Radiation in the Treatment of Oligometastatic and Oligoprogressive Disease: Rationale, Recent Data, and Research Questions.
Ablation Techniques
/ methods
Biomarkers, Tumor
/ analysis
Clinical Trials, Phase III as Topic
Evidence-Based Medicine
/ methods
Humans
Neoplasm Metastasis
/ diagnosis
Neoplasms
/ diagnosis
Patient Selection
Progression-Free Survival
Radiation Oncology
/ methods
Radiosurgery
/ methods
Randomized Controlled Trials as Topic
Time-to-Treatment
/ standards
Journal
Cancer journal (Sudbury, Mass.)
ISSN: 1540-336X
Titre abrégé: Cancer J
Pays: United States
ID NLM: 100931981
Informations de publication
Date de publication:
Historique:
entrez:
25
3
2020
pubmed:
25
3
2020
medline:
27
4
2021
Statut:
ppublish
Résumé
The use of local ablative therapy or metastasis-directed therapy is an emerging management paradigm in oligometastatic and oligoprogressive cancer. Recent randomized evidence has demonstrated that stereotactic ablative radiotherapy (SABR) targeting all metastatic deposits is tolerable and can improve progression-free and overall survival. While SABR is noninvasive, minimally toxic, and generally safe, rare grade 5 events have been reported. Given this and recognizing the often-uncertain prognosis of patients with metastatic disease, equipoise persists regarding the therapeutic window within which to deploy SABR for this indication. Ongoing phase III trials are aimed at validating the demonstrated safety, tolerability, and survival benefits while also refining patient selection, possibly with the aid of novel biomarkers. This narrative review of the role of SABR in oligometastatic and oligoprogressive disease summarizes recent randomized evidence and ongoing clinical trials, discusses our rationale for treatment and key management principles, and posits that SABR should be considered the preferred modality for multisite, metastasis-directed ablative therapy.
Identifiants
pubmed: 32205541
doi: 10.1097/PPO.0000000000000436
pii: 00130404-202003000-00011
doi:
Substances chimiques
Biomarkers, Tumor
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
156-165Références
Palma DA, Salama JK, Lo SS, et al. The oligometastatic state—separating truth from wishful thinking. Nat Rev Clin Oncol. 2014;11:549–557.
Patel PH, Palma D, McDonald F, et al. The dandelion dilemma revisited for oligoprogression: treat the whole lawn or weed selectively? Clin Oncol (R Coll Radiol). 2019;31:824–833.
Collen C, Christian N, Schallier D, et al. Phase II study of stereotactic body radiotherapy to primary tumor and metastatic locations in oligometastatic nonsmall-cell lung cancer patients. Ann Oncol. 2014;25:1954–1959.
Olson R, Senan S, Harrow S, et al. Quality of life outcomes after stereotactic ablative radiation therapy (SABR) versus standard of care treatments in the oligometastatic setting: a secondary analysis of the SABR-COMET randomized trial. Int J Radiat Oncol Biol Phys. 2019;105:943–947.
Wintner LM, Giesinger JM, Zabernigg A, et al. Quality of life during chemotherapy in lung cancer patients: results across different treatment lines. Br J Cancer. 2013;109:2301–2308.
Vilela RA, Navarro NF, Faria ET, et al. Use of stereotactic body radiation therapy for oligometastatic recurrent prostate cancer: a systematic review. J Med Imaging Radiat Oncol. 2018;62:692–706.
Ost P, Reynders D, Decaestecker K, et al. Surveillance or metastasis-directed therapy for oligometastatic prostate cancer recurrence: a prospective, randomized, multicenter phase II trial. J Clin Oncol. 2018;36:446–453.
Iyengar P, Wardak Z, Gerber DE, et al. Consolidative radiotherapy for limited metastatic non–small-cell lung cancer: a phase 2 randomized clinical trial. JAMA Oncol. 2018;4:e173501.
