Oligometastatic non‐small cell lung cancer: Impact of local and contemporary systemic treatment approaches on clinical outcome
Oligometastatic (OMD) non‐small cell lung cancer (NSCLC) is a distinct but heterogeneous entity. Current guidelines recommend systemic therapy and consolidation with local ablative therapy (LAT). However, evidence regarding the optimal choice of multimodal treatment approaches is lacking, in particu...
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| Veröffentlicht in: | International journal of cancer 2025-02, Vol.156 (4), p.776-787 |
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| creator | Wiesweg, Marcel Küter, Claudia Schnorbach, Johannes Keyl, Julius Metzenmacher, Martin Cvetkovic, Jelena Saalfeld, Felix Carl Glanemann, Franziska Eberhardt, Wilfried Oezkan, Filiz Theegarten, Dirk Stenzinger, Albrecht Darwiche, Kaid Koschel, Dirk Herth, Felix Bölükbas, Servet Winter, Hauke Weykamp, Fabian Wermke, Martin Stuschke, Martin Plönes, Till Thomas, Michael Schuler, Martin Christopoulos, Petros |
| description | Oligometastatic (OMD) non‐small cell lung cancer (NSCLC) is a distinct but heterogeneous entity. Current guidelines recommend systemic therapy and consolidation with local ablative therapy (LAT). However, evidence regarding the optimal choice of multimodal treatment approaches is lacking, in particular with respect to the integration of immunotherapy. This real‐world study identified 218 patients with OMD NSCLC (2004–2023, prespecified criteria: ≤5 metastases in ≤2 organ systems) from three major German comprehensive cancer centers. Most patients had one (72.5%) or two (17.4%) metastatic lesions in a single (89.9%) organ system. Overall survival (OS) was significantly longer with a single metastatic lesion (HR 0.54, p = .003), and female gender (HR 0.4, p |
| doi_str_mv | 10.1002/ijc.35199 |
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What's new?
The current treatment recommendations for oligometastatic non‐small cell lung cancer are based on evidence gathered prior to the immunotherapy era. This multicenter cohort study of 218 patients over the 2004–2023 period provides updated evidence that may guide the choice of systemic therapy for patients with oligometastatic non‐small cell lung cancer. The findings provide evidence supporting the benefit of multimodality approaches integrating immunotherapy‐based systemic treatment and local ablation of all cancer sites. Treatment goals should be prolonged disease control, with long‐term survival achievable in a subset of patients.</description><identifier>ISSN: 0020-7136</identifier><identifier>ISSN: 1097-0215</identifier><identifier>EISSN: 1097-0215</identifier><identifier>DOI: 10.1002/ijc.35199</identifier><identifier>PMID: 39319506</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cancer therapies ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - therapy ; Chemotherapy ; Combined Modality Therapy ; Female ; Humans ; Immune checkpoint inhibitors ; Immunotherapy ; Immunotherapy - methods ; locally ablative treatment ; Lung cancer ; Lung Neoplasms - drug therapy ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lung Neoplasms - therapy ; Male ; Metastases ; Metastasis ; Middle Aged ; multimodal concepts ; Neoplasm Metastasis ; Non-small cell lung carcinoma ; observational study ; oligometastatic NSCLC ; Patients ; RESEARCH ARTICLE ; Retrospective Studies ; Sensory integration ; Small cell lung carcinoma ; Treatment Outcome</subject><ispartof>International journal of cancer, 2025-02, Vol.156 (4), p.776-787</ispartof><rights>2024 The Author(s). published by John Wiley & Sons Ltd on behalf of UICC.