AUA 2018: Multicentric Prospective Local Treatment of Metastatic Prostate Cancer (LoMP) Trial

San Francisco, CA (  The multicentric prospective Local treatment of Metastatic Prostate cancer (LoMP) trial investigates the role of cytoreductive radical prostatectomy (cRP) in addition to standard of care (SoC) for patients with newly diagnosed metastatic prostate cancer (mPC). The authors evaluated clinical outcomes and prognostic factors. 

This is an ongoing trial and since 2014, 72 asymptomatic patients were prospectively included (NTC02138721). cRP was performed in patients with a resectable tumor, fit to undergo surgery (group A). Only SoC was administered to patients who were ineligible or unwilling to undergo cRP (group B). 

Compared to group B, patients in group A were younger (median 66 vs 76 years, p=0.001), had a better health status (ECOG2 of 0% vs 16%, p=0.026), lower initial PSA (median 18 vs 166 g/L, p=0.001) and less high-volume mPC (21% vs 63%, p=0.001) with a lower number of bone metastases (2 vs 7, p=0.005). Tumor grade group (WHO4 in 88% vs 82%, p=0.5) and cT-stage (cT3-4 in 68% vs 79%, p=0.3) showed no significant difference between group A and B.

Median follow-up was 11 months (IQR 5-21). One year CRPC-FS (91% vs 61%, p=0.019), OS (100% vs 80%, p=0.003) and CSS (100% vs 83%, p=0.009) were significantly better in group A compared to group B. For OS, higher age (p=0.001), increased ECOG (p=0.001) and initial PSA (p= 0.005) were demonstrated to be risk factors. 

UroToday AUA2018 cumulativesurvival
Asymptomatic patients with newly diagnosed mPC eligible to undergo cRP show more favorable characteristics compared to those receiving only SoC. These patients show significantly better oncological outcomes and a lower risk of developing both early local and skeletal-related events. This study does not elaborate to what extent these benefits can be attributed to Crp, and this needs to be further explored.

Presented by: Sarah Buelens, Ghent, Belgium
Co-Author: Filip Poelaert, Bert Dhondt, Elise De Bleser, Caroline Verbaeys, Ghent, Belgium, Bernard Rappe, Aalst, Belgium, Bart Kimpe, Ghent, Belgium, Ignace Billiet, Kortrijk, Belgium, Hendrik Plancke, Bonheiden, Belgium, Karen Fransis, Antwerp, Belgium, Patrick Willemen, Hasselt, Belgium, Bart De Troyer, Sint-Niklaas, Belgium, Piet Ost, Karel Decaestecker, Nicolaas Lumen, Ghent, Belgium

Written by:  Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA