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ASTRO 2023: Disease Progression–Directed Therapy May Postpone Next-Line Treatment of Oligoprogressive Prostate Cancer

By: Julia Fiederlein Cipriano, MS
Posted: Tuesday, October 24, 2023

Disease progression–directed therapy appeared to postpone the need for next-line systemic treatment for almost 1.5 years in patients with oligoprogressive metastatic castration-refractory prostate cancer, according to Gert De Meerleer, MD, PhD, of Catholic University, Leuven, Belgium, and colleagues. Their findings from the single-center phase II MEDCARE trial, which were presented during the 2023 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 143), also revealed no incidence of severe toxicity with this strategy.

“Next-line systemic treatment for progressive metastatic castration-refractory prostate cancer is associated with significant costs and non-negligible toxicity,” the investigators remarked.

The investigators focused on patients with oligoprogressive disease who were undergoing androgen-deprivation therapy with (n = 12) or without (n = 8) an androgen receptor–targeted agent. All progressive lesions must have been treatable via disease progression–directed therapy with either stereotactic body radiotherapy or metastasectomy. Five patients received repeated disease progression–directed therapy at the time of further oligoprogression. Follow-up data were provided for a median of 28 months.

The median duration of next-line systemic treatment–free survival was 17 months. With regard to clinical progression–free, overall, and prostate cancer–specific survival, the median durations were 6 months, 29 months, and not reached, respectively. Deaths occurred because of progressive prostate cancer (n = 6) and rapid progression of a second primary tumor (small cell lung cancer, leiomyosarcoma, and acute myeloid leukemia; n = 3). Disease progression–directed therapy was reported to be well tolerated, with neither acute nor late grade 3 toxicities.

Disclosure: Dr. De Meerleer reported no conflicts of interest.

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