June 6, 2016, MD Anderson Cancer Center -- Lung cancer patients with oliogometastases, defined as three or fewer sites of metastasis, may benefit from aggressive local therapy, surgery or radiation, after standard chemotherapy, according to research led by The University of Texas MD Anderson Cancer Center. If validated in larger studies, the findings could represent a dramatic shift in clinical care for thousands of lung cancer patients.
Daniel Gomez, M.D., associate professor, Radiation Oncology, will present the results June 6 in an oral presentation at the 2016 American Society of Clinical Oncology Annual Meeting. He and his colleagues found an eight month progression free survival benefit (PFS) in patients treated with local consolidative therapy (LCT).
According to the American Cancer Society, 224,390 people will be diagnosed with lung cancer and 158,080 will die from the disease in the U.S. this year. Of those diagnosed, says Gomez, approximately 50 percent have metastatic disease, and it has estimated that about 20-50 percent present with three or fewer metastases.
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Historically, explains Gomez, all metastatic lung cancer patients have been treated with chemotherapy and thought to have incurable disease. With treatment advances over the past decade, however, a number of retrospective studies have suggested that in those lung cancer patients with minimal metastases, theoretically, the disease could be better controlled long-term by LCT.
"With recent advances in radiation delivery, targeted agents and systemic and maintenance therapy, some research has suggested it's possible to control the disease. Yet those studies have inherent bias because patients treated with local consolidative therapy were selected due to favorable risk factors," explains Gomez, the study's corresponding author.
"Our research is the first randomized prospective study of oligometastases in lung cancer to look at treating patients aggressively and comparing results to standard therapy, which typically is maintenance therapy or observation."
The prospective Phase II study was planned for 94 patients; however, because of the benefit seen in the study arm, the trial was stopped early. In total, the study enrolled and evaluated 49 non-small cell lung cancer patients from three participating centers, with MD Anderson serving as the lead site. All patients had: Stage IV disease; three or fewer metastases and no progression after initial treatment with chemotherapy. The study's primary endpoint was PFS.
