Oligometastatic non-small cell lung cancer: Impact of local and contemporary systemic treatment approaches on clinical outcome.

Autor: Wiesweg M; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; Division of Thoracic Oncology, West German Cancer Center, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Essen, Germany., Küter C; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Schnorbach J; Department of Thoracic Oncology, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany., Keyl J; Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; Institute for Artificial Intelligence in Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Metzenmacher M; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; Division of Thoracic Oncology, West German Cancer Center, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Essen, Germany., Cvetkovic J; Department of Thoracic Oncology, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany., Saalfeld FC; Clinic for Internal Medicine I, University Hospital, Technische Universität Dresden, Dresden, Germany.; National Center for Tumor Diseases (NCT/UCC), Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany., Glanemann F; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Eberhardt W; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; Division of Thoracic Oncology, West German Cancer Center, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Essen, Germany., Oezkan F; Department of Pulmonary Medicine, Section of Interventional Pneumology, West German Cancer Center, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Essen, Germany., Theegarten D; Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Stenzinger A; Institute of Pathology, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.; National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg, Germany., Darwiche K; Department of Pulmonary Medicine, Section of Interventional Pneumology, West German Cancer Center, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Essen, Germany.; National Center for Tumor Diseases (NCT), NCT West, Essen, Germany., Koschel D; Department of Pneumology, Fachkrankenhaus Coswig, Lung Center, Coswig and Division of Pneumology, Medical Department I, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Herth F; Department of Pneumology and Critical Care Medicine, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany., Bölükbas S; National Center for Tumor Diseases (NCT), NCT West, Essen, Germany.; Department of Thoracic Surgery and Endoscopy, West German Cancer Center, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Essen, Germany., Winter H; National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg, Germany.; Department of Thoracic Surgery, Thoraxklinik at Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany., Weykamp F; Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Wermke M; Clinic for Internal Medicine I, University Hospital, Technische Universität Dresden, Dresden, Germany.; National Center for Tumor Diseases (NCT/UCC), Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany., Stuschke M; National Center for Tumor Diseases (NCT), NCT West, Essen, Germany.; Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Plönes T; National Center for Tumor Diseases (NCT/UCC), Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.; Department of Thoracic Surgery, Fachkrankenhaus Coswig, Lung Center, Coswig and Division of Thoracic Surgery, Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.; Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany., Thomas M; Department of Thoracic Oncology, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany.; National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany., Schuler M; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany.; Division of Thoracic Oncology, West German Cancer Center, University Medicine Essen-Ruhrlandklinik, University Duisburg-Essen, Essen, Germany.; National Center for Tumor Diseases (NCT), NCT West, Essen, Germany., Christopoulos P; Department of Thoracic Oncology, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany.; National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2024 Sep 25. Date of Electronic Publication: 2024 Sep 25.
DOI: 10.1002/ijc.35199
Abstrakt: Oligometastatic (OMD) non-small cell lung cancer (NSCLC) is a distinct but heterogeneous entity. Current guidelines recommend systemic therapy and consolidation with local ablative therapy (LAT). However, evidence regarding the optimal choice of multimodal treatment approaches is lacking, in particular with respect to the integration of immunotherapy. This real-world study identified 218 patients with OMD NSCLC (2004-2023, prespecified criteria: ≤5 metastases in ≤2 organ systems) from three major German comprehensive cancer centers. Most patients had one (72.5%) or two (17.4%) metastatic lesions in a single (89.9%) organ system. Overall survival (OS) was significantly longer with a single metastatic lesion (HR 0.54, p = .003), and female gender (HR 0.4, p < .001). Median OS of the full cohort was 27.8 months, with 29% survival at 5 years. Patients who had completed LAT to all NSCLC sites, typically excluding patients with early progression, had a median OS of 34.4 months (37.7% 5-year OS rate) with a median recurrence-free survival (RFS) of 10.9 months (13.3% at 5 years). In those patients, systemic treatment as part of first-line therapy was associated with doubling of RFS (12.3 vs. 6.4 months, p < .001). Despite limited follow-up of patients receiving chemo-immunotherapy (EU approval 2018/2019), RFS was greatly improved by adding checkpoint inhibitors to chemotherapy (HR 0.44, p = .008, 2-year RFS 51.4% vs. 15.1%). In conclusion, patients with OMD NSCLC benefitted from multimodality approaches integrating systemic therapy and local ablation of all cancer sites. A substantial proportion of patients achieved extended OS, suggesting a potential for cure that can be further augmented with the addition of immunotherapy.
(© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)
Databáze: MEDLINE
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