The WOLVERINE study analyzed five trials and found metastasis -directed therapy -- primarily radiation -- may delay castration resistance and improve other long-term outcomes in prostate cancer. While overall survival data remain immature, ongoing larger trials like PRESTO and PLATON could provide clearer answers in the future.
In this exclusive MedPage Today video, Chad Tang, MD, of the University of Texas MD Anderson Cancer Center in Houston, discusses the significance of WOLVERINE and the future trajectory of metastasis-directed therapy* in prostate cancer treatment.*
Following is a transcript of his remarks :
WOLVERINE is part of a larger collaboration we're doing across the country and the world. We are amalgamating, randomized oligometastatic trials looking at the benefits of metastasis-directed therapy across all the tumors.
And across these different histologies, we have found that the most common tumor that we are treating or see on trials is prostate cancer. So WOLVERINE was based on that. We looked at all randomized studies that have been published investigating metastasis-directed therapy -- primarily with radiation -- for oligometastatic prostate cancer.
So this includes five studies, including some studies in Europe and North America, and patients generally were randomized to radiation therapy plus standard of care systemic therapy versus standard of care systemic therapy.
And the take-home points of this analysis was that this is one of the first times we're showing that not only is progression-free survival benefited with metastasis-directed therapy, but also that we see a benefit in longer-term endpoints such as radiographic progression-free survival and castration resistance-free survival in these patients.
We saw a borderline trend for significance looking at overall survival -- which I would think is a primary endpoint of interest -- with a P value somewhere between 0.51 and 0.57 depending on the statistical analysis that we used.
So a practicing physician, I think, should be encouraged by results that metastasis-directed therapy is going to benefit a patient not only for progression-free survival, but also for later endpoints and possibly for overall survival, although the data is immature there.
We are waiting for the larger trials to read out -- such as PRESTO or PLATON -- but it will probably take many years for that to read out given the event rate in these patients is not very high. So we're hopeful that once they read out, we can amalgamate these larger trials into the meta-analysis, but at this point we are looking at another set of smaller phase II studies that we hope to publish that hopefully will be published soon and we can add, but this probably is the best we're going to have for a little bit.
author['full_name']
Greg Laub is the Senior Director of Video and currently leads the video and podcast production teams. Follow