MDT in omCSPC in the ORIOLE and STOMP Trials

Matthew Deek, MD, Department of Radiation Oncology, Rutgers Cancer Institute, New Brunswick, NJ, shares with us how he and his co-researchers evaluated long-term outcomes of metastasis-directed therapy in oligometastatic castration-sensitive prostate cancer patients in both the ORIOLE and STOMP trials.

Dr. Deek: Prostate cancer, it’s a little bit unique compared to other cancers in that there’s just a huge spectrum of patients, and sometimes it becomes a little bit difficult to really represent all of those patients in any one trial. And sometimes some patients are kind of, for lack of a better word, excluded, or not well included in specific trials. And this oligometastatic castration-sensitive prostate cancer patient cohorts, it’s probably one of those groups that hasn’t been included as much as other groups of prostate cancer patients in a lot of clinical trials. And that was really the interest behind STOMP and ORIOLE, to take men who have a few number of metastatic lesions. That’s where oligo comes from. And they were still early on in their disease course, which is castration-sensitive. They respond to hormones, and to say, are there other treatment options for these patients?

Because oftentimes the treatment for them were to be treated with hormone therapies or androgen deprivation therapy, and that comes with a lot of side effects. And so the idea was, are there other treatment options available for these patients? And so STOMP and ORIOLE were both very similar in terms of what kind of patients were accrued and what the treatments were. So these were individuals who had three or less metastatic lesions, were castration-sensitive, as I just mentioned, and then some of them got metastasis-directed therapy, which is just using, for the most part, radiation to treat these couple of metastatic sites.

And the other group were just observed. They had no treatment, we just followed them without anything. And so similar patient populations, similar treatment interventions. And what we decided to do is pull these two trials together to get a much larger cohorts, and look at the long-term outcomes of these patients. So some of these trials were originally published a couple years ago with shorter term follow up, but now we’re looking at, how do these patients do on the order of three to five years after getting their treatment? And because the two trials were so similar, we were able to group these patients together, group these trials together, and sort of augment the number of patients and try to get some additional insights into how these patients responded to treatment.

View Dr. Deek’s other comments on oligometastatic prostate cancer, including PSMA Imaging, High-Risk Mutations, and The Future of Personalized Care.