Several trials have evaluated metastasis directed therapy for oligometastatic prostate cancer, however most have been limited in size. WOLVERINE was a systematic review and meta-analysis of clinical trials comparing MDT and standard systemic therapy for oligometastatic prostate cancer. It included 6 phase 2 trials that randomized 472 patients to standard systemic therapy with (52.5%) or without (47.5%) MDT. MDT was associated with significant improvements in PFS, radiographic PFS, and castration resistance PFS. Overall survival strongly favored MDT, but didn’t quite reach statistical significance (HR 0.64, CI 0.40 – 1.01, P=0.057). | Tang, Lancet Oncol 2026
