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Some people have only a few sites of spread and can be treated at each one; others have further deposits not yet visible, and counting lesions cannot tell them apart. A signature built from tumour DNA levels, microRNA classifiers and clonal diversity across lesions would define the biology and spare futile ablation.
Ablative treatment of all visible lesions improves survival in selected patients, but selection today is anatomical and therefore crude. Candidate discriminators include ctDNA level and clearance kinetics, microRNA classifiers reported in oligometastatic lung cancer, and clonal diversity across lesions. A locked signature, prospectively validated, would define the biology rather than the lesion count.
One bottleneck page and 16 idea pages on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
Metastatic prostate cancer is a communicating population, not a set of independent colonies, which is an argument for treating the whole body rather than chasing individual deposits, and an argument that resistance to androgen receptor drugs will emerge in several places at once because it emerges convergently.
Shares Are 90% of deaths from cancer caused by metastases?, Metastasis is understood least and studied last, Circulating tumour DNA (ctDNA), Biomarkers are not validated or standardised.
Shares Are 90% of deaths from cancer caused by metastases?, Metastasis is understood least and studied last, Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer, Oligometastatic disease, Metastasis is understood least and studied last, SBRT / SABR (stereotactic radiotherapy).
Shares Are 90% of deaths from cancer caused by metastases?, Metastasis is understood least and studied last, Biomarkers are not validated or standardised, Liquid biopsy (ctDNA).
Shares Are 90% of deaths from cancer caused by metastases?, Oligometastatic disease, Metastasis is understood least and studied last, Colorectal cancer.
Shares Are 90% of deaths from cancer caused by metastases?, Metastasis is understood least and studied last, MRD / molecular residual disease testing, Colorectal cancer.
Shares Are 90% of deaths from cancer caused by metastases?, Metastasis is understood least and studied last, MRD / molecular residual disease testing, Colorectal cancer.
Shares Are 90% of deaths from cancer caused by metastases?, Metastasis is understood least and studied last, MRD / molecular residual disease testing, Liquid biopsy (ctDNA).