Metastatic prostate cancer – site of metastasis matters

By Marcos Franca

During the rapid oral abstract session A: prostate cancer in ASCO – GU 2024, Dr Umang Swami, from University of Utah, presented the results of Abstract 21: Differences in genomic, transcriptomic, and immune landscape of prostate cancer (PCa) based on site of metastasis (mets).
He showed a clear correlation of the site of metastasis, and the mutation found according to a 592 gene panel performed in the patients. There were differences in the mutation rates if the site of metastasis was visceral or not. Patients with visceral metastasis, especially the ones with liver mets, harbored more RB1, TP53, PTEN and androgen receptor alterations. This last one could, maybe, explain the resistant of antiandrogen therapy found in the ones with visceral metastasis.

A straight correlation with liver visceral metastases was also found, mainly for the ones with liver nodules, which had a median overall survival of 13,5m compared to 31,6m to patients with on lymph node mets.

The purpose of this study could guide treatment intensification, with selecting the most appropriate treatment according to these findings.

Marcos Franca is a clinical oncologist at Oncoclinicas in Brasilia, Brazil .