Metastasis-directed Radiotherapy (MDRT) for Men With De-novo Oligometastatic Prostate Cancer Treated With Long-term ADT (METANOVA)

February 6, 2024

The METANOVA Trial investigates treating oligometastatic prostate cancer with metastasis-directed radiotherapy (MDRT) in addition to standard systemic and prostate-directed therapy. MDRT, using targeted radiation on all metastatic sites, aims to extend the time until cancer returns and potentially improve patient survival.

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Narrator: This video is an overview of a new clinical trial for men with oligometastatic prostate cancer who have been treated with long-term hormone therapy. When prostate cancer spreads outside the prostate to bones or other organs, it is called metastatic prostate cancer. Doctors can count the number of metastatic spots seen on scans. When there are only a limited number of spots, it is called oligometastatic prostate cancer. The current standard treatment for patients with oligometastatic prostate cancer is systemic therapy and treatment to the prostate. Standard systemic therapy includes hormone therapy. Hormone therapy means drugs that can prevent testosterone from fueling growth of prostate cancer. Hormone therapy can slow or stop the growth of oligometastatic prostate cancer.

Prostate treatment can be done with radiation. Radiation is non-invasive, high-energy X-rays targeted at cancer in the prostate. In the past, radiation treatments for oligometastatic prostate cancer were mainly aimed at improving quality of life. But recent studies suggest that patients with oligometastatic disease may benefit from treating all sites of disease with radiation. This is called metastasis-directed radiotherapy or MDRT. MDRT uses highly targeted radiation to each site of metastasis. Studies have shown MDRT extends the time until cancer returns and may help some patients live longer. A key question is whether adding MDRT to standard systemic therapy and prostate-directed treatment can extend the time until prostate cancer grows back, or make patients live longer.

In this clinical trial, participants are randomly assigned to receive either the standard treatment with systemic therapy and prostate-directed treatment or systemic therapy, prostate treatment and MDRT to all sites of metastasis. Patients can enroll on this trial if they have up to 10 sites of oligometastatic disease. The study is open-label, which means that the participants and the researchers will know which treatment each participant is receiving. After treatment, all participants will be followed by doctors for routine testing to see how cancer responded to treatment. The primary benefit of enrolling on this trial is helping patients in the future receive more effective treatment for oligometastatic prostate cancer.

Another potential benefit is that very few patients off-trial would get MDRT to all sites of oligometastasis, especially when up to 10 are present. This may improve patient outcomes in regards to tumor control as well as quality of life by preventing these areas from causing problems later. To learn more about the study, talk to your doctor or click the link shown here.