Gomez DR, Tang C, Zhang J, et al. Local consolidative therapy vs. maintenance therapy or observation for patients with oligometastatic non–small-cell lung cancer: long-term results of a multi-institutional, phase II, randomized study. J Clin Oncol. 2019;37:1558–1565.
Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. Lancet. 2019;393:2051–2058.
Phillips R, Lim SJ, Shi WY, et al. Primary outcomes of a phase II randomized trial of observation versus stereotactic ablative RadiatIon for OLigometastatic prostate CancEr (ORIOLE). Int J Radiat Oncol Biol Phys. 2019;105:681.
Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy for the comprehensive treatment of 4–10 oligometastatic tumors (SABR-COMET-10): study protocol for a randomized phase III trial. BMC Cancer. 2019;19:816.
Gomez DR, Blumenschein GR Jr., Lee JJ, et al. Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non–small-cell lung cancer without progression after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study. Lancet Oncol. 2016;17:1672–1682.
Radwan N, Phillips R, Ross A, et al. A phase II randomized trial of observation versus stereotactic ablative RadiatIon for OLigometastatic prostate CancEr (ORIOLE). BMC Cancer. 2017;17:453.
Qu MX, Chen Y, Zaric G, et al. Is SABR cost-effective in oligometastatic cancer? An economic analysis of SABR-COMET. Int J Radiat Oncol Biol Phys. 1052019.
Twyman-Saint Victor C, Rech AJ, Maity A, et al. Radiation and dual checkpoint blockade activate non-redundant immune mechanisms in cancer. Nature. 2015;520:373–377.
Riihimäki M, Thomsen H, Hemminki A, et al. Comparison of survival of patients with metastases from known versus unknown primaries: survival in metastatic cancer. BMC Cancer. 2013;13:36.
Al-Shafa F, Arifin AJ, Rodrigues GB, et al. A review of ongoing trials of stereotactic ablative radiotherapy for oligometastatic cancers: where will the evidence lead? Front Oncol. 2019;9:543.
Yu HA, Arcila ME, Rekhtman N, et al. Analysis of tumor specimens at the time of acquired resistance to EGFR-TKI therapy in 155 patients with EGFR-mutant lung cancers. Clin Cancer Res. 2013;19:2240–2247.
Scher HI, Morris MJ, Stadler WM, et al. Trial design and objectives for castration-resistant prostate cancer: updated recommendations from the Prostate Cancer Clinical Trials Working Group 3. J Clin Oncol. 2016;34:1402–1418.
Camidge DR, Pao W, Sequist LV. Acquired resistance to TKIs in solid tumours: learning from lung cancer. Nat Rev Clin Oncol. 2014;11:473–481.
Iyengar P, Kavanagh BD, Wardak Z, et al. Phase II trial of stereotactic body radiation therapy combined with erlotinib for patients with limited but progressive metastatic non–small-cell lung cancer. J Clin Oncol. 2014;32:3824–3830.
Weickhardt AJ, Scheier B, Burke JM, et al. Local ablative therapy of oligoprogressive disease prolongs disease control by tyrosine kinase inhibitors in oncogene-addicted non–small-cell lung cancer. J Thorac Oncol. 2012;7:1807–1814.
Chan OSH, Lee VHF, Mok TSK, et al. The role of radiotherapy in epidermal growth factor receptor mutation–positive patients with oligoprogression: a matched-cohort analysis. Clin Oncol (R Coll Radiol). 2017;29:568–575.
Triggiani L, Alongi F, Buglione M, et al. Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study. Br J Cancer. 2017;116:1520–1525.
Merino Lara T, Helou J, Poon I, et al. Multisite stereotactic body radiotherapy for metastatic non–small-cell lung cancer: delaying the need to start or change systemic therapy? Lung Cancer. 2018;124:219–226.
Santini D, Ratta R, Pantano F, et al. Outcome of oligoprogressing metastatic renal cell carcinoma patients treated with locoregional therapy: a multicenter retrospective analysis. Oncotarget. 2017;8:100708–100716.
Sequist LV, Waltman BA, Dias-Santagata D, et al. Genotypic and histological evolution of lung cancers acquiring resistance to EGFR inhibitors. Sci Transl Med. 2011;3:75ra26.
