Stereotactic Body Radiation Therapy in Patients with Oligometastatic Disease: Clinical State of the Art and Perspectives

Kinj, Rémy; Muggeo, Emilien; Schiappacasse, Luis; Bourhis, Jean; Herrera, Fernanda G.

doi:10.3390/cancers14051152

Cited by 15 publications

(8 citation statements)

References 90 publications

(91 reference statements)

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“…Oligo-progression is not rare during treatment with immunotherapy, and especially in patients who have prolonged periods of partial response or stable disease. In these cases, an ablative local treatment, such as stereotactic radiotherapy, might play an important role, as reported in other cancer types [31,32].…”

Section: Role Of Progression Free Survivalmentioning

confidence: 73%

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New Challenges in Evaluating Outcomes after Immunotherapy in Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma

et al. 2022

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In many recurrent and/or metastatic cancers, the advent of immunotherapy opens up new scenarios of treatment response, with new phenomena, such as pseudoprogression and hyperprogression. Because of this, different immune-related response criteria have been developed, and new therapeutic strategies adopted, such as treatment beyond progression. Moreover, the role of progression-free survival as a surrogate has been questioned, and new surrogate endpoint hypotheses have arisen. A proper understanding of radiological imaging, an assessment of the biological events triggered by therapy, and the clinical evolution of the lesions and of the patient performance status are all factors that should be considered to guide the oncologist’s treatment choice. The primary aim of this article is to discuss how all these concepts apply to recurrent/metastatic head and neck squamous cell carcinoma patients when treated with immunotherapy.

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Section: Role Of Progression Free Survivalmentioning

confidence: 73%

“…Data suggest that treatment beyond progression (TBP) after ICI therapy confers prolonged survival in selected patients with asymptomatic progression of disease [31]. Increased survival with TBP was also shown in patients with RM HNSCC by a post hoc analysis of CheckMate 141.…”

Section: Treatment Beyond Progressionmentioning

confidence: 96%

New Challenges in Evaluating Outcomes after Immunotherapy in Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma

et al. 2022

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“…However, current studies suffer from small numbers, heterogenous inclusion criteria, and a lack of standardized outcome measures, as well as long-term data. Hence, a universal approach and consensus is still lacking [3,24].…”

Section: Metastasis-directed Therapy (Mdt)mentioning

confidence: 99%

Oligometastatic Prostate Cancer—The Middle Child Syndrome

Lim,

Su,

Saiduzzaman

et al. 2023

JCM

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Oligometastatic prostate cancer is an evolving clinical entity as more data from novel imaging tools such as PSMA PET/CT emerges. Recognition of this disease entity allows for unique interventions which differ from conventional treatment of metastatic prostate cancers such as the initiation of chemotherapy. With metastasis-directed therapy (MDT), there is potential for early eradication of limited disease metastases and a delay in systemic treatment with its associated treatment-related toxicities. This review explores the current evidence and outcomes of different metastasis-directed therapies such as the role of radiotherapy in low volume metastasis and the use of PSMA ligands to facilitate pelvic lymph node dissections. With a deeper understanding of this low metastasis state, it has revolutionized the current viable treatment options, and more studies are ongoing to provide further insights into this unique disease entity.

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“…In 1995, Hellman and Weichselbaum first proposed oligometastatic disease as a distinct cancer state between locally confined and systemic metastatic disease [ 100 ], which refers to a metastatic tumor with no more than three to five metastases [ 101 , 102 , 103 , 104 , 105 , 106 ]. For these patients, some researchers claim oligometastasis-directed SBRT should be delivered to all tumor lesions to yield efficient tumor control and immune-stimulating effect [ 76 , 107 , 108 ].…”

Section: Clinical Decision Suggestionsmentioning

confidence: 99%

A ‘Hybrid’ Radiotherapy Regimen Designed for Immunomodulation: Combining High-Dose Radiotherapy with Low-Dose Radiotherapy

Zhou

2022

Cancers

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Radiotherapy (RT) affects anti-tumor immunity. However, the exact impact of RT on anti-tumor immune response differs among cancer types, RT dose and fractions, patients’ innate immunity, and many other factors. There are conflicting findings on the optimal radiation dose and fractions to stimulate effective anti-tumor immunity. High-dose radiotherapy (HDRT) acts in the same way as a double-edged sword in stimulating anti-tumor immunity, while low-dose radiotherapy (LDRT) seems to play a vital role in modulating the tumor immune microenvironment. Recent preclinical data suggest that a ‘hybrid’ radiotherapy regimen, which refers to combining HDRT with LDRT, can reap the advantages of both. Clinical data have also indicated a promising potential. However, there are still questions to be addressed in order to put this novel combination therapy into clinical practice. For example, the selection of treatment site, treatment volume, the sequencing of high-dose radiotherapy and low-dose radiotherapy, combined immunotherapy, and so on. This review summarizes the current evidence supporting the use of HDRT + LDRT, explains possible immune biology mechanisms of this ‘hybrid’ radiotherapy, raises questions to be considered when working out individualized treatment plans, and lists possible avenues to increase efficiency in stimulating anti-tumor immunity using high-dose plus low-dose radiotherapy.

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Stereotactic Body Radiation Therapy in Patients with Oligometastatic Disease: Clinical State of the Art and Perspectives

Cited by 15 publications

References 90 publications

New Challenges in Evaluating Outcomes after Immunotherapy in Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma

New Challenges in Evaluating Outcomes after Immunotherapy in Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma

Oligometastatic Prostate Cancer—The Middle Child Syndrome

A ‘Hybrid’ Radiotherapy Regimen Designed for Immunomodulation: Combining High-Dose Radiotherapy with Low-Dose Radiotherapy

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