seems to be a promising tactic for oligometastatic PCa, that combines SBRT with an ADT mix . The Abstract starts off by noting that with metastatic hormone sensitive PCa, recurrence almost always happens within six months of recovery of testosterone. But this regimen kept it lower-<.05.
"The results confirm that addition of metastasis-directed SBRT to highly potent systemic therapy can maintain low PSA after testosterone recovery, although further studies are needed to clarify the optimal systemic therapy regimen."
We'll have to let TA explain what exactly is different from standard treatment about this regimen, if anything
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Xavier10
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Unfortunately, there was no control group in this SATURN trial.
But... there was a very similar and much larger trial, PRESTO, that looked at recurrent men who had no metastases on conventional imaging, but had a short PSADT. It is likely that they would have been oligometastatic if they had a PSMA PET scan. Similar to SATURN, they received "androgen annihilation" with ADT+apalutamide±abiraterone (1 year in PRESTO, ½ year in SATURN). The major difference was there was no metastasis-directed therapy (MDT) in PRESTO.
PRESTO similarly showed over 2 years before PSA began to rise. (It also showed testosterone recovery in 4-5 months).
So did MDT add anything? We can't draw definite conclusions because patients were not randomized. But it suggests that only hormone therapy matters.
I did notice the first comment to the twitter post was PRESTO just as you mentioned. As in, PRESTO did the same thing. So, did SBRT do anything really. Maybe they should have waited a couple years more. EDIT, sorry, I didn't realize that first poster was YOU, TA. So you were on this immediately. I see Kishan is countering with some arguments about eugonadal which I will have to investigate what he is talking about.
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