Qiu B, Liang Y, Li Q, et al. Local therapy for oligoprogressive disease in patients with advanced stage non–small-cell lung cancer harboring epidermal growth factor receptor mutation. Clin Lung Cancer. 2017;18:e369–e373.
Yu HA, Arcila ME, Rekhtman N, et al. Analysis of tumor specimens at the time of acquired resistance to EGFR-TKI therapy in 155 patients with EGFR-mutant lung cancers. Clin Cancer Res. 2013;19:2240–2247.
Kelly P, Ma Z, Baidas S, et al. Patterns of progression in metastatic Estrogen receptor positive breast cancer: an argument for local therapy. Int J Breast Cancer. 2017;2017:1367159.
Morgan RL, Camidge DR. Reviewing RECIST in the era of prolonged and targeted therapy. J Thorac Oncol. 2018;13:154–164.
De Wolf K, Rottey S, Vermaelen K, et al. Combined high dose radiation and pazopanib in metastatic renal cell carcinoma: a phase I dose escalation trial. Radiat Oncol. 2017;12:157.
Correa RJ, Salama JK, Milano MT, et al. Stereotactic body radiotherapy for oligometastasis: opportunities for biology to guide clinical management. Cancer J. 2016;22:247–256.
Luke JJ, Lemons JM, Karrison TG, et al. Safety and clinical activity of pembrolizumab and multisite stereotactic body radiotherapy in patients with advanced solid tumors. J Clin Oncol. 2018;36:1611–1618.
Hu ZI, McArthur HL, Ho AY. The abscopal effect of radiation therapy: what is it and how can we use it in breast cancer? Curr Breast Cancer Rep. 2017;9:45–51.
McBride SM, Sherman EJ, Tsai CJ, et al. A phase II randomized trial of nivolumab with stereotactic body radiotherapy (SBRT) versus nivolumab alone in metastatic (M1) head and neck squamous cell carcinoma (HNSCC). J Clin Oncol. 2018;36(suppl 15):6009.
Theelen W, Peulen HMU, Lalezari F, et al. Effect of pembrolizumab after stereotactic body radiotherapy vs pembrolizumab alone on tumor response in patients with advanced non–small cell lung cancer: results of the PEMBRO-RT phase 2 randomized clinical trial. JAMA Oncol. 2019;5:1276.
Shaverdian N, Lisberg AE, Bornazyan K, et al. Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non–small-cell lung cancer: a secondary analysis of the KEYNOTE-001 phase 1 trial. Lancet Oncol. 2017;18:895–903.
Parker CC, James ND, Brawley CD, et al. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial. Lancet. 2018;392:2353–2366.
Chen M, You R, You-Ping L, et al. Chemotherapy plus local-regional radiotherapy versus chemotherapy alone in primary metastatic nasopharyngeal carcinoma: a randomized, open-label, phase III trial. Annals of Oncology. 2019;30(suppl 5).
Palma DA, Louie AV, Rodrigues GB. New strategies in stereotactic radiotherapy for oligometastases. Clin Cancer Res. 2015;21:5198–5204.
Hong JC, Ayala-Peacock DN, Lee J, et al. Classification for long-term survival in oligometastatic patients treated with ablative radiotherapy: a multi-institutional pooled analysis. PLoS One. 2018;13:e0195149.
Tang C, Lee WC, Chang L, et al. Radiation induced changes in the circulating T-cell repertoire and circulating tumor DNA in oligometastatic NSCLC; translational correlatives from a mature randomized phase II trial. Int J Radiat Oncol Biol Phys. 2019;105:S25.
Chmura SJ, Winter KA, Al-Hallaq HA, et al. NRG-BR002: a phase IIR/III trial of standard of care therapy with or without stereotactic body radiotherapy (SBRT) and/or surgical ablation for newly oligometastatic breast cancer (NCT02364557). https://doiorg/101200/JCO20193715_supplTPS1117. 2019;37(15_suppl):TPS1117.