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Cytoreductive cryotherapy for newly diagnosed oligometastatic hormone-sensitive prostate cancer

Prostate Cancer and Prostatic Diseases volume 23, pages 537–538 (2020)Cite this article

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Oligometastatic prostate cancer is a potentially highly favourable limited metastatic state [1]. Cryotherapy has been theorised to produce a cryoimmulogical effect with immune-meditate oncological benefits at distant sites via a systemic “anti-tumour” response [1]. This is in a similar vain to the proposed abscopal response to cytotoxic radiotherapy [1]. Despite being considered a low immunogenic cancer, a sub-set of men with metastatic prostate cancer appear to gain oncological benefit from the addition of immunotherapy in a castrate resistant setting, warranting evaluation in metastatic hormone-sensitive prostate cancer (mHSPC) [2].

We read with interest the commendable work by Ross et al. pilot 12-patient study exploring local cytoreductive whole-gland cryotherapy in combination with pembrolizumab monotherapy in men with mHSPC [3]. Oligometastatic disease in this study was defined as </=5 extra-pelvic metastases, including lymph nodes, bones, or soft tissue. This was diagnosed on conventional imaging alone. Over 90% of men had high-grade (Gleason >/= 8) M1b disease.

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References

  1. Connor MJ, Shah TT, Horan G, Bevan CL, Winkler M, Ahmed HU. Cytoreductive treatment strategies for de novo metastatic prostate cancer. Nat Rev Clin Oncol. 2019;11:1–5.

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  3. Ross AE, Hurley PJ, Tran PT, Rowe SP, Benzon B, O’Neal T, et al. A pilot trial of pembrolizumab plus prostatic cryotherapy for men with newly diagnosed oligometastatic hormone-sensitive prostate cancer. Prostate Cancer Prostatic Dis. 2019;14:1–0.

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Authors and Affiliations

  1. Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, W6 8RF, UK

    M. J. Connor, M. Winkler & H. U. Ahmed

  2. Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, W6 8RF, UK

    M. Winkler & H. U. Ahmed

Authors
  1. M. J. Connor
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  2. M. Winkler
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  3. H. U. Ahmed
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Correspondence to M. J. Connor.

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Conflict of interest

MJC has received funding from the Wellcome Trust and University College London Hospital (UCLH) Charity. MW: None. HUA reports receipt of grant funding and personal fees from SonaCare Medical Inc, grant funding from Trod Medical, and grant funding and personal fees from Sophiris Bio Inc. HUA also receives core funding from the UK National Institute of Health Research Imperial Biomedical Research Centre and grants from Wellcome Trust, MRC (UK), Cancer Research UK, Prostate Cancer UK, The Urology Foundation, BMA Foundation and Imperial Healthcare Charity.

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Connor, M.J., Winkler, M. & Ahmed, H.U. Cytoreductive cryotherapy for newly diagnosed oligometastatic hormone-sensitive prostate cancer. Prostate Cancer Prostatic Dis 23, 537–538 (2020). https://doi.org/10.1038/s41391-020-0216-4

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