Table 1.
Randomized trials which have reported outcomes differentially based on volume of disease (i.e., oligometastatic or low-volume versus high volume)
| Trial (author) | Treatment arms | Definition of oligometastatic or low volume | Patients meeting low volume definition (N/total) | Outcome interaction with metastatic burden |
|---|---|---|---|---|
| SWOG 9916 (Hussain et al.) [7] | Intermittent ADT Continuous ADT (mHSPC) | Confined to vertebral, and/or pelvic bones, and/or LNs | 792/1535 | OS better with continuous ADT (HR 1.19; 95% CI, 0.98–1.43) for low and high volume |
| CHAARTED (Sweeney et al.) [8] | ADT standard ADT and docetaxel (mHSPC) | Fewer than four bone metastases, none outside axial skeleton | 277/790 | OS benefit for upfront docetaxel not significant (HR 1.04, 95% CI, 0.7–1.55) for low volume |
| ALSYMPCA (Parker et al.) [9] | Standard carea Standard and radium223 (mCRPC) | Less than six bone metastases (visceral excluded entirely) | 138/921 | OS benefit weaker than higher volume subsets (HR for OS 0.95, 95% CI, 0.46–1.95) |
ADT, androgen deprivation therapy; ALSYMPCA, alpharadin in symptomatic prostate cancer patients; CHAARTED, ChemoHormonal Therapy versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer; CI, confidence interval; HR, hazard ratio; LN, lymph node; mCRPC, metastatic castration-resistant prostate cancer; mHSPC, metastaic hormone-sensitive prostate cancer; OS, overall survival; SWOG, Southwest Ocology Group.
a
Standard care for mCRPC included bicalutamide, ketoconazole, estrogen, and bisphosphonates.