Diego A. Díaz García, Medical Oncologist, CEO and Founder at CánCare – Advanced Specialty in Oncology, shared a post on LinkedIn:
“WOLVERINE: MDT in Oligometastatic Prostate Cancer.
Metastasis-directed therapy remains widely adopted in oligometastatic prostate cancer despite limited phase 3 data. WOLVERINE provides individual patient data across randomized phase 2 trials.
Seven trials, 574 patients
Primary analysis: 6 trials, 472 patients
Median follow-up: 40.7 months
MDT plus standard of care vs SOC:
- PFS
Trial-level HR 0.44 (95% CI 0.35–0.56), p<0.0001
Patient-level HR 0.45 (0.35–0.57), p<0.0001 - Radiographic PFS
Trial-level HR 0.60 (0.42–0.85), p=0.0039
Patient-level HR 0.59 (0.46–0.76), p<0.0001 - Castration resistance–free survival
Trial-level HR 0.58 (0.37–0.92), p=0.019
Patient-level HR 0.58 (0.37–0.91), p=0.017 - Overall survival
Trial-level HR 0.63 (0.39–1.00), p=0.051
Patient-level HR 0.64 (0.40–1.01), p=0.057
Clear benefit in disease control endpoints. OS signal did not reach statistical significance.
Key considerations:
Phase 2 data only. Heterogeneous imaging, systemic therapy backbones, and MDT modalities. Long-term impact on survival and quality of life remains uncertain.
Does improved PFS and delayed castration resistance justify routine MDT in all oligometastatic cases, or should selection be biologically refined?”
Title: Metastasis-directed therapy and standard of care versus standard of care for oligometastatic prostate cancer (WOLVERINE): a systematic review and individual patient data meta-analysis from the X-MET collaboration
Authors: Chad Tang, Alex Sherry, Hyunsoo Hwang, David Farris, Giulio Francolini, Vanessa Di Cataldo, Lorenzo Livi, Phuoc Tran, Paul Corn, Ana Aparicio, Gabriele Simontacchi, Ana Kiess, Jarey Wang, Valerie Fonteyne, Renee Bultijnck, Ryan Phillips, Matthew Deek, Robert Olson, Stephen Harrow, Giulia Marvaso, Chiara Lorubbio, Barbara Jereczek-Fossa, Ethan Ludmir, Pierre Blanchard, Andrew Warner, Ryan Sun, David Palma, Piet Ost
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