Mp60-07 Predictors of Response to Metastasis Directed Therapy (Mdt) in Prostate Cancer Patients With Solitary Metastases Treated With MDT

You have accessJournal of UrologyProstate Cancer: Advanced (Including Drug Therapy) III (MP60)1 May 2024MP60-07 PREDICTORS OF RESPONSE TO METASTASIS DIRECTED THERAPY (MDT) IN PROSTATE CANCER PATIENTS WITH SOLITARY METASTASES TREATED WITH MDT Mohamed E. Ahmed, Jack Andrews, Ahmed Mahmoud, A. Tuba Kendi, Matthew K. Tollefson, R. J. Karnes, and Eugene D. Kwon Mohamed E. AhmedMohamed E. Ahmed , Jack AndrewsJack Andrews , Ahmed MahmoudAhmed Mahmoud , A. Tuba KendiA. Tuba Kendi , Matthew K. TollefsonMatthew K. Tollefson , R. J. KarnesR. J. Karnes , and Eugene D. KwonEugene D. Kwon View All Author Informationhttps://doi.org/10.1097/01.JU.0001008804.84010.ec.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Systemic treatment with chemohormonal therapy represents the mainstay treatment of patients with metastatic prostate cancer. Given well known side effects of systemic treatment, there has been a growing interest in metastases-targeted therapy (MDT). In clinical trials, use of MDT without additional systemic treatment in patients with oligometastasis disease has shown promising outcomes. As controversy remains regarding its efficacy, we thought to investigate, in a single institution study, factors associated with favorable response to MDT in patients presented with solitary metastatic disease. METHODS: We identified 124 consecutive prostate cancer patients from 2008 to 2018 with a solitary oligo recurrent metastatic lesion on PET imaging who were treated with MDT without ADT from the Mayo Clinic C-11 Choline registry. MDT consisted of either stereotactic body radiation therapy (SBRT) or surgical excision. Favorable response was defined by ≥50% reduction in PSA from pre-MDT PSA value with complete radiographic resolution of the target lesion and no new lesions identified. In univariable and multivariable analyses models, we investigated factors associated with favorable response including primary Gleason score, pre-MDT HT, pre-MDT PSA, pre-MDT blood pool corrected SUVmax, and/or site of the lesion (lymph node versus bone disease). RESULTS: Of these 124 patients, 60 patients presented with bone metastases and received SBRT and 64 presented with lymph node disease and were treated with surgery. Table 1 demonstrated univariable and multivariable analyses of factors that presumed to influence response to MDT. Only site of the lesion and pretreatment blood pool corrected SUV max were the only significant factors associated with favorable response to MDT, with odds ratio of 5.77 for patients with lymph node disease versus bone disease and 1.25 for each unit increase in pretreatment blood pool corrected SUV max. CONCLUSIONS: Our data demonstrates that patients with lymph node disease and high intensity pretreatment blood pole corrected SUV max tend to have favorable response to MDT. Also, our study demonstrates the potential prognostic rule of using metabolic imaging in selecting patients for MDT. Further studies are warranted. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1001 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mohamed E. Ahmed More articles by this author Jack Andrews More articles by this author Ahmed Mahmoud More articles by this author A. Tuba Kendi More articles by this author Matthew K. Tollefson More articles by this author R. J. Karnes More articles by this author Eugene D. Kwon More articles by this author Expand All Advertisement PDF downloadLoading ...