</rights><rights>2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3349-7572b7665761447fc85c965788e9212f847600be662230a397d5c7adaf5764dc3</cites><orcidid>0000-0003-4284-3586 ; 0000-0002-9698-9559 ; 0000-0003-1001-103X ; 0000-0001-9511-055X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijc.35199$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijc.35199$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39319506$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wiesweg, Marcel</creatorcontrib><creatorcontrib>Küter, Claudia</creatorcontrib><creatorcontrib>Schnorbach, Johannes</creatorcontrib><creatorcontrib>Keyl, Julius</creatorcontrib><creatorcontrib>Metzenmacher, Martin</creatorcontrib><creatorcontrib>Cvetkovic, Jelena</creatorcontrib><creatorcontrib>Saalfeld, Felix Carl</creatorcontrib><creatorcontrib>Glanemann, Franziska</creatorcontrib><creatorcontrib>Eberhardt, Wilfried</creatorcontrib><creatorcontrib>Oezkan, Filiz</creatorcontrib><creatorcontrib>Theegarten, Dirk</creatorcontrib><creatorcontrib>Stenzinger, Albrecht</creatorcontrib><creatorcontrib>Darwiche, Kaid</creatorcontrib><creatorcontrib>Koschel, Dirk</creatorcontrib><creatorcontrib>Herth, Felix</creatorcontrib><creatorcontrib>Bölükbas, Servet</creatorcontrib><creatorcontrib>Winter, Hauke</creatorcontrib><creatorcontrib>Weykamp, Fabian</creatorcontrib><creatorcontrib>Wermke, Martin</creatorcontrib><creatorcontrib>Stuschke, Martin</creatorcontrib><creatorcontrib>Plönes, Till</creatorcontrib><creatorcontrib>Thomas, Michael</creatorcontrib><creatorcontrib>Schuler, Martin</creatorcontrib><creatorcontrib>Christopoulos, Petros</creatorcontrib><title>Oligometastatic non‐small cell lung cancer: Impact of local and contemporary systemic treatment approaches on clinical outcome</title><title>International journal of cancer</title><addtitle>Int J Cancer</addtitle><description>Oligometastatic (OMD) non‐small cell lung cancer (NSCLC) is a distinct but heterogeneous entity. Current guidelines recommend systemic therapy and consolidation with local ablative therapy (LAT). However, evidence regarding the optimal choice of multimodal treatment approaches is lacking, in particular with respect to the integration of immunotherapy. This real‐world study identified 218 patients with OMD NSCLC (2004–2023, prespecified criteria: ≤5 metastases in ≤2 organ systems) from three major German comprehensive cancer centers. Most patients had one (72.5%) or two (17.4%) metastatic lesions in a single (89.9%) organ system. Overall survival (OS) was significantly longer with a single metastatic lesion (HR 0.54, p = .003), and female gender (HR 0.4, p < .001). Median OS of the full cohort was 27.8 months, with 29% survival at 5 years. Patients who had completed LAT to all NSCLC sites, typically excluding patients with early progression, had a median OS of 34.4 months (37.7% 5‐year OS rate) with a median recurrence‐free survival (RFS) of 10.9 months (13.3% at 5 years). In those patients, systemic treatment as part of first‐line therapy was associated with doubling of RFS (12.3 vs. 6.4 months, p < .001). Despite limited follow‐up of patients receiving chemo‐immunotherapy (EU approval 2018/2019), RFS was greatly improved by adding checkpoint inhibitors to chemotherapy (HR 0.44, p = .008, 2‐year RFS 51.4% vs. 15.1%). In conclusion, patients with OMD NSCLC benefitted from multimodality approaches integrating systemic therapy and local ablation of all cancer sites. A substantial proportion of patients achieved extended OS, suggesting a potential for cure that can be further augmented with the addition of immunotherapy.
What's new?
The current treatment recommendations for oligometastatic non‐small cell lung cancer are based on evidence gathered prior to the immunotherapy era. This multicenter cohort study of 218 patients over the 2004–2023 period provides updated evidence that may guide the choice of systemic therapy for patients with oligometastatic non‐small cell lung cancer. The findings provide evidence supporting the benefit of multimodality approaches integrating immunotherapy‐based systemic treatment and local ablation of all cancer sites. Treatment goals should be prolonged disease control, with long‐term survival achievable in a subset of patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer therapies</subject><subject>Carcinoma, Non-Small-Cell Lung - drug therapy</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - therapy</subject><subject>Chemotherapy</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Immune checkpoint inhibitors</subject><subject>Immunotherapy</subject><subject>Immunotherapy - methods</subject><subject>locally ablative treatment</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - therapy</subject><subject>Male</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>multimodal