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Lung cancer

Local therapy, global benefits?

Nature Reviews Clinical Oncology volume 14, page 4 (2017)Cite this article

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Retrospective data indicate that failure of first-line chemotherapy in patients with non-small-cell lung cancer and ≤3 metastases occurs mostly at lesions known to exist prior to treatment, and that advances in local and maintenance therapies can be leveraged to improve survival. This possibility has now been tested prospectively in a phase II trial.

Patients with at least stable disease after first-line treatment were randomly assigned to receive either local treatment plus optional maintenance therapy, or maintenance therapy or observation alone. As first author Daniel Gomez explains, “the intention was to make the trial pragmatic in nature, allowing physicians to deliver the treatment that they would in their clinic. For example, we allowed for variations in frontline treatment based on the presence of EGFR or ALK alterations, permitted treatment of CNS lesions prior to systemic therapy, and put no major restrictions on the use of local therapies.”

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References

  1. Gomez, D. R. 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. http://dx.doi.org/10.1016/S1470-2045(16)30532-0 (2016)

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  1. David Killock
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Killock, D. Local therapy, global benefits?. Nat Rev Clin Oncol 14, 4 (2017). https://doi.org/10.1038/nrclinonc.2016.187

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