Metastasis-directed Therapy in Prostate Cancer: Prognostic Significance of the ESTRO/EORTC Classification in Oligometastatic Bone Disease

Nicholls, Luke; Chapman, E.; Khoo, Vincent; Suh, Yae-eun; Tunariu, Nina; Wang, Y.; As, N. van

doi:10.1016/j.clon.2021.10.004

Cited by 8 publications

(3 citation statements)

References 35 publications

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“…Since oligometastasis encompasses a range of diseases, the European Society for Radiotherapy and Oncology (ESTRO) and the European Organization for Research and Treatment of Cancer (EORTC) recently classified oligometastasis into nine specific categories 10 . Several researchers have reported that the prognosis of oligometastasis may vary depending on the specific category; although it was not statistically significant, it has been suggested that oligorecurrence or oligoprogression could have a poorer prognosis than de novo disease 11 – 13 . Oligomestasis is mostly defined as having fewer than three or five metastatic foci, but the definition varies from researcher to researcher.…”

Section: Introductionmentioning

confidence: 97%

Role of local ablative treatment in oligometastatic non-small cell lung cancer: a meta-analysis

Rim

Cho

Park

et al. 2023

International Journal of Surgery

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Introduction: This meta-analysis analyzed the oncologic role of local ablative treatment (LAT) in oligometastatic nonsmall cell lung cancer. Method: Pubmed, MEDLINE, Embase, and Cochrane Library were searched until October, 2022. Studies comparing LAT with standard care (control) were included. Sensitivity analyses were performed including randomized controlled studies (RCTs). Subgroup analyses were performed according to specific categories and metastatic burden. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Considering the median OS and PFS from landmark studies, 2-year OS and 1-year PFS rates were used to calculate pooled odds ratios (ORs). Results: A total of 20 studies (four RCTs) encompassing 1750 patients were included. Surgery and radiotherapy (60 and 90% of studies) were mainly used as LATs. Pooled ORs of OS and PFS were 3.492 (95% CI:2.612–4.699, P<0.001) and 3.743 (95% CI: 2.586–5.419, P<0.001), favoring LAT, respectively. Sensitivity analyses, including RCTs showed ORs of 4.111 (P<0.001) and 4.959 (P=0.001) regarding OS and PFS, favoring LCT, respectively. Pooled 1-year and 2-year OS rates were 83.8 and 58.4% in LAT arms, whereas 64.4 and 31% in control arms; pooled 1-year and 2-year PFS rates were 64.6 and 32.8% in LAT arms, and 36.1 and 10% in control arms. In subgroup analyses, the pooled ORs were 3.981 (P<0.001), 3.355 (P<0.001), and 1.726 (P=0.373) in synchronous, oligopersistence, and oligoprogression/recurrence subgroups, respectively. Regarding PFS comparison, pooled ORs were 5.631 (P<0.001), 3.484 (P<0.001), and 1.777 (P=0.07), respectively. According to metastatic burden categories, pooled ORs favored LAT arms in both analyses including low-metastatic and high-metastatic burden subgroups. Conclusion: The present study supports the role of LAT in treating nonsmall cell lung cancer oligometastasis. The oligoprogression/recurrence disease could have less LAT benefit than synchronous or oligopersistent disease.

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Section: Introductionmentioning

confidence: 97%

Role of local ablative treatment in oligometastatic non-small cell lung cancer: a meta-analysis

