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Dear Authors
Thank you for making the corrections suggested by the referees.
The manuscript after revision and answer of all reviewers point has improved.
The research in not original, it stated a known information.
The study is not novel.
Satisfactory. The manuscript is clearly written, well-structured, and the reporting is appropriate. This review article touch upon an important topic in urological field. The data presented were useful for clinician as a reference for managing these patients.
Satisfactory. The design and methodology follow standard meta-analysis guidelines and are well justified.
Satisfactory. The findings are valid and supported by the presented data and analysis.
No.
Dear Authors
One of the referees (R2) has recommended rejection while other referees have suggested revisions, kindly make all the changes suggested by the reviewers and resubmit with a rebuttal letter addressing each change
[# PeerJ Staff Note: It is PeerJ policy that additional references suggested during the peer-review process should *only* be included if the authors are in agreement that they are relevant and useful #]
No comment.
No comments.
No comments.
a well-designed study with clear professional English. The introduction sections provided sufficient and referenced explanations of the current knowledge and gaps in the field. Data collection and use were well explained and relevant to the study design. well-presented figures and tables.
Results were well correlated to the study hypothesis.
The study : "Surgery, radiotherapy and endocrine therapy for oligometastatic prostate cancer efficacy: a systematic review and network meta-analysis" is a trial to confirm specific therapy for oligometstatic prostate cancer, The mentioned published data has omitted the recent research and data in prostate cancer.
Comment:
Due to the improved Staging of oligometastatic prostate cancer ( omPCa) had improved dramaticall in present years, and will become a more prevalent disease entity, both at primary diagnosis and in the oligorecurrent setting. Retrospective and small prospective cohorts suggest that surgery (e.g. CRP, SLND, metastasectomy) offers favorable short-term oncologic outcomes combined with local disease control. Nevertheless, there is a lack of high-quality data on oncological outcomes after surgical treatment in omPCa. For de novo omHSPC, several trials are currently investigating the oncological efficacy of surgical therapy of the primary tumor. In metachronous metastatic disease, SLND should only be applied in well-selected patients in a multimodal approach to eliminate all detectable disease and prolong PFS. Moreover, in omPCa, growing evidence suggests that treating every metastatic site to reach no evidence of disease improves survival. Consensus efforts need to be made to standardize terminology, capitalize on the full potential of PSME-PET imaging, combine imaging with molecular biomarkers to risk stratify each case, refine surgical/radiation local therapy, and integrate novel therapeutics such as radiopharmaceutical-driven approach (1).
At present major topic areas are investigated that will pave the route to precise therapy of primary and metastatic cance included: cancer genomics and sequencing, functional genomic approaches to studying mediators of plasticity, emerging signaling pathways in metastatic castration resistant prostate cancer (mCRPC), Wnt signaling biology and the challenges of targeted therapy, clonal hematopoiesis, neuroendocrine cell plasticity and anti-tumor immunity, cancer immunotherapy and its synergizers, and imaging the tumor microenvironment and metabolism(2).
The recent success of immune-checkpoint blockade therapies has sparked interest within the prostate cancer field to combine immune modulatory therapies with standard CRPC treatments. This has now been extended to include targeting of the Wnt signaling cascade to modulate the immune microenvironment. DKK-1 that blocks Wnt signaling. The recent results showed that DKN-01as monotherapy or in combination with docetaxel has vafourate results in patients with advanced CRPC. (3,4,5).
1, von Deimling et al. The current role of precision surgery in oligometastatic prostate cancer. ESMO Open. 2022 Dec;7(6):100597. doi: 10.1016/j.esmoop.2022.100597. Epub 2022 Oct 6. PMID: 36208497; PMCID: PMC9551071
2, Miyahira et al. Prostate cancer research in the 21st century; report from the 2021 Coffey-Holden prostate cancer academy meeting. Prostate. 2022 Feb;82(2):169-181. doi: 10.1002/pros.24262. Epub 2021 Nov 3. PMID: 34734426; PMCID: PMC8688282.
3,Gillessen S et al. Management of Patients with Advanced Prostate Cancer. Part I: Intermediate-/High-risk and Locally Advanced Disease, Biochemical Relapse, and Side Effects of Hormonal Treatment: Report of the Advanced Prostate Cancer Consensus Conference 2022. Eur Urol. 2023 Mar;83(3):267-293. doi: 10.1016/j.eururo.2022.11.002. Epub 2022 Dec 6. PMID: 36494221; PMCID: PMC7614721.
4, Ashrafizadeh M et al.. Targeting autophagy in prostate cancer: preclinical and clinical evidence for therapeutic response. J Exp Clin Cancer Res. 2022 Mar 22;41(1):105. doi: 10.1186/s13046-022-02293-6. PMID: 35317831; PMCID: PMC8939209.
[# PeerJ Staff Note: It is PeerJ policy that additional references suggested during the peer-review process should *only* be included if the authors are in agreement that they are relevant and useful #]
The included published data in the text has omitted the recent research in prostate cancer and the new modalities, beside the limited and indefinite therapeutic modalities the authors included.
according to the recent research in PCa, and clinical application of new modalities, the findings in the manuscript is invalid.
The lack of novelty of the study, the missing recent research results, and the committed major studies in this field, indicates that the study is not appropriate for consideration for publication,
Language: The manuscript is written clearly in English.
Background and Literature: The introduction provides context and cites relevant literature. However, including further details on the definition of oligometastatic prostate cancer, the rationale for treating both the primary tumor and metastases, insights into chemotherapy in this context, the benefits of androgen receptor-targeted agents, and how this scenario is evolving with the introduction of PET PSMA would enrich the background.
Structure: The manuscript adheres to standard journal norms. Figures and tables are well-organized and appropriately annotated.
Originality: The study is pertinent to the journal's scope, addressing a crucial gap in understanding the comparative efficacy of treatment modalities for oligometastatic prostate cancer.
Research Question: The research question is clearly defined and meaningful.
Methods: The methods adhere to PRISMA-NMA guidelines.
Replicability: Methodological transparency ensures that replication is feasible.
Data Robustness: Data is statistically sound, and analyses use appropriate models (e.g., SUCRA rankings).
Conclusions: Conclusions are well-supported by the data but should emphasize limitations more clearly.
Limitations: While limitations are acknowledged, additional discussion on their potential impact on clinical recommendations would strengthen the paper.
The discussion could better contextualize findings within ongoing clinical trials, bridging gaps between current knowledge and future research directions.
This manuscript is well written and the study topic is relevant to current clinical challenge in prostate cancer oligometastasis management. Meta-analysis of the topic provided a good summary of current evidences of the management of oligometastasis prostate cancer.
This study is in line with the amis and scope of the journal. The research method using standard meta-analysis tool and fulfilled the analysis standard.
The results presented in the manuscript are meaningful and useful to clinicians who are taking care of these patients. The figures and tables are also well prepared and easy for readers to understand and keep tract of the information.
As the management of oligometastasis prostate cancer evolve whenever new treatment modality is emerged, readers will be benefit if they can keep track of the latest information of this topic. I suggested that the authors should prepare a table listing all the on-going clinical trial involved in this topic. This will surely increase the merit of this manuscript.
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