# Exploring treatment models for oligometastatic castration-sensitive prostate cancer: evolution of therapeutic strategies

**Authors:** Haizhong Xu, Jialin Guo, Wenrui Peng, Jianqiang Wang, Longlong Shi, Xukai Yang

PMC · DOI: 10.3389/fonc.2026.1778687 · Frontiers in Oncology · 2026-02-12

## TL;DR

This paper reviews treatment strategies for oligometastatic prostate cancer, emphasizing new imaging and therapies to improve patient outcomes.

## Contribution

The paper provides an updated synthesis of diagnostic and therapeutic approaches for oligometastatic castration-sensitive prostate cancer.

## Key findings

- PSMA-PET/CT improves detection of oligometastatic lesions.
- Combination therapies are replacing ADT alone for better outcomes.
- Local therapies may delay disease progression in oligometastatic cases.

## Abstract

Oligometastatic castration (hormone)-sensitive prostate cancer (omCSPC) represents an intermediate disease state between localized and widely metastatic cancer. This review synthesizes current evidence on diagnosis, treatment, and biomarkers in omCSPC to guide personalized therapeutic strategies and improve clinical outcomes. A comprehensive literature review was conducted, focusing on the role of PSMA-PET/CT in lesion detection, evolving local and systemic treatment modalities, and the prognostic and predictive value of biomarkers in omCSPC.PSMA-PET/CT has improved the precision of oligometastatic lesion identification. Treatment of omCSPC has evolved from Androgen Deprivation Therapy (ADT) alone to combination regimens incorporating novel hormonal agents or chemotherapy. Local therapies, including radiotherapy and surgery, are increasingly utilized and may delay disease progression. omCSPC exhibits clinical and molecular heterogeneity, with several emerging biomarkers showing prognostic potential, though standardization is still needed. The management of omCSPC requires a multidisciplinary approach and personalized treatment strategies. Further research into biomarkers and the optimal integration of local therapies is essential to improve patient quality of life and long-term survival.

## Linked entities

- **Diseases:** prostate cancer (MONDO:0005159)

## Full-text entities

- **Genes:** TRBV20OR9-2 (T cell receptor beta variable 20/OR9-2 (non-functional)) [NCBI Gene 6962] {aka CDR3, TCRBV20S2, TCRBV2O, TCRBV2S2O}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, PTEN (phosphatase and tensin homolog) [NCBI Gene 5728] {aka 10q23del, BZS, CWS1, DEC, GLM2, MHAM}, FOLH1 (folate hydrolase 1) [NCBI Gene 2346] {aka FGCP, FOLH, GCP2, GCPII, NAALAD1, PSM}, KLK3 (kallikrein related peptidase 3) [NCBI Gene 354] {aka APS, KLK2A1, PSA, hK3}, HSD3B1 (hydroxy-delta-5-steroid dehydrogenase, 3 beta- and steroid delta-isomerase 1) [NCBI Gene 3283] {aka 3BETAHSD, HSD3B, HSDB3, HSDB3A, SDR11E1}, SPOP (speckle type BTB/POZ protein) [NCBI Gene 8405] {aka BTBD32, NEDMACE, NEDMIDF, NSDVS1, NSDVS2, TEF2}, AR (androgen receptor) [NCBI Gene 367] {aka AIS, AR8, DHTR, HPCX3, HUMARA, HYSP1}, CYP17A1 (cytochrome P450 family 17 subfamily A member 1) [NCBI Gene 1586] {aka CPT7, CYP17, P450C17, S17AH}, RB1 (RB transcriptional corepressor 1) [NCBI Gene 5925] {aka OSRC, PPP1R130, RB, p105-Rb, p110-RB1, pRb}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, ATM (ATM serine/threonine kinase) [NCBI Gene 472] {aka AT1, ATA, ATC, ATD, ATDC, ATE}, TWSG1 (twisted gastrulation BMP signaling modulator 1) [NCBI Gene 57045] {aka TSG}
- **Diseases:** omCSPC.PSMA (MESH:D011472), aggressiveness (MESH:D010554), CRPC (MESH:D064129), lymph node and distant metastasis (MESH:D008207), toxicities (MESH:D064420), bone lesions (MESH:D001847), Tumor (MESH:D009369), resistant (MESH:D060467), nutritional (MESH:D044342), bone pain (MESH:D010146), inflammation (MESH:D007249), OMD (MESH:D004194), MDT (MESH:D009362), PCa (MESH:D011471), symptom (MESH:D012816)
- **Chemicals:** Darolutamide (MESH:C000607739), Docetaxel (MESH:D000077143), nilutamide (MESH:C021277), flutamide (MESH:D005485), orteronel (MESH:C571806), testosterone (MESH:D013739), abiraterone acetate (MESH:D000069501), enzalutamide (MESH:C540278), prednisone (MESH:D011241), 18F-DCFPyL (MESH:C572626), apalutamide (MESH:C572045), abiraterone (MESH:C089740), 18F-sodium fluoride (-), bicalutamide (MESH:C053541), Radium-223 (MESH:C000615150)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

111 references — full list in the complete paper: https://tomesphere.com/paper/PMC12935621/full.md

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Source: https://tomesphere.com/paper/PMC12935621