The Promise of Metastasis-Directed Therapy for Oligometastatic Prostate Cancer: Going Beneath the Surface with Molecular Imaging

Article Figures & Data

TABLE 1.

Randomized Clinical Trials Demonstrating Improvements in Progression-Free Survival with the Addition of Metastasis-Directed Therapy

Author	Disease site	Timing of oligometastasis	Oligometastatic definition	Sample size	Therapy	Primary endpoint
Iyengar et al. (1)	NSCLC	Synchronous	≤6 metastases (including primary)	29	SABR to all sites of disease followed by maintenance chemotherapy vs. maintenance chemotherapy	Median PFS, 9.7 vs. 3.5 mo favoring SABR
Gomez et al. (2)	NSCLC	Synchronous	≤3 metastases (not including primary)	49	LCT (surgery or RT) to all sites of disease followed by maintenance chemotherapy vs. maintenance chemotherapy	Median PFS, 14.2 vs. 4.4 mo favoring LCT
Phillips et al. (3)	CSPC	Metachronous	≤3 metastases	54	SABR to all sites of disease vs. observation	6-mo disease progression, 19% vs. 61% favoring SABR
Ost et al. (4)	CSPC	Metachronous	≤3 metastases	62	MDT (surgery or RT) to all sites of disease vs. observation	Median ADT-free survival, 21 vs. 13 mo favoring MDT
Palma et al. (5)	Varied histology	Metachronous	≤5 metastases	99	Standard of care + SABR vs. standard of care alone	5-y OS, 42.3% vs. 17.35 favoring SABR
EORTC 40004 (15)	Colorectal	Metachronous	<10 metastases	119	Standard of care + LCT vs. standard of care alone	Median OS, 45.6 mo vs. 40.5 mo favoring LCT

NSCLC = non–small cell lung cancer; PFS = progression-free survival; LCT = local consolidative therapy; RT = radiation therapy; CSPC = castration-sensitive prostate cancer; ADT = androgen deprivation therapy; OS = overall survival.