प्रणालीगत चिकित्सा के दौरान ओलिगोप्रोग्रेशन के साथ EGFR-म्यूटेंट NSCLC और ऑन्कोजीन-संचालित ट्यूमर में फुफ्फुसीय मेटास्टेसिस का उपचार

References

DOI: 10.21037/asj-21-81

• Oligoprogressive disease includes situations in which the tumor is not limited to a single or few metastatic lesions, but the failure of the initial systemic treatment is represented by a limited number of sites, potentially suitable for loco-regional approaches.
• Notably, this occurrence has been largely described in oncogenic-driven tumors, such as EGFR-mutant NSCLC.
• The development of new isolated lesions in a disease which is otherwise under control during systemic treatment creates a good opportunity for loco-regional approaches including surgery and radiation therapy, as such treatments might succeed in ablating a lesion characterized by cell clones resistant to the systemic therapy, hence potentially delaying the occurrence of actual, systemic progression requiring the switch to a subsequent line of therapy.
• In a study of ablative treatments in association with TKIs for NSCLC, patients receiving crizotinib for ALK-rearranged NSCLC (n=38) or erlotinib for EGFR-mutant NSCLC (n=27) were treated with local ablative treatments (either surgery or radiotherapy), resulting in approximately 6 months of additional disease control.
• The occurrence of oligoprogression can be treated with local approaches (in this case, preferably radiation therapy).