Highlights
The WOLVERINE systematic review and individual patient data (IPD) meta-analysis provides the most robust evidence to date regarding the role of metastasis-directed therapy (MDT) in oligometastatic prostate cancer. The study found that MDT, when added to the standard of care (SOC), significantly improves progression-free survival (PFS) with a hazard ratio of 0.44. Furthermore, the intervention significantly delayed the time to castration resistance, a critical milestone in the natural history of prostate cancer. While a trend toward improved overall survival (OS) was observed, the results did not reach conventional statistical significance, highlighting the need for longer-term follow-up and larger phase 3 trials.