Antonin Levy1, Lizza E L Hendriks2, Thierry Berghmans3, Corinne Faivre-Finn4, Matteo GiajLevra5, Niccolò GiajLevra6, Baktiar Hasan7, Alessia Pochesci7, Nicolas Girard8, Laurent Greillier9, Sylvie Lantuéjoul10, John Edwards11, Mary O'Brien12, Martin Reck13, Benjamin Besse14, Silvia Novello15, Anne-Marie C Dingemans16. 1. Department of Radiation Oncology, Gustave Roussy, Institut D'Oncologie Thoracique (IOT), INSERM U1030 Molecular Radiotherapy, Université Paris-Saclay, F-94805, Villejuif, France; Univ Paris Sud, Université Paris-Saclay, F-94270, Le Kremlin-Bicêtre, France; Young Investigators EORTC Lung Cancer Group (YI EORTC LCG). Electronic address: Antonin.LEVY@gustaveroussy.fr. 2. Young Investigators EORTC Lung Cancer Group (YI EORTC LCG); Department of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands. 3. Department of Intensive Care and Oncological Emergencies & Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. 4. Division of Cancer Sciences Institute of Cancer Sciences, University of Manchester, Christie NHS Foundation Trust, Manchester, UK. 5. Young Investigators EORTC Lung Cancer Group (YI EORTC LCG); Respiratory Oncology Unit, Department of Thoracic and Vascular Disease, CHU Grenoble Alpes, Grenoble, France. 6. Young Investigators EORTC Lung Cancer Group (YI EORTC LCG); Radiation Oncology, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy; Department of Oncology, University of Turin, Torino, Italy. 7. European Organisation for Research and Treatment of Cancer, Brussels, Belgium. 8. Institut Du Thorax Curie-Montsouris, Institut Curie, Paris, France; University Lyon 1, Lyon, France. 9. Multidisciplinary Oncology and Therapeutic Innovations, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, Marseille, France. 10. Department of Biopathology, Centre Léon Bérard UNICANCER, Lyon, France; Université Grenoble Alpes, INSERM U1209/CNRS 5309 Institute for Advanced Biosciences, Grenoble France. 11. Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom. 12. Department of Medicine, Royal Marsden NHS Foundation Trust, London, UK. 13. LungenClinic Grosshansdorf, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany. 14. Univ Paris Sud, Université Paris-Saclay, F-94270, Le Kremlin-Bicêtre, France; Department of Medical Oncology, Gustave Roussy, Institut D'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France. 15. Oncology Department, University of Turin, AOU San Luigi, Orbassano (TO), Italy. 16. Department of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: a.dingemans@erasmusmc.nl.
Abstract
BACKGROUND: Synchronous oligometastatic disease (sOM) has been described as a distinct disease entity; however, there is no consensus on OM definition (OM-d) in non-small-cell lung cancer (NSCLC). A consensus group was formed aiming to agree on a common OM-d that could be used in future clinical trials. A European survey was circulated to generate questions and input for the consensus group meeting. METHODS: A European Organisation for Research and Treatment of Cancer Lung Cancer Group (LCG)/sOM-d consensus group survey was distributed to LCG, sOM-d consensus group, and several European thoracic oncology societies' members. RESULTS: 444 responses were analysed (radiation oncologist: 55% [n = 242], pulmonologist: 15% [n = 66], medical oncologist: 14% [n = 64]). 361 physicians (81%) aimed to cure sOM NSCLC patients and 82% (n = 362) included the possibility of radical intent treatment in their sOM-d. The maximum number of metastases considered in sOM-d varied: 12% replied 1 metastasis, 42% ≤ 3, and 17% ≥ 5 metastases. 79% (n = 353) stated that number of organs involved was important for sOM-d, and most (80%, n = 355) considered that only ≤3 involved organs (excluding primary) should be included. 317 (72%) included mediastinal lymph node involvement in the sOM-d and 22% (n = 70/317) counted mediastinal lymph node as a metastatic site. Most physicians completed sOM staging with brain magnetic resonance imaging (91%, n = 403) and positron emission tomography/computed tomography (98%, n = 437). Pathology proof of metastatic disease was a requirement to define sOM for 315 (71%) physicians. The preferred primary outcome for sOM clinical trials was overall survival (73%, n = 325). CONCLUSION: Although consensual answers were obtained, several issues remain unresolved and will require further research to agree on a sOM-d.
BACKGROUND:Synchronous oligometastatic disease (sOM) has been described as a distinct disease entity; however, there is no consensus on OM definition (OM-d) in non-small-cell lung cancer (NSCLC). A consensus group was formed aiming to agree on a common OM-d that could be used in future clinical trials. A European survey was circulated to generate questions and input for the consensus group meeting. METHODS: A European Organisation for Research and Treatment of Cancer Lung Cancer Group (LCG)/sOM-d consensus group survey was distributed to LCG, sOM-d consensus group, and several European thoracic oncology societies' members. RESULTS: 444 responses were analysed (radiation oncologist: 55% [n = 242], pulmonologist: 15% [n = 66], medical oncologist: 14% [n = 64]). 361 physicians (81%) aimed to cure sOMNSCLCpatients and 82% (n = 362) included the possibility of radical intent treatment in their sOM-d. The maximum number of metastases considered in sOM-d varied: 12% replied 1 metastasis, 42% ≤ 3, and 17% ≥ 5 metastases. 79% (n = 353) stated that number of organs involved was important for sOM-d, and most (80%, n = 355) considered that only ≤3 involved organs (excluding primary) should be included. 317 (72%) included mediastinal lymph node involvement in the sOM-d and 22% (n = 70/317) counted mediastinal lymph node as a metastatic site. Most physicians completed sOM staging with brain magnetic resonance imaging (91%, n = 403) and positron emission tomography/computed tomography (98%, n = 437). Pathology proof of metastatic disease was a requirement to define sOM for 315 (71%) physicians. The preferred primary outcome for sOM clinical trials was overall survival (73%, n = 325). CONCLUSION: Although consensual answers were obtained, several issues remain unresolved and will require further research to agree on a sOM-d.
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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