What is your preferred choice and timing of systemic therapy in a patient with high risk oligometastatic prostate cancer undergoing metastasis directed therapy to all sites of disease, including the prostate?

Metastasis-directed therapy (MDT) is an option for patients with oligometastatic prostate cancer who wish to delay initiation of ADT, based on STOMP (Decaestecker et al., PMID: 25223986) and ORIOLE (Phillips et al., PMID: 32215577) trials. In the STOMP study, 61% of patients (3 or fewer metastases) ...