Abstract
Simple SummaryOligometastatic prostate cancer represents a transitional state between localized and widespread metastatic disease and it is defined by presence of five or fewer metastatic sites. In the current narrative review, we provide an overview of the current treatment landscape of oligometastatic cancer, focusing on the current biomarkers used in the identification of true oligometastatic disease and highlighting the impact of molecular imaging on stage shift in different scenarios. Finally, we address current and future directions regarding the use of genetic and epigenetic targeting treatments in oligometastatic prostate cancer.During the last decade, the body of knowledge regarding the oligometastatic state has increased exponentially. Several molecular frameworks have been established, aiding our understanding of metastatic spread caused by genetically unstable cells that adapt to a tissue environment which is distant from the primary tumor. In the current narrative review, we provide an overview of the current treatment landscape of oligometastatic cancer, focusing on the current biomarkers used in the identification of true oligometastatic disease and highlighting the impact of molecular imaging on stage shift in different scenarios. Finally, we address current and future directions regarding the use of genetic and epigenetic targeting treatments in oligometastatic prostate cancer.
Highlights
During the last decade, the body of knowledge regarding the oligometastatic state has increased exponentially
Several molecular frameworks have been established that aid the understanding of metastatic spread caused by genetically unstable cells that adapt to a tissue environment which is distant from the primary tumor [1]
In the current narrative review, we provide an overview of the molecular landscape of oligometastatic prostate cancer (omPCa), evaluate current biomarkers used in the identification of true oligometastatic disease and highlight the impact of molecular imaging on stage shift in different scenarios
Summary
The body of knowledge regarding the oligometastatic state has increased exponentially. The current literature describes several subgroups of omPCa: (1) de novo (synchronous) oligometastatic prostate cancer; (2) oligorecurrent (metachronous) prostate cancer, defined as a metastatic recurrence following previous definitive therapy of the primary tumor; and (3) oligoprogressive prostate cancer, defined as a progression of a small number of metastases in otherwise stable disease stages [5]. To date, it is still to be elaborated whether certain metastatic sites act as checkpoints and prevent further metastatic spread if metastasis-directed therapy is applied. These reflections are supported by the fact that in colorectal cancer, differences in oncological outcomes based on the metastasis site have been described before [4].
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