1. Introduction
’, glucose tolerance [, ’ nutritional status, PCa, oligometastasis, prostate cancer
CANCER PROGRESSION, OLIGOMETASTATIC DISEASE, DISEASE, CASTRATION-SENSITIVE PROSTATE CANCER, METASTASES, PROSTATE CANCER
These authors contributed equally to this work.These authors contributed equally to this work.(1) Background: In the RADIOSA phase II randomized clinical trial (NCT03940235), the biology task entails the identification of predictive and prognostic biomarkers in the context of oligorecurrent, castration-sensitive prostate cancer in order to distinguish polymetastatic from oligometastatic disease. This may lay the groundwork for personalized treatments for those patients who could really benefit from metastasis-directed therapies. (2) Methods: Oligorecurrent PCa pts with three or fewer bone or lymph nodal localizations were randomized 1:1 to receive SBRT alone (arm A) or SBRT + 6 months of ADT (arm B). Common serum-derived biomarkers were collected at baseline, and at 3 months after RT. The prognostic nutritional index, an immune and nutrition-based prognostic score, and the controlling nutritional status (CONUT) score, a scoring system for evaluating patient’s nutritional status, were calculated in accordance with the body of available literature. As inflammatory indicators, neutrophil–lymphocyte ratio (NLR) and the NLR–albumin ratio (NLRAR) were assessed. Changes in these parameters between baseline and the 3-month timepoint were evaluated both in absolute and relative values. Changes in these parameters between baseline and the 3-month timepoint were evaluated. Significant differences in the trend of these parameters were assessed using the non-parametric Wilcoxon rank-sum test. A network analysis to analyze the relationships between different features stratifying patients according to the arm of study and site of metastases was performed. (3) Results: The current analysis comprised 88 patients (45 arm A, SBRT only, and 43 arm B, SBRT + ADT). When patients were stratified by ADT administration, cholesterol values showed an increasing trend in the group receiving ADT (The use of metastasis-directed therapy (MDT) is rapidly increasing in the setting of oligometastatic prostate cancer (PCa) [However, in some cases, clinical oligometastasis may represent only the tip of the iceberg for a subclinical polymetastatic disease. In this scenario, proper patient selection, as well as the definitions of the real oligometastatic state, may be of critical importance to properly guide the treatment choice in the oligometastatic disease. While important advances in prostate-specific membrane antigen—positron emission tomography (PSMA-PET) and in advanced imaging overall have been reached [It is well known that nutrition and immunity play an important role in cancer progression and in the metastasisation process [In parallel, patients’ nutritional status (including albumin levels, hemoglobin, and other nutritional indexes) has also been indicated as an important factor affecting oncological outcomes [PCa patients’ nutritional status has been demonstrated to be particularly affected by ADT administration which is linked to an increase in cholesterol and triglyceride levels, increased visceral fat, decreased testosterone levels, and a decrease in glucose tolerance [The aim of the present study is to report preliminary results of the biology task of the phase II randomized clinical trial RADIOSA (NCT03940235) [