Abstract Objectives This work aimed to report real‐world outcomes from the use of SBRT to treat ADT naïve, PSMA‐detected oligometastatic prostate cancer (OPCa) and to assess disease and treatment characteristics in this heterogeneous population intersect or impact treatment response. Subjects and Methods This retrospective single‐institution study examined PSMA‐PET–detected oligometastases ( n = 1–5) in ADT‐naïve OPCa patients, treated with metastasis‐directed therapy (MDT) using SBRT delivered via MRI‐ or CT‐guided linear accelerator. Primary endpoint was biochemical progression free survival (PSA ≥ 25% if baseline 3 m at MDT were associated with prolonged time to PSA progression. Median PSA fall was 68.9%; PSA 50% response was observed in 55.2%. Twenty‐nine patients (43%) had a complete metabolic response after MDT. Median ADT‐free survival was not reached. Conclusions MDT in PSMA‐PET‐detected OPCa can provide clinically meaningful disease control in a subset of patients. This study supports this approach but warrants continued prospective study and exploration into the castrate‐resistant setting.
Shekar et al. (2025) studied this question.