Journal Article

DKFZ-2024-01931

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Oligometastatic non-small cell lung cancer: Impact of local and contemporary systemic treatment approaches on clinical outcome.

Wiesweg, M. ; Küter, C. ; Schnorbach, J. ; Keyl, J. ; Metzenmacher, M. ; Cvetkovic, J. ; Saalfeld, F. C. ; Glanemann, F. ; Eberhardt, W. ; Oezkan, F. ; Theegarten, D. ; Stenzinger, A. ; Darwiche, K. ; Koschel, D. ; Herth, F. ; Bölükbas, S. ; Winter, H. ; Weykamp, F.DKFZ* ; Wermke, M. ; Stuschke, M. ; Plönes, T. ; Thomas, M. ; Schuler, M. ; Christopoulos, P.

2025
Wiley-Liss Bognor Regis

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Please use a persistent id in citations: doi:10.1002/ijc.35199

Abstract: 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.

Keyword(s): immunotherapy ; locally ablative treatment ; multimodal concepts ; observational study ; oligometastatic NSCLC

Note: 2025 Feb 15;156(4):776-787

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Contributing Institute(s):

1. E050 KKE Strahlentherapie (E050)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2024

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Wiley ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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