The Future of Personalized Care in Oligometastatic Prostate Cancer

Matthew Deek, MD, Department of Radiation Oncology, Rutgers Cancer Institute, New Brunswick, NJ, shares with us what research should be done to better personalize care for patients with oligometastatic prostate cancer.

Dr. Deek: The two realms that we can probably benefit patients a lot are the two things that we’ve kind of talked about. One is continuing to integrate this more advanced imaging, things like PSMA, into patients with prostate cancer, and two, better understanding the genetics of these patients. And I think that’s a lot of the work that’s going to come out in the near future. We’ve done a good job in some situations, for example, in patients who have had their prostate removed, they don’t have any metastatic disease, but they have their prostate removed. We have tests like Decipher that can help us decide, do we want to add radiation after a prostatectomy? And so I think we’re going to want to move the needle to better understand genetics in the much larger spectrum of prostate cancer.

That’s patients who are not metastatic, patients who are metastatic, patients who are hormone-sensitive, patients who are castration-resistant. And so, like I started off with this interview saying that there’s a huge spectrum of patients with prostate cancer. We need to start really delving into this large spectrum to better understand the genetic differences between these groups and how we can leverage that to come up with new treatment paradigms. And beyond that, we just talked about five genes, but we know our genome is much larger than that, and there’s many other things that we can look into. And so I think going beyond just some of the typical genes that we think about, or that we’re used to seeing being altered in prostate cancer, but looking at this in a larger scale, to just better understand the bigger picture is going to just allow us to continue to personalize treatment for these individuals.

View Dr. Deek’s other comments on oligometastatic prostate cancer, including MDT in the ORIOLE and STOMP Trials, PSMA Imaging, and High-Risk Mutations.