Department of Radiation Oncology, International Center for Thoracic Cancers (CICT), Gustave Roussy, F-94805 Villejuif, France.
Department of Cancer Medicine, International Center for Thoracic Cancers (CICT), Gustave Roussy, F-94805 Villejuif, France.
Cancer Treat Rev. 2023 Nov;120:102621. doi: 10.1016/j.ctrv.2023.102621. Epub 2023 Sep 2.
Progresses of systemic treatments in advanced non-small cell lung cancer (NSCLC), such as immune checkpoint blockers (ICB) and targeted therapies, led to the increased incidence of oligoprogressive disease (OPD). The OPD is a subtype of oligometastatic disease (OMD) defined as a progression of a limited number of lesions during systemic treatment exposure. The hypothesis was formulated that local radical treatments (LRT) could eradicate progressive lesions resulting from resistant clones, ultimately leading to systemic treatment sensitivity restoration. Recently published international consensuses and guidelines aim to obtain a uniform definition of OMD NSCLC, to standardize the inclusion of these patients in future clinical trials, as well as their management in daily practice. Although there is no specific definition of OPD, LRT strategies in OPD are supported after reporting promising results. Both retrospective and preliminary prospective randomized data of LRT for patients with OPD NSCLC are encouraging. More clinical and translational data are needed for selecting best scenarios where LRT should be delivered. In this review, we analyze the current available literature on LRT for patients with OPD in advanced NSCLC and discuss about future trial design and challenges.
晚期非小细胞肺癌（NSCLC）的系统治疗进展，如免疫检查点抑制剂（ICB）和靶向治疗，导致寡进展性疾病（OPD）的发病率增加。OPD 是寡转移性疾病（OMD）的一种亚型，定义为在系统治疗暴露期间有限数量的病变进展。提出了这样的假设，即局部根治性治疗（LRT）可以根除耐药克隆引起的进展性病变，最终导致系统治疗敏感性恢复。最近发表的国际共识和指南旨在获得 OMD NSCLC 的统一定义，规范将这些患者纳入未来临床试验，并在日常实践中对其进行管理。尽管 OPD 没有特定的定义，但在报告有希望的结果后，支持 OPD 的 LRT 策略。OPD 患者接受 LRT 的回顾性和初步前瞻性随机数据令人鼓舞。需要更多的临床和转化数据来选择最佳的 LRT 应用场景。在这篇综述中，我们分析了晚期 NSCLC 中 OPD 患者接受 LRT 的现有文献，并讨论了未来的试验设计和挑战。
