Multimodality Treatment vs Androgen Deprivation Therapy Alone in Patients With Oligometastatic Prostate Cancer 

Multimodality treatment in patients with oligometastatic prostate cancer was associated with lower cancer-specific mortality, metastatic castration-resistant prostate cancer, and second-line therapy rates compared with androgen deprivation therapy alone, according to study findings published in Cancers.

Multimodality treatment consisted of robot-assisted radical prostatectomy with androgen deprivation therapy, with or without adjuvant radiotherapy, explained researchers.

“Overall, our results do not imply the necessity to deliver radical prostatectomy to all oligometastatic prostate cancer patients and do not imply the superiority of radical prostatectomy on other treatment strategies, such as radiotherapy, for the treatment of this specific setting of patients,” wrote researchers. “Instead, the current study supports our initial hypothesis that patients who underwent multimodality treatment had better oncologic outcomes relative to those who received androgen deprivation therapy alone.”

The study included 74 patients with oligometastatic prostate cancer: 40 received multimodality treatment and 34 received androgen deprivation therapy alone.

Kaplan-Meier plots depicted lower cancer-specific mortality (5.9% vs 37.1%), metastatic castration-resistant prostate cancer (24.0% vs 62.5%), and second-line systemic therapy (33.3% vs. 62.5%) with multimodality treatment compared with androgen deprivation therapy, according to study authors.

Multivariable Cox regression models adjusted for metastatic site and prostate-specific antigen also found a lower metastatic castration-resistant prostate cancer rate with multimodality treatment.

Treatment-related adverse events affected 12.5% of patients receiving multimodality treatment compared with 44.1% of patients receiving androgen deprivation therapy alone, showed study findings.

Disease progression, however, did not significantly differ between the treatment groups.

“Taken together, these findings suggest that, despite similar disease progression rates between the 2 groups, the use of multimodality treatment, particularly the combination of stereotactic body radiotherapy after cytoreductive robot-assisted radical prostatectomy with androgen deprivation therapy in case of localized disease progression, has improved the overall cancer-specific mortality relative to androgen deprivation therapy alone,” concluded researchers.

Reference:
Mistretta FA, Luzzago S, Conti A, et al. Oligometastatic prostate cancer: a comparison between multimodality treatment vs. androgen deprivation therapy alone. Cancers. 2022;14(9):2313. doi:10.3390/cancers14092313