Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy.
Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.
Clin Exp Metastasis. 2021 Apr;38(2):227-230. doi: 10.1007/s10585-021-10072-4. Epub 2021 Jan 20.
Recent findings from literature evidenced that metastatic prostate cancer often shows heterogeneous response to therapy, with persistent sensibility to systemic treatments after biochemical, clinical, or radiographic progression. This highlights the advantage of integrated approaches in which local ablative treatments (e.g., stereotactic body radiation therapy) could prolong clinical benefit of systemic therapies beyond oligo-progression. Of course, development of predictive biomarker could be helpful in order to select patients who could much benefit from this treatment strategy. Circulating tumor cell detection and analysis could also have a crucial role in this field. A joint effort of two prospective ongoing trials (ARTO, clinical.gov identifier NCT03449719 and PRIMERA, clinical.gov identifier NCT04188275) might help to improve criteria to select patients in whom a local ablative approach might confer significant benefit. In this commentary, we summarized recent data from literature to support this thesis.
最近的文献研究结果表明，转移性前列腺癌对治疗常常表现出异质性反应，在生化、临床或影像学进展后，仍对系统治疗保持敏感性。这突出了综合治疗方法的优势，局部消融治疗（例如，立体定向体部放射治疗）可以在寡进展后延长系统治疗的临床获益。当然，预测生物标志物的发展可能有助于选择从这种治疗策略中获益更多的患者。循环肿瘤细胞的检测和分析在这一领域也可能具有关键作用。两项正在进行的前瞻性试验（ARTO，clinical.gov 标识符 NCT03449719 和 PRIMERA，clinical.gov 标识符 NCT04188275）的联合努力可能有助于改善选择局部消融治疗可能带来显著获益的患者的标准。在这篇评论中，我们总结了文献中的最新数据来支持这一观点。
