Robert E. Reiter, MD, presented “Management of Oligometastatic Disease” during the 31st International Prostate Cancer Update in July 2021 in Snowbird, Utah.
How to cite: Reiter, Robert E. “Management of Oligometastatic Disease.” July 2021. Accessed Dec 2024. https://grandroundsinurology.com/management-of-oligometastatic-disease/
Management of Oligometastatic Disease – Summary
Robert E. Reiter, MD, the Bing Professor of Urology and Molecular Biology and Director of the Prostate Cancer Treatment and Research Program at the David Geffen School of Medicine at the University of California, Los Angeles, discusses oligometastatic prostate cancer, explaining how to treat it and the long-term benefits of doing so. He describes oligometastatic prostate cancer (PCa) as an intermediate disease state characterized by limited disease (1-5 lesions). Dr. Reiter then shows evidence of the oligometastatic disease state through data suggesting that if you can identify patients with oligometastases and have a treatment plan for them then you can have a great impact on their OS. He discusses the impact of imaging on defining oligometastases through a study on the distribution of lesions in men with BCR, finding that as PSA increases so does the range of areas that PSMA detects lesions within; a UCLA study comparing PSMA and conventional imaging (CI), finding that 21% of cases showed non-concordance between the two methods for node-positive PCa; and a pathologic assessment of PSMA PET in the detection of nodal disease, showing that PSMA PET still misses small positive lymph nodes in about 20% of patients. Dr. Reiter continues with a review of clinical trials in Oligometastatic disease. He shows data from the SABR-COMET trial suggesting that treating oligometastatic disease in many different cancer types did improve overall survival and progression-free survival in the long term, and the STOMP trial, finding that administration of SABR to patients with oligometastatic disease defined by choline has a beneficial effect on PCa outcomes. Dr. Reiter concludes with the ORIOLE study which suggests that patients in whom all lesions can be found and treated will have significantly better outcomes than others, and a study on curative-intent metastasis-directed therapies for molecularly-defined oligorecurrent PCa using PSMA finding that median time to progression could be extended to 17 months.
About The 31st Annual International Prostate Cancer Update:
The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. Dr. Reiter delivered this educational activity during the 31st iteration of the meeting in July 2021 in Snowbird, Utah.
ABOUT THE AUTHOR
Robert E. Reiter, MD, MBA, is the Bing Professor of Urology and Molecular Biology and Director of the Prostate Cancer Treatment and Research Program at the David Geffen School of Medicine at the University of California, Los Angeles. He is currently the Principal Investigator of UCLA’s SPORE (Specialized Program in Research Excellence) program, a $12 million research grant from the National Cancer Institute to develop new diagnostic and treatment options for men with prostate cancer. Dr. Reiter’s clinical interests include robotic surgical management of prostate cancer and the use of both MRI and molecular imaging tools to manage this disease. His research is focused on the development of novel antibodies for both treatment and imaging of prostate cancer, as well as on the role of epithelial to mesenchymal transition in castration and treatment resistance. Dr. Reiter completed his undergraduate studies at Yale University and earned his medical degree at Stanford University Medical School.
