Treatment of Oligometastatic Non-Small Cell Lung Cancer: An ASTRO/ESTRO Clinical Practice Guideline

Iyengar, Puneeth; All, Sean; Berry, Mark F.; Boike, Thomas; Bradfield, Lisa; Dingemans, Anne‐Marie C.; Feldman, Jill; Gomez, Daniel R.; Hesketh, Paul J.; Jabbour, Salma K.; Jeter, Melenda; Lievens, Yolande; McDonald, Fiona; Perez, Bradford A.; Ricardi, Umberto; Ruffini, Enrico; Ruysscher, Dirk De; Saeed, Hina; Schneider, Bryan J.; Senan, Suresh; Widder, Joachim; Gückenberger, Matthias

doi:10.1016/j.prro.2023.04.004

Cited by 40 publications

(10 citation statements)

References 71 publications

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“…Given the increased utilization of local therapy with systemic therapy in the management of oligometastatic NSCLC, a clinical practice guideline was also released jointly by the ASTRO and ESTRO in 2023 (96). In this guideline, oligometastatic NSCLC's definition, choice of local treatment and its sequencing with systemic therapy, radiotherapy dose/fractionation and techniques, as while as the indications for additional local therapy upon progression were reviewed.…”

Section: Discussionmentioning

confidence: 99%

Combining stereotactic body radiotherapy with immunotherapy in stage IV non-small cell lung cancer

Liu,

Chi

2023

Front. Oncol.

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Immunotherapy has revolutionized the treatment of metastatic non-small cell lung cancer (NSCLC). Oligometastasis has been associated with better prognosis than widespread metastatic disease and may be curable by stereotactic body radiotherapy (SBRT). SBRT can stimulate immunogenic anti-tumor activity, which can be further augmented when combined with immunotherapy, such as immune checkpoint inhibitors (ICIs). Thus, its combination with immunotherapy was recognized as a promising treatment option, especially in the metastatic setting. However, the most optimal approach to combine SBRT with immunotherapy remains controversial with early clinical evidence emerging. Here, we review the current clinical evidence supporting the combination of SBRT with immunotherapy in the treatment of metastatic NSCLC. Also, we discuss the current controversies and areas for further exploration associated with this treatment strategy.

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Section: Discussionmentioning

confidence: 99%

Combining stereotactic body radiotherapy with immunotherapy in stage IV non-small cell lung cancer

Liu,

Chi

2023

Front. Oncol.

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“…Given limited efficacy of second-line therapy, it is paramount to confirm completion of expanded molecular testing of patients with advanced NSCLC including more recently emerged actionable alterations, such as for example KRAS G12C 55 or ERBB2 mutations etc, and consider clinical trials participation for appropriate patients. Careful integration of supportive and palliative care 56 and judicious use of additional supportive and palliative treatment options (eg, palliative radiation 57 ) are key elements of optimal patient management for patients with advanced NSCLC.…”

Section: Second-line and Subsequent Therapiesmentioning

confidence: 99%

Therapy for Stage IV Non–Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2023.3

Jaiyesimi,

Leighl,

Ismaila

et al. 2024

JCO

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Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the ASCO Guidelines Methodology Manual . ASCO Living Guidelines follow the ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines . Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating provider and do not account for individual variation among patients. See complete disclaimer in Appendix 1 and Appendix 2 for more. Updates are published regularly and can be found at https://ascopubs.org/nsclc-non-da-living-guideline . PURPOSE To provide evidence-based recommendations for patients with stage IV non–small cell lung cancer (NSCLC) without driver alterations. METHODS This ASCO living guideline offers continually updated recommendations based on an ongoing systematic review of randomized clinical trials (RCTs), with the latest time frame spanning February to October 2023. An Expert Panel of medical oncology, pulmonary, community oncology, research methodology, and advocacy experts were convened. The literature search included systematic reviews, meta-analyses, and randomized controlled trials. Outcomes of interest include efficacy and safety. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS This guideline consolidates all previous updates and reflects the body of evidence informing this guideline topic. Ten new RCTs were identified in the latest search of the literature to date. RECOMMENDATIONS Evidence-based recommendations were updated to address first, second, and subsequent treatment options for patients without driver alterations. Additional information is available at www.asco.org/living-guidelines .

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“…Regarding the treatment of oligometastatic lung cancer, new ASTRO/ESTRO guidelines were recently published [ 77 ] and were presented and discussed at the 2023 ERS Congress. Oligometastatic lung cancer is defined as metastatic disease limited in number and location for whom a radical treatment is technically feasible with acceptable toxicity.…”

Section: Evolving Concepts In Lung Cancer Management: Unravelling Con...mentioning

confidence: 99%

ERS International Congress 2023: highlights from the Thoracic Oncology Assembly

Catarata,

Creamer,

Dias

et al. 2023

ERJ Open Res

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Lung cancer is the leading cause of cancer mortality in the world. It greatly affects the patients’ quality of life, being a challenge for the daily practice in Respiratory Medicine. Advances in the genetic knowledge of thoracic tumours mutational landscape, the development of targeted therapies and immune checkpoint inhibitors, led to a paradigm shift in the treatment of lung cancer and pleural mesothelioma. During the annual ERS Congress in Milan, Italy, experts from all over the world presented their high-quality research and reviewed best clinical practices. Lung cancer screening, management of early-stages of lung cancer, application of artificial intelligence and biomarkers were discussed and they will be summarised here.

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Treatment of Oligometastatic Non-Small Cell Lung Cancer: An ASTRO/ESTRO Clinical Practice Guideline

Cited by 40 publications

References 71 publications

Combining stereotactic body radiotherapy with immunotherapy in stage IV non-small cell lung cancer

Combining stereotactic body radiotherapy with immunotherapy in stage IV non-small cell lung cancer

Therapy for Stage IV Non–Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2023.3

ERS International Congress 2023: highlights from the Thoracic Oncology Assembly

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