Rim

Cho

Park

et al. 2023

International Journal of Surgery

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“…OPC represents a phenotype with limited metastatic potential, and reveals heterogeneity in clinical behavior [ 1 , 4 ]. Metastases-directed, ablative SBRT has been gaining validation as a safe and effective treatment option for oligorecurrent/oligoprogressive PC [ 52 ]. Beyond the large number of promising findings from retrospective data, the prospective, phase II Observation versus stereotactic ablative RadiatIon for OLigometastatic Prostate CancEr Trial (ORIOLE) recently confirmed SBRT to improve oncologic outcomes in a certain setting of oligometastatic PC patients, with an excellent local control of disease and mild adverse events, with no impact on the patient quality of life [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Stratification of Oligometastatic Prostate Cancer Patients by Liquid Biopsy: Clinical Insights from a Pilot Study

et al. 2022

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We propose a pilot, prospective, translational study with the aim of identifying possible molecular markers underlying metastatic prostate cancer (PC) evolution with the use of liquid biopsy. Twenty-eight castrate sensitive, oligometastatic PC patients undergoing bone and/or nodal stereotactic body radiotherapy (SBRT) were recruited. Peripheral blood samples were collected before the commencement of SBRT, then they were processed for circulating cell free DNA (cfDNA) extraction. Deep targeted sequencing was performed using a custom gene panel. The primary endpoint was to identify differences in the molecular contribution between the oligometastatic and polymetastatic evolution of PC to same-first oligo-recurrent disease presentation. Seventy-seven mutations were detected in 25/28 cfDNA samples: ATM in 14 (50%) cases, BRCA2 11 (39%), BRCA1 6 (21%), AR 13 (46%), ETV4, and ETV6 2 (7%). SBRT failure was associated with an increased risk of harboring the BRCA1 mutation (OR 10.5) (p = 0.043). The median cfDNA concentration was 24.02 ng/mL for ATM mutation carriers vs. 40.04 ng/mL for non-carriers (p = 0.039). Real-time molecular characterization of oligometastatic PC may allow for the identification of a true oligometastatic phenotype, with a stable disease over a long time being more likely to benefit from local, curative treatments or the achievement of long-term disease control. A prospective validation of our promising findings is desirable for a better understanding of the real impact of liquid biopsy in detecting tumor aggressiveness and clonal evolution.

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“…As novel imaging modalities such as PSMA-PET improve the ability to detect early metastatic prostate cancer, debate grows about the best way to manage oligometastatic disease. The definition of ''oligometastatic prostate cancer'' is in fact in flux but will hopefully be defined eventually by randomized trials that correlate a variety of definitions of this disease state with long term efficacy outcomes in response to therapies [26]. As a proof of principle, the Stereotactic Ablative Radiotherapy for the Comprehensive Treatment of Oligometastases (SABR-COMET) trial evaluated 99 patients with a variety of oligometastatic malignancies who had their primary tumor treated and had 1-5 oligometastases amenable to SABR.…”

Section: Management Of Oligometastatic Disease: More Than Just System...mentioning

confidence: 99%

Treatments and challenges in advanced prostate cancer

Gourdin

Velayati

2023

Current Opinion in Oncology

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Purpose of reviewThis review is designed to highlight recent research examining treatment progress in advanced prostate cancer while identifying ongoing challenges to clinical outcomes. Recent findingsRecent randomized trials suggest an overall survival advantage to treating some men with newly identified metastatic prostate cancer with a ''triplet'' of androgen deprivation therapy, docetaxel, and an androgen receptor axis-targeted agent. Questions remain about which men are best served by these combinations. Additional treatment success is being identified with prostate-specific membrane antigen positron emission tomography (PSMA)-radiopharmaceuticals, combinations involving targeted therapies, and novel manipulations of the androgen receptor axis. Challenges remain in selecting between available therapies, harnessing immune therapies, and treating tumors with emergent neuroendocrine differentiation.

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Metastasis-directed Therapy in Prostate Cancer: Prognostic Significance of the ESTRO/EORTC Classification in Oligometastatic Bone Disease

Cited by 8 publications

References 35 publications

Role of local ablative treatment in oligometastatic non-small cell lung cancer: a meta-analysis

Role of local ablative treatment in oligometastatic non-small cell lung cancer: a meta-analysis

Stratification of Oligometastatic Prostate Cancer Patients by Liquid Biopsy: Clinical Insights from a Pilot Study

Treatments and challenges in advanced prostate cancer

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