The Spectrum of Metastasis: An Opportunity for Cure?

In this review, we outline the clinical and biologic evidence supporting the existence of an oligometastatic state. We first discuss the surgical and radiotherapeutic data that demonstrate clear benefits to cancer-specific outcomes with local ablative therapy in subsets of patients with metastatic disease. We then delve into the evolving preclinical and translational studies already beginning to define the biology of oligometastasis, with a specific focus on the genetics, epigenetics, and immunologic aspects of oligometastatic disease. We conclude by highlighting the importance of focusing significant effort as a research community on developing an integrated clinical-molecular classification of metastatic disease to personalize treatment for patients with potentially curable oligometastatic disease.