Proposing synchronous oligometastatic non–small‐cell lung cancer based on progression after first‐line systemic therapy

Abstract

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Association between oligo-residual disease and patterns of failure during EGFR-TKI treatment in EGFR-mutated non-small cell lung cancer: a retrospective study

“…Therefore, we evaluated the number of patients with residual disease at 3 months after EGFR-TKI treatment initiation, to evaluate the incidence of oligo-residual disease. Synchronous oligometastatic disease was defined as the presence of 1 – 3 metastases (1 – 4 lesions including the primary site) at the time of NSCLC diagnosis [ 12 , 14 , 23 ]. Oligo-residual disease was defined as the presence of 1 – 4 residual lesions, including the primary site, at 3 months after the start of EGFR-TKI (Fig.…”

“…Progressive disease (PD) after first-line chemotherapy has been shown to be predominantly limited to the original site of disease, providing a rationale for the addition of LAT in patients with oligometastatic NSCLC [ 14 , 15 ]. In patients with EGFR -mutated NSCLC, almost half had PD limited to the original sites of disease after first-line treatment with EGFR-TKIs [ 16 – 18 ].…”

Coexisting opportunities and challenges: In which scenarios can minimal/measurable residual disease play a role in advanced non-small cell lung cancer?

“…This state is considered an intermediate status between locally advanced and widely metastatic phases ( 34 ). The definition of OMD remains controversial; most retrospective studies defined OMD as a synchronous metastasis based on M1b staging of the eighth edition of The International Association for the Study of Lung Cancer (IASLC) Classification (within 6 months of diagnosis) or up to three metastatic cerebral metastases ( 35 ); however, some are defined as no more than five metastases ( 36 ). Stage M1b is defined as the presence of one metastasis in a single organ; the median overall survival (mOS) of patients with stage M1b disease (11.4 months) is similar to that of patients with one metastasis to the contralateral lung (stage M1a) (11.8 months), whereas mOS of patients with multiple lesions in one other organ in addition to the primary site (7.0 months) is similar to that for plurimetastatic patients (6.2 months) ( 37 ).…”

Association Between Oligo-Residual Disease and Patterns of Failure During EGFR-TKI Treatment in EGFR-Mutated Non-Small Cell Lung Cancer: A Retrospective Study

“…[16,23] Synchronous oligometastatic disease was de ned as the presence of 1 -3 metastases (1 -4 lesions including the primary site) at the time of NSCLC diagnosis. [14,22] Oligo-residual disease was de ned as the presence of 1 -4 residual lesions, including the primary site, at 3 months after the start of EGFR-TKI (Figure 1). [19,22] Residual disease was de ned as detectable lesions on imaging evaluation after 3 months of EGFR-TKI therapy.…”

“…[11][12][13] Progressive disease (PD) after rst-line chemotherapy has been shown to be predominantly limited to the original disease site of disease, providing a rationale for the addition of LAT in patients with oligometastatic NSCLC. [14,15] In patients with EGFR-mutated NSCLC, almost half had PD limited to the original sites of disease after rst-line treatment with EGFR-TKIs. [16][17][18] No signi cant association was found between synchronous oligometastatic disease and patterns of initial PD after EGFR-TKI treatment.…”