Treating Oligometastatic Prostate Cancer in the PSMA PET Era with Dr. Andrew W. Hahn, MD

Andrew W. Hahn, MD, Assistant Professor of Genitourinary Medical Oncology, MD Anderson Cancer Center, Houston, Texas, addresses the treatment of oligometastatic prostate cancer in the PSMA PET era from a medical oncology perspective. In this 15-minute presentation, Dr. Hahn notes that oligometastatic disease, defined by up to five metastatic sites, is increasingly diagnosed due to improved imaging. While lesion count does not directly correlate with outcomes, disease biology and clinical presentation remain key factors in determining prognosis and treatment. Dr. Hahn emphasizes the role of metastasis-directed therapy in delaying hormone therapy initiation, supported by data from trials like STOMP, ORIOLE, and XTEND. He recommends ADT combined with an AR pathway inhibitor for low-volume metastatic disease. Cases illustrating biochemical recurrence and de novo oligometastatic disease demonstrate the importance of tailored approaches, combining radiation with systemic therapy when appropriate. Emerging studies focus on managing oligo-progressive disease to delay chemotherapy or radioligand therapy. Ongoing studies investigate optimal treatment strategies in this evolving space, particularly for oligo-progressive disease.