You have accessJournal of UrologyCME1 Apr 2023MP29-03 MULTI-INSTITUTIONAL ANALYSIS OF METASTASIS DIRECTED THERAPY WITH OR WITHOUT ANDROGEN DEPRIVATION THERAPY IN OLIGOMETASTATIC CASTRATION SENSITIVE PROSTATE CANCER Matthew Deek, Phillip Sutera, Yuezhou Jing, David Pryor, Heather Day, Mai Anh Huynh, Bridget Koontz, Andrew Armstrong, Ellen Debruycker, Piet Dirix, Carole Mercier, Piet Ost, Danny Song, Antonio Conde-Moreno, Miguel Angel Berenguer, Bradley Stish, Justine Buroker, Davide Giovanni Bosetti, Shankar Siva, Melissa Bruce, Alejandro Berlin, Matthew Ramotar, Stephanie Kroeze, Niall Corcoran, Nicholas Howard, Bruce Trock, Silke Gillessen, Phuoc Tran, and Christopher Sweeney Matthew DeekMatthew Deek More articles by this author , Phillip SuteraPhillip Sutera More articles by this author , Yuezhou JingYuezhou Jing More articles by this author , David PryorDavid Pryor More articles by this author , Heather DayHeather Day More articles by this author , Mai Anh HuynhMai Anh Huynh More articles by this author , Bridget KoontzBridget Koontz More articles by this author , Andrew ArmstrongAndrew Armstrong More articles by this author , Ellen DebruyckerEllen Debruycker More articles by this author , Piet DirixPiet Dirix More articles by this author , Carole MercierCarole Mercier More articles by this author , Piet OstPiet Ost More articles by this author , Danny SongDanny Song More articles by this author , Antonio Conde-MorenoAntonio Conde-Moreno More articles by this author , Miguel Angel BerenguerMiguel Angel Berenguer More articles by this author , Bradley StishBradley Stish More articles by this author , Justine BurokerJustine Buroker More articles by this author , Davide Giovanni BosettiDavide Giovanni Bosetti More articles by this author , Shankar SivaShankar Siva More articles by this author , Melissa BruceMelissa Bruce More articles by this author , Alejandro BerlinAlejandro Berlin More articles by this author , Matthew RamotarMatthew Ramotar More articles by this author , Stephanie KroezeStephanie Kroeze More articles by this author , Niall CorcoranNiall Corcoran More articles by this author , Nicholas HowardNicholas Howard More articles by this author , Bruce TrockBruce Trock More articles by this author , Silke GillessenSilke Gillessen More articles by this author , Phuoc TranPhuoc Tran More articles by this author , and Christopher SweeneyChristopher Sweeney More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003257.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Several prospective trials in oligometastatic castration sensitive prostate cancer (omCSPC) have shown metastasis-directed therapy (MDT) can delay time to progression and initiation of androgen deprivation therapy (ADT) compared to observation. However, its use with ADT remains poorly studied. Here we report a multi-national, multi-institutional retrospective cohort of omCSPC treated with MDT to understanding the long-term outcomes of patients treated with MDT alone or in combination with ADT. METHODS: Patients from 13 institutions with omCSPC ( < 5 lesions) were included. Patients treated with MDT with or without a defined course of ADT were included. Time to biochemical progression (ttBP) (nadir + 2 ng/dl for patients treated with radiation or increase above 0.2 ng/dl for surgery) was calculated using Kaplan-Meier method and stratified by treatment group (MDT alone vs MDT + ADT). Multivariable Cox regression was performed adjusted for variables found to be prognostic on univariate analysis. RESULTS: A total of 263 patients were included (105 with ADT and 158 without ADT) treated between 2003 and 2018 with a median follow-up of 49.5 months with ADT and 54.5 months without ADT. The majority were metachronous (90%) and had bone lesions (60%). Median length of ADT use was 21.3 months (IQR 12.0-31.9). Patients who received ADT vs. no ADT had poorer prognostic features including 23% vs. 1% synchronous, and 55% vs 40% Gleason 8-10. ADT use was associated with a better 5-year rate of freedom from biochemical progression (51% (95% CI, 41%-61%) vs 11% (95% CI, 6% - 17%); p<0.0001). On multivariable analysis the use of ADT remained significantly associated with ttBP (HR 0.23 [95% CI 0.16 – 0.33], p <0.001). Other factors associated with longer ttBP were original diagnosis year (HR 1.11, p = 0.004), disease free years (HR 1.09, p = 0.02), and post-MDT PSA nadir (HR 1.1, p <0.0001). CONCLUSIONS: In this large multi-institutional cohort of patients with oligometastatic prostate cancer treated with MDT, the addition of concurrent ADT appears to be associated with a greater rate of freedom from BP, though a small group of patients will have sustained biochemical response with MDT alone. Future prospective trials are needed to identify the optimal way to integrate hormonal therapy (testosterone suppression and/or potent antiandrogens) with MDT. Source of Funding: Movember © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e381 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Deek More articles by this author Phillip Sutera More articles by this author Yuezhou Jing More articles by this author David Pryor More articles by this author Heather Day More articles by this author Mai Anh Huynh More articles by this author Bridget Koontz More articles by this author Andrew Armstrong More articles by this author Ellen Debruycker More articles by this author Piet Dirix More articles by this author Carole Mercier More articles by this author Piet Ost More articles by this author Danny Song More articles by this author Antonio Conde-Moreno More articles by this author Miguel Angel Berenguer More articles by this author Bradley Stish More articles by this author Justine Buroker More articles by this author Davide Giovanni Bosetti More articles by this author Shankar Siva More articles by this author Melissa Bruce More articles by this author Alejandro Berlin More articles by this author Matthew Ramotar More articles by this author Stephanie Kroeze More articles by this author Niall Corcoran More articles by this author Nicholas Howard More articles by this author Bruce Trock More articles by this author Silke Gillessen More articles by this author Phuoc Tran More articles by this author Christopher Sweeney More articles by this author Expand All Advertisement PDF downloadLoading ...