Chang Enoch, Sherry Alexander D, Liermann Jakob, Abdollahi Amir, Tzeng Ching-Wei D, Tang Chad, Aguilera Todd A, Koay Eugene J, Das Prajnan, Koong Albert C, Pant Shubham, Ludmir Ethan B
Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
J Gastrointest Cancer. 2025 Jan 18;56(1):47. doi: 10.1007/s12029-024-01145-0.
Multiple randomized trials have suggested that the addition of comprehensive metastasis-directed therapy to best systemic therapy improves disease control and survival among patients with oligometastatic disease, even for histologies with a high propensity for rapid spread. Here, we review the growing literature supporting the oligometastatic paradigm in pancreatic ductal adenocarcinoma. We summarize key details from nascent institutional series and reflect on the recently reported phase II randomized EXTEND trial. We discuss various strategies for enhancing the clinical and technical implementation of metastasis-directed therapy in this patient population. Lastly, we highlight multiple ongoing landmark trials seeking to optimize and validate the role of metastasis-directed therapy in oligometastatic pancreatic cancer. Ultimately, these and other continued clinical and translational research efforts will be critical to improve care and outcomes for patients with oligometastatic pancreatic ductal adenocarcinoma.
多项随机试验表明，在最佳全身治疗基础上加用全面的转移灶定向治疗可改善寡转移疾病患者的疾病控制情况和生存率，即使对于具有快速扩散高倾向的组织学类型亦是如此。在此，我们回顾了支持胰腺导管腺癌寡转移模式的不断增加的文献。我们总结了新兴机构系列研究的关键细节，并对最近报道的II期随机EXTEND试验进行了思考。我们讨论了在该患者群体中加强转移灶定向治疗临床和技术实施的各种策略。最后，我们强调了多项正在进行的具有里程碑意义的试验，这些试验旨在优化和验证转移灶定向治疗在寡转移胰腺癌中的作用。最终，这些以及其他持续的临床和转化研究工作对于改善寡转移胰腺导管腺癌患者的治疗和预后至关重要。
