Dr. Yu Discusses Treatment Strategies for Patients With Oligometastatic Prostate Cancer

Evan Y. Yu, MD, professor, Department of Medicine, Division of Oncology, University of Washington, Seattle Cancer Care Alliance, discusses treatment strategies for patients with oligometastatic prostate cancer.

Ongoing trials for patients with oligometastatic disease are evaluating how to eradicate the primary lesion of the prostate, says Yu. The rationale stems from the fact that the primary lesion will shed micrometastases, leading to more metastases. Ablating those lesions when the patient has a lower volume of disease may be beneficial, he explains. However, ongoing studies are still evaluating ablation of the primary prostate lesion in metastatic disease as well.

In the HORRAD trial, patients with metastatic bone prostate cancer were randomized to receive either androgen deprivation therapy (ADT) alone or ADT in combination with radiation therapy. Although the overall trial was negative, subgroup analysis from the STAMPEDE trial showed a benefit with lower doses of radiation, providing a strong rationale to ablate the primary lesion, even in patients who have very low-metastases and oligometastases, says Yu.