Oscar Arrieta1, Feliciano Barrón2, Federico Maldonado2, Luis Cabrera3, José Francisco Corona-Cruz2, Monika Blake2, Laura Alejandra Ramírez-Tirado2, Zyanya Lucia Zatarain-Barrón2, Andrés F Cardona4, Osvaldo García2, Osvaldo Arén5, Jaime De la Garza2. 1. Thoracic Oncology Unit, National Cancer Institute (INCan), San Fernando #22, Sección XVI, Tlalpan, CP 14080, Mexico City, Mexico. Electronic address: ogar@unam.mx. 2. Thoracic Oncology Unit, National Cancer Institute (INCan), San Fernando #22, Sección XVI, Tlalpan, CP 14080, Mexico City, Mexico. 3. Thoracic Oncology Unit, National Cancer Institute (INCan), San Fernando #22, Sección XVI, Tlalpan, CP 14080, Mexico City, Mexico; Médica Sur Oncology Center, Mexico. 4. Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia; Foundation for Clinical and Applied Cancer Research- FICMAC, Bogotá, Colombia; Clinical Research and Biology Systems Department, Universidad El Bosque, Bogotá, Colombia. 5. Centro de Investigación Clínica Bradford Hill, Santiago, Chile.
Abstract
OBJECTIVES: Evidence is rapidly accumulating for the use of radical consolidative treatment (RCT) for patients with oligometastatic non-small cell lung cancer (NSCLC). Nonetheless, published studies have several limitations, including a selection of patients whose favorable characteristics might dictate therapeutic success, as well as scarce prospective data regarding overall survival (OS). The objective of this study was to determine whether RCT increases OS in patients with oligometastatic NSCLC. MATERIALS AND METHODS: In this prospective, single-arm phase II study, we sought to evaluate the efficacy of RCT in patients with oligometastatic NSCLC in terms of OS. Patients with pathologically confirmed stage IV NSCLC who presented ≤5 synchronous, any-site metastases (including central nervous system [CNS] metastases), as assessed by PET-CT, were included. All patients received four initial cycles of systemic treatment. Following, those with stable disease/partial response received RCT to the primary site and metastases. The response to RCT was evaluated with PET-CT. The primary end-point was OS. Secondary end-points included progression-free survival (PFS) and best response by PET-CT. The study is registered in clinicaltrials.gov (NCT02805530). RESULTS: Thirty-seven patients were included in the analysis. The mean age was 55.8 years (range: 33-75 years). At diagnosis, 43.2% of patients presented with CNS metastases. Following RCT, 19 (51.4%) patients achieved a complete-response (CR) by PET-CT, while 18 (48.6%) had a non-complete response (NON-CR). The median OS was nonreached (NR) and was positively affected by CR on PET-CT (NR vs. 27.4 [95% CI: 16.4-38.3]; p = 0.011). The median PFS was 23.5 months (95% CI: 13.6-33.3) and was positively affected by CR on PET-CT (NR vs. 14.3 [95% CI: 11.7-16.9]; p < 0.001; HR: 0.19 [0.07-0.52]; p=0.001). CONCLUSION: Patients with oligometastatic NSCLC who undergo RCT have a high response rate and favorable OS. Patients with a CR by PET-CT have significantly longer OS, rendering this an important potential prognostic marker.
OBJECTIVES: Evidence is rapidly accumulating for the use of radical consolidative treatment (RCT) for patients with oligometastatic non-small cell lung cancer (NSCLC). Nonetheless, published studies have several limitations, including a selection of patients whose favorable characteristics might dictate therapeutic success, as well as scarce prospective data regarding overall survival (OS). The objective of this study was to determine whether RCT increases OS in patients with oligometastatic NSCLC. MATERIALS AND METHODS: In this prospective, single-arm phase II study, we sought to evaluate the efficacy of RCT in patients with oligometastatic NSCLC in terms of OS. Patients with pathologically confirmed stage IV NSCLC who presented ≤5 synchronous, any-site metastases (including central nervous system [CNS] metastases), as assessed by PET-CT, were included. All patients received four initial cycles of systemic treatment. Following, those with stable disease/partial response received RCT to the primary site and metastases. The response to RCT was evaluated with PET-CT. The primary end-point was OS. Secondary end-points included progression-free survival (PFS) and best response by PET-CT. The study is registered in clinicaltrials.gov (NCT02805530). RESULTS: Thirty-seven patients were included in the analysis. The mean age was 55.8 years (range: 33-75 years). At diagnosis, 43.2% of patients presented with CNS metastases. Following RCT, 19 (51.4%) patients achieved a complete-response (CR) by PET-CT, while 18 (48.6%) had a non-complete response (NON-CR). The median OS was nonreached (NR) and was positively affected by CR on PET-CT (NR vs. 27.4 [95% CI: 16.4-38.3]; p = 0.011). The median PFS was 23.5 months (95% CI: 13.6-33.3) and was positively affected by CR on PET-CT (NR vs. 14.3 [95% CI: 11.7-16.9]; p < 0.001; HR: 0.19 [0.07-0.52]; p=0.001). CONCLUSION:Patients with oligometastatic NSCLC who undergo RCT have a high response rate and favorable OS. Patients with a CR by PET-CT have significantly longer OS, rendering this an important potential prognostic marker.
Authors: Stephanie T H Peeters; Evert J Van Limbergen; Lizza E L Hendriks; Dirk De Ruysscher Journal: Cancers (Basel) Date: 2021-04-28 Impact factor: 6.639
Authors: Relinde I Y Lieverse; Evert J Van Limbergen; Cary J G Oberije; Esther G C Troost; Sine R Hadrup; Anne-Marie C Dingemans; Lizza E L Hendriks; Franziska Eckert; Crispin Hiley; Christophe Dooms; Yolande Lievens; Monique C de Jong; Johan Bussink; Xavier Geets; Vincenzo Valentini; Giuliano Elia; Dario Neri; Charlotte Billiet; Amir Abdollahi; David Pasquier; Pierre Boisselier; Ala Yaromina; Dirk De Ruysscher; Ludwig J Dubois; Philippe Lambin Journal: BMC Cancer Date: 2020-06-15 Impact factor: 4.430
Authors: Felipe Couñago; Javier Luna; Luis Leonardo Guerrero; Blanca Vaquero; María Cecilia Guillén-Sacoto; Teresa González-Merino; Begoña Taboada; Verónica Díaz; Belén Rubio-Viqueira; Ana Aurora Díaz-Gavela; Francisco José Marcos; Elia Del Cerro Journal: World J Clin Oncol Date: 2019-10-24