Phase II Trial of SBRT and Hormone Therapy for Oligometastases in Prostate Cancer

Abstract

patients in concurrent group developed grade 2 or 3 pneumonitis at some point during crizotinib therapy. Time to onset of pneumonitis ranged from 14 days to 61 days in concurrent group. Imaging analysis was strongly consistent with lung parenchyma changes in the irradiated lung volume receiving a total dose of 15-38 Gy. Pulmonary toxicity was manageable; however, interruption of crizotinib therapy was not necessary. Three (37.5%) experienced development of a grade 2 pneumonitis in sequential group. Pneumonitis in irradiated lungs did not aggravate after crizotinib therapy in sequential group. Conclusion: In conclusion, this is, to our knowledge, the first report of lung toxicity after treatment with crizotinib and TRT. We observed a high incidence of pulmonary toxicity when crizotinib and concurrent TRT were administered in patients with ALK-positive NSCLC. Careful consideration and monitoring for pneumonitis may be warranted in patients treated with crizotinib in concurrent with TRT. In addition, using other schedules (e.g., sequential as opposed to concurrent administration) may be safe and optimal strategies.

Stereotactic ablative radiotherapy for oligometastatic prostate cancer

“…The POP-START trial reported a 1- and 2- year PFS of 58% and 39% [ 17 ]. A multicentric study [ 12 ] observed a PFS of 22%, while a phase II trial reported a free-from-ARTA survival of 66% after almost 10 months from SBRT [ 12 , 33 ]. In our study, we observed an average delay time of around 7 months, before starting systemic therapy.…”

Liver Metastasis–Directed Ablative Radiotherapy in Pancreatic Cancer Offers Prolonged Time Off Systemic Therapy in Selected Patients

“…With the advent of the oligometastatic paradigm, which suggests that cancer patients with a limited number (1 to 5) of metastases may be amenable to a curative treatment approach, there is currently increasing interest in the use of radical local therapy such as ablative radiotherapy (RT) to treat oligometastatic tumors 7 . Emerging data support the safety and efficacy of ablative RT in selected patients with oligometastatic disease 8–17 . Recently, the phase II Stereotactic Ablative Radiotherapy for the Comprehensive Treatment of Oligometastases trial demonstrated both a progression-free survival (PFS) and overall survival (OS) benefit with ablative RT of oligometastases in patients with controlled primary solid malignancies including breast, colorectal, lung, and prostate 17 .…”

“…7 Emerging data support the safety and efficacy of ablative RT in selected patients with oligometastatic disease. [8][9][10][11][12][13][14][15][16][17] Recently, the phase II Stereotactic Ablative Radiotherapy for the Comprehensive Treatment of Oligometastases trial demonstrated both a progression-free survival (PFS) and overall survival (OS) benefit with ablative RT of oligometastases in patients with controlled primary solid malignancies including breast, colorectal, lung, and prostate. 17 However, to date, there is limited data on the use of ablative RT in MPC given its poor prognosis and predisposition for widespread systemic disease.…”