kyriakopoulos C.E., Chen Y.H., Carducci M.A., Liu G., Jarrard D.F., Hahn N.M., Shevrin D.H., Dreicer R., Hussain M., Eisenberger M., et al. Each radioisotope has characteristic physical properties. Oncol. Of 43 patients, 10 (23.3%) had M1 disease, and 33 (76.7%) had N1-only disease. Epub 2021 Mar 6. 2022 Update on Prostate Cancer Epidemiology and Risk Factors-A Systematic Review Eur Urol. However, until definitive results on cancer outcomes from the above trials become available, the feasibility of CRP can only be hypothesised to be equal to RT as a local treatment option in OMPC. Prostate Cancer Prostatic Dis. All Rights Reserved. Accessibility Might Men Diagnosed with Metastatic Prostate Cancer Benefit from Definitive Treatment of the Primary Tumor? The role of Ga-68 PSMA PET/CT scan on differentiating of oligometastatic and high risk prostate cancer. Google Scholar. and V.D.R. Federal government websites often end in .gov or .mil. Authors Refers to Hlscher, T. et al. The rate of any acute toxicity was 1.3%, and late grade 2 toxicity was 1.2% [57]. Disparities: Social Determinants of Health, TESTICULAR, PENILE & RARE GU MALIGNANCIES, The RALU Study: Treatment Considerations in the First Line Setting of mCRPC. MDT therapy is currently a matter of debate. Metastasis-directed therapy; Metastatic prostate cancer; Radiotherapy. OMPC has been defined based on the number of metastases (typically 5), while the onset of metastases (synchronous, defined as de novo or within 3 months of primary diagnosis vs metachronous or recurrent metastases) or previous TDA (castration-naive vs castration-resistant) is still a matter of debate [13]. 2022 Nov 11;S1558-7673(22)00222-1. doi: 10.1016/j.clgc.2022.10.015. This study is the first randomized trial to evaluate the impact of adding radiation to hormone therapy for patients with oligometastatic prostate cancer meaning those whose cancer has. National Library of Medicine These results show that local control is excellent, with minimal acute or late toxicity and a median duration to initiation of ADT of 20 months. This narrative review will cover the current OMPC scenario. The SubtlePET can be used for 68 Ga-PSMA scans using half the signal with similar image quality to Q.Clear series and superior quality to VPFX series, but it significantly modifies quantitative measurements and should not beused for comparative examinations if standard algorithm is applied during follow-up.
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