Long-Term Outcomes and Genetic Predictors of Response to Metastasis-Directed Therapy Versus Observation in Oligometastatic Prostate Cancer: Analysis of STOMP and ORIOLE Trials

被引：167

作者：

Deek, Matthew P. ^{[1
,2
]}

Van der Eecken, Kim ^{[3
]}

Sutera, Philip ^{[2
]}

Deek, Rebecca A. ^{[4
]}

Fonteyne, Valerie ^{[5
]}

Mendes, Adrianna A. ^{[6
]}

Decaestecker, Karel ^{[7
]}

Kiess, Ana Ponce ^{[2
]}

Lumen, Nicolaas ^{[5
]}

Phillips, Ryan ^{[8
]}

De Bruycker, Aurelie ^{[7
]}

Mishra, Mark ^{[9
]}

Rana, Zaker ^{[9
]}

Molitoris, Jason ^{[9
]}

Lambert, Bieke ^{[10
,11
]}

Delrue, Louke ^{[12
]}

Wang, Hailun ^{[2
]}

Lowe, Kathryn ^{[2
]}

Verbeke, Sofie ^{[13
]}

Van Dorpe, Jo ^{[13
]}

Bultijnck, Renee ^{[7
]}

Villeirs, Geert ^{[10
,11
]}

De Man, Kathia ^{[14
]}

Ameye, Filip ^{[15
]}

Song, Daniel Y. ^{[2
]}

DeWeese, Theodore ^{[2
]}

Paller, Channing J. ^{[16
]}

Feng, Felix Y. ^{[17
]}

Wyatt, Alexander ^{[18
,19
]}

Pienta, Kenneth J. ^{[16
,20
]}

Diehn, Maximillian ^{[21
]}

Bentzen, Soren M. ^{[9
,22
]}

Joniau, Steven ^{[23
]}

Vanhaverbeke, Friedl ^{[24
]}

De Meerleer, Gert ^{[25
]}

Antonarakis, Emmanuel S. ^{[26
]}

Lotan, Tamara L. ^{[6
]}

Berlin, Alejandro ^{[27
]}

Siva, Shankar ^{[28
]}

Ost, Piet ^{[29
,30
]}

Tran, Phuoc T. ^{[2
,9
,16
,20
]}

机构：

[1] Rutgers State Univ, Robert Wood Johnson Med Sch, Rutgers Canc Inst New Jersey, Dept Radiat Oncol, New Brunswick, NJ USA

[2] Johns Hopkins Univ, Dept Radiat Oncol & Mol Radiat Sci, Sch Med, Baltimore, MD USA

[3] Univ Ghent, Dept Pathol & Human Struct & Repair, Ghent, Belgium

[4] Univ Penn, Perelman Sch Med, Dept Biostat Epidemiol & Informat, Philadelphia, PA 19104 USA

[5] Ghent Univ Hosp, Dept Radiat Oncol, Ghent, Belgium

[6] Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD 21205 USA

[7] Ghent Univ Hosp, Dept Urol, Ghent, Belgium

[8] Mayo Clin, Dept Radiat Oncol, Rochester, MN USA

[9] Univ Maryland, Sch Med, Dept Radiat Oncol, 850 W Baltimore St, Baltimore, MD 21201 USA

[10] Univ Ghent, Dept Radiol & Nucl Med, Ghent, Belgium

[11] AZ Maria Middelares Ghent, Dept Nucl Med, Ghent, Belgium

[12] Ghent Univ Hosp, Dept Radiol, Ghent, Belgium

[13] Ghent Univ Hosp, Dept Pathol, Ghent, Belgium

[14] Ghent Univ Hosp, Dept Nucl Med, Ghent, Belgium

[15] AZ Maria Middelares Ghent, Dept Urol, Ghent, Belgium

[16] Johns Hopkins Univ, Sch Med, Dept Oncol, Sidney Kimmel Comprehens Canc Ctr, Baltimore, MD 21205 USA

[17] UCSF, Dept Med Urol & Radiat Oncol, San Francisco, CA USA

[18] Univ British Columbia, Dept Urol Sci, Vancouver, BC, Canada

[19] Vancouver Prostate Ctr, Vancouver, BC, Canada

[20] Johns Hopkins Sch Med, James Buchanan Brady Urol Inst, Baltimore, MD USA

[21] Stanford Univ, Dept Radiat Oncol, Sch Med, Stanford, CA 94305 USA

[22] Univ Maryland, Sch Med, Dept Epidemiol & Publ Hlth, Baltimore, MD 21201 USA

[23] Katholieke Univ Leuven, Dept Urol, Leuven, Belgium

[24] AZ Nikolaas, Dept Urol, St Niklaas, Belgium

[25] Katholieke Univ Leuven, Dept Radiat Oncol, Leuven, Belgium

[26] Univ Minnesota, Sch Med, Dept Med, Minneapolis, MN 55455 USA

[27] Princess Margaret Canc Ctr, Dept Radiat Oncol, Toronto, ON, Canada

[28] Peter MacCallum Canc Ctr, Dept Radiat Oncol, Melbourne, Vic, Australia

[29] Iridium Network, Dept Radiat Oncol, Antwerp, Belgium

[30] Univ Ghent, Dept Human Struct & Repair, Ghent, Belgium

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2022年 / 40卷 / 29期

关键词：

STEREOTACTIC BODY RADIOTHERAPY;

D O I：

10.1200/JCO.22.00644

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. The initial STOMP and ORIOLE trial reports suggested that metastasis-directed therapy (MDT) in oligometastatic castration-sensitive prostate cancer (omCSPC) was associated with improved treatment outcomes. Here, we present long-term outcomes of MDT in omCSPC by pooling STOMP and ORIOLE and assess the ability of a high-risk mutational signature to risk stratify outcomes after MDT. The primary end point was progression-free survival (PFS) calculated using the Kaplan-Meier method. High-risk mutations were defined as pathogenic somatic mutations within ATM, BRCA1/2, Rb1, or TP53. The median follow-up for the whole group was 52.5 months. Median PFS was prolonged with MDT compared with observation (pooled hazard ratio [HR], 0.44; 95% CI, 0.29 to 0.66; P value < .001), with the largest benefit of MDT in patients with a high-risk mutation (HR high-risk, 0.05; HR no high-risk, 0.42; P value for interaction: .12). Within the MDT cohort, the PFS was 13.4 months in those without a high-risk mutation, compared with 7.5 months in those with a high-risk mutation (HR, 0.53; 95% CI, 0.25 to 1.11; P = .09). Long-term outcomes from the only two randomized trials in omCSPC suggest a sustained clinical benefit to MDT over observation. A high-risk mutational signature may help risk stratify treatment outcomes after MDT.

引用

页码：3377 / +

页数：7

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