Oligoprogression in Non-Small Cell Lung Cancer

Area of Science:

• Oncology
• Radiation Oncology
• Medical Oncology

Background:

• Oligoprogressive disease (OPD) is a pattern of limited metastatic progression in advanced non-small cell lung cancer (NSCLC).
• The frequency of OPD varies widely (15-47%) based on definition and patient population.
• Understanding OPD is crucial for optimizing treatment strategies in advanced NSCLC.

Purpose of the Study:

• To review the current literature on oligoprogressive disease (OPD) and local ablative therapy (LAT) in advanced non-small cell lung cancer (NSCLC).
• To evaluate the efficacy and implications of continuing anticancer agents after LAT for OPD.
• To explore the role of LAT in conjunction with immune checkpoint inhibitors (ICIs) for OPD.

Main Methods:

• Literature review of studies investigating oligoprogressive disease (OPD) and local ablative therapy (LAT) in advanced non-small cell lung cancer (NSCLC).
• Analysis of retrospective data supporting the continuation of systemic therapy after LAT for OPD.
• Examination of studies involving immune checkpoint inhibitors (ICIs) and LAT in the context of OPD.

Main Results:

• Retrospective evidence supports continuing systemic therapy after LAT for OPD, a strategy included in some clinical guidelines.
• OPD cases treated with immune checkpoint inhibitors (ICIs) show a relatively promising prognosis.
• LAT combined with first-line ICI and chemotherapy may potentially overcome treatment resistance via an abscopal effect.

Conclusions:

• Continuing systemic therapy after LAT for oligoprogressive disease (OPD) in advanced non-small cell lung cancer (NSCLC) is a viable strategy supported by retrospective data.
• Local ablative therapy (LAT) may enhance the efficacy of immune checkpoint inhibitors (ICIs) in managing OPD, possibly through abscopal effects.
• Prospective comparative studies are essential to determine optimal therapeutic methods, timing, and patient selection for long-term survival in advanced NSCLC with OPD.