The UroOnc Minute: MDT for Oligometastatic Prostate Cancer, with Chad Tang, MD

Welcome back to The UroOnc Minute!

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, speaks with Chad Tang, MD, associate professor of genitourinary radiation oncology at MD Anderson Cancer Center, about the evolving role of metastasis-directed therapy (MDT) for patients with oligometastatic prostate cancer. Drawing on recently published data from the WOLVERINE collaborative meta-analysis,¹ Tang provides an overview of the strongest evidence of MDT to date in this increasingly recognized disease state.

The discussion centers on the WOLVERINE analysis, which combined data from 7 phase 2 studies that enrolled men with up to 5 metastatic lesions. By aggregating outcomes across trials, investigators were able to evaluate the impact of MDT on key oncologic end points with greater statistical power than any individual study alone. Tang reviews the analysis' major findings, including significant improvements in progression-free survival, radiographic progression-free survival, and castration resistance–free survival among patients who received MDT in addition to standard of care. He also discusses the overall survival findings, which favored MDT but missed the threshold for statistical significance, underscoring both the promise of the approach and the need for continued investigation.

Beyond the data, Weiner and Tang explore how these findings translate to everyday clinical practice. Tang discusses patient selection in the era of PSMA-PET imaging, the applicability of MDT in both recurrent and de novo oligometastatic disease, and the importance of multidisciplinary collaboration among urologists, radiation oncologists, and medical oncologists.

The conversation also looks ahead to ongoing phase 3 studies that may further define the role of MDT, as well as emerging treatment strategies designed to preserve quality of life by reducing reliance on long-term hormone therapy. Together, the discussion provides a concise update on a rapidly evolving area of prostate cancer care and the evidence shaping its future.

REFERENCE

1. Tang C, Sherry AD, Hwang H, et al. Metastasis-directed therapy and standard of care versus standard of care for oligometastatic prostate cancer (WOLVERINE): a systematic review and individual patient data meta-analysis from the X-MET collaboration. Lancet Oncol. 2026;27(2):181-190. doi: 10.1016/S1470-2045(25)00658-8