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Updated: Oct 23, 2025
Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Current and future research efforts in oligometastatic non-small cell lung cancer-a systematic review
Mariana Brandão1, Valérie Durieux2, Thierry Berghmans1
1Clinic of Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Background:
Major progresses in the systemic treatment of non-small cell lung cancer (NSCLC) were obtained during the last decade, including the use of immunotherapy and tyrosine kinase inhibitors (TKIs), with impressive results in terms of response and survival rates. Moreover, novel imaging and radiotherapy techniques have allowed the development of stereotactic body radiotherapy (SBRT), with high rates of local disease control and minimal toxicity. These factors propelled the use of combined systemic and local treatment strategies in patients with a low burden of metastases-the oligometastatic disease (OMD).
Methods:
We systematically review the evidence from prospective randomized and non-randomized trials on local ablative therapy for OMD NSCLC published until June 2020. In addition, we present a review of the ongoing and/or recruiting trials in the field.
Results:
We included 16 articles, reporting on 14 prospective clinical trials, starting from the pilot trial conducted in the early 2000's to the recent randomized trials that have showed benefits in survival. We found 24 ongoing trials, which combine multiple local ablative regimens with new systemic therapies, such as new generation TKIs and immunotherapy.
Discussion:
Despite these vast current and ongoing prospective research efforts, there are several issues that impair the generalizability of their findings. These include the heterogeneous definition of OMD, trial design, staging, patient selection, tumor mutational status and treatments used, which may limit their applicability in the clinical practice.
Insights
Systemic therapies and SBRT have advanced non-small cell lung cancer (NSCLC) treatment for oligometastatic disease (OMD). However, inconsistent definitions and trial designs hinder the widespread clinical application of these combined strategies.
Area of Science:
- Oncology
- Pulmonology
- Radiotherapy
Background:
- Recent advancements in systemic treatments like immunotherapy and tyrosine kinase inhibitors (TKIs) have significantly improved outcomes for non-small cell lung cancer (NSCLC).
- Stereotactic body radiotherapy (SBRT) has emerged as an effective local treatment option with high disease control rates and low toxicity.
- The combination of systemic therapies and SBRT has led to the development of treatment strategies for oligometastatic disease (OMD) in NSCLC patients.
Purpose of the Study:
- To systematically review existing evidence on local ablative therapy for OMD NSCLC from prospective trials.
- To provide an overview of ongoing clinical trials investigating combined treatment approaches for OMD NSCLC.
Main Methods:
- Systematic review of prospective randomized and non-randomized trials published up to June 2020.
- Inclusion of data from 16 articles reporting on 14 prospective clinical trials.
- Compilation of information on 24 ongoing and recruiting trials.
Main Results:
- Evidence from early pilot studies to recent randomized trials demonstrates survival benefits for OMD NSCLC treated with local ablative therapy.
- Numerous ongoing trials are exploring combinations of various local ablative techniques with novel systemic therapies, including next-generation TKIs and immunotherapies.
Conclusions:
- Despite promising research, the generalizability of findings is limited by heterogeneous definitions of OMD, varied trial designs, and inconsistencies in staging, patient selection, and treatment modalities.
- Further standardization in research methodology is crucial for the effective clinical application of combined treatment strategies in OMD NSCLC.
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