Honestly, I wanted to write something about "Optimal Treatment Strategies for Hormone-sensitive Metastatic Prostate Cancer: Does Local Radiotherapy Play a Role in High-volume Disease?" It's in preprinting on Elsevier (European Urology journal) and looks interesting but I could find nothing more than the following
"Optimal treatment strategies for metastatic hormone-sensitive prostate cancer (mHSPC) are evolving with novel multimodal approaches. For well-selected patients, early local radiotherapy can play a pivotal role in high-volume mHSPC. Radiotherapy controls local disease, reduces symptoms, and may potentially delay castration resistance, warranting its consideration alongside systemic therapies in high-volume mHSPC." ...as you can imagine that "may potentially delay castration resistance" is quite interesting for us! Even if from past articles I think there may be no benefit at OS level, being hormone sensitive for a longer period could give us access to new treatments for mHSPC before we move to castration resistant.
Once published, it will be behind a very think paywall, so I gave up for now. But from the same author I found an interesting interview and I summarized it.
Dr. Karim Fizazi, is advocating for a shift in how metastatic hormone-sensitive prostate cancer (mHSPC) is treated. Traditionally, treatment decisions have been based on the volume of metastases (low vs. high), but Dr. Fizazi emphasizes the importance of the timing of metastasis.
His analysis shows that patients with de novo/synchronous disease (metastases present at initial diagnosis) benefit significantly from docetaxel, regardless of volume, while those with relapsed/metachronous disease do not.
Dr. Fizazi’s evolving approach calls for broader use of triplet therapy in de novo disease and a reevaluation of traditional treatment paradigms.
Oligometastatic prostate cancer: Reality or figment of imagination?
Strategies to Re-Sensitize Castration-Resistant Prostate Cancer to Antiandrogen Therapy