concepts</subject><subject>Neoplasm Metastasis</subject><subject>Non-small cell lung carcinoma</subject><subject>observational study</subject><subject>oligometastatic NSCLC</subject><subject>Patients</subject><subject>RESEARCH ARTICLE</subject><subject>Retrospective Studies</subject><subject>Sensory integration</subject><subject>Small cell lung carcinoma</subject><subject>Treatment Outcome</subject><issn>0020-7136</issn><issn>1097-0215</issn><issn>1097-0215</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kcGOFCEQhonRuOPqwRcwJF700LvQ0DB4MWay6phN9qJnwtD0LBMaWqA1c9tH8Bn3Saxx1o2aeIFU6qufn_oRek7JGSWkPfc7e8Y6qtQDtKBEyYa0tHuIFtAjjaRMnKAnpewIobQj_DE6YYpR1RGxQDdXwW_T6Kop1VRvcUzx9uZHGU0I2Do4why32JpoXX6D1-NkbMVpwCFZE7CJPbYpVjdOKZu8x2VfoACdmp2po4sVm2nKydhrV3CK2AYf_WE0zdXCw0_Ro8GE4p7d3afoy_uLz6uPzeXVh_Xq3WVjGeOqkZ1sN1KITgrKuRzssrMKquXSqZa2w5JLQcjGCdG2jBimZN9ZaXozwATvLTtFb4-607wZXW_BWTZBT9mP4Fsn4_Xfneiv9TZ905QKAWtToPDqTiGnr7MrVY--HFZkoktz0QxWzxltyRLQl_-guzTnCP8DikvOIZ8OqNdHyuZUSnbDvRtK9CFYDcHqX8EC--JP-_fk7yQBOD8C331w-_8r6fWn1VHyJz40r2E</recordid><startdate>20250215</startdate><enddate>20250215</enddate><creator>Wiesweg, Marcel</creator><creator>Küter, Claudia</creator><creator>Schnorbach, Johannes</creator><creator>Keyl, Julius</creator><creator>Metzenmacher, Martin</creator><creator>Cvetkovic, Jelena</creator><creator>Saalfeld, Felix Carl</creator><creator>Glanemann, Franziska</creator><creator>Eberhardt, Wilfried</creator><creator>Oezkan, Filiz</creator><creator>Theegarten, Dirk</creator><creator>Stenzinger, Albrecht</creator><creator>Darwiche, Kaid</creator><creator>Koschel, Dirk</creator><creator>Herth, Felix</creator><creator>Bölükbas, Servet</creator><creator>Winter, Hauke</creator><creator>Weykamp, Fabian</creator><creator>Wermke, Martin</creator><creator>Stuschke, Martin</creator><creator>Plönes, Till</creator><creator>Thomas, Michael</creator><creator>Schuler, Martin</creator><creator>Christopoulos, Petros</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4284-3586</orcidid><orcidid>https://orcid.org/0000-0002-9698-9559</orcidid><orcidid>https://orcid.org/0000-0003-1001-103X</orcidid><orcidid>https://orcid.org/0000-0001-9511-055X</orcidid></search><sort><creationdate>20250215</creationdate><title>Oligometastatic non‐small cell lung cancer: Impact of local and contemporary systemic treatment approaches on clinical outcome</title><author>Wiesweg, Marcel ; Küter, Claudia ; Schnorbach, Johannes ; Keyl, Julius ; Metzenmacher, Martin ; Cvetkovic, Jelena ; Saalfeld, Felix Carl ; Glanemann, Franziska ; Eberhardt, Wilfried ; Oezkan, Filiz ; Theegarten, Dirk ; Stenzinger, Albrecht ; Darwiche, Kaid ; Koschel, Dirk ; Herth, Felix ; Bölükbas, Servet ; Winter, Hauke ; Weykamp, Fabian ; Wermke, Martin ; Stuschke, Martin ; Plönes, Till ; Thomas, Michael ; Schuler, Martin ; Christopoulos, Petros</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3349-7572b7665761447fc85c965788e9212f847600be662230a397d5c7adaf5764dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer therapies</topic><topic>Carcinoma, Non-Small-Cell Lung - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wiesweg, Marcel</au><au>Küter, Claudia</au><au>Schnorbach, Johannes</au><au>Keyl, Julius</au><au>Metzenmacher, Martin</au><au>Cvetkovic, Jelena</au><au>Saalfeld, Felix Carl</au><au>Glanemann, Franziska</au><au>Eberhardt, Wilfried</au><au>Oezkan, Filiz</au><au>Theegarten, Dirk</au><au>Stenzinger, Albrecht</au><au>Darwiche, Kaid</au><au>Koschel, Dirk</au><au>Herth, Felix</au><au>Bölükbas, Servet</au><au>Winter, Hauke</au><au>Weykamp, Fabian</au><au>Wermke, Martin</au><au>Stuschke, Martin</au><au>Plönes, Till</au><au>Thomas, Michael</au><au>Schuler, Martin</au><au>Christopoulos, Petros</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oligometastatic non‐small cell lung cancer: Impact of local and contemporary systemic treatment approaches on clinical outcome</atitle><jtitle>International journal of cancer</jtitle><addtitle>Int J Cancer</addtitle><date>2025-02-15</date><risdate>2025</risdate><volume>156</volume><issue>4</issue><spage>776</spage><epage>787</epage><pages>776-787</pages><issn>0020-7136</issn><issn>1097-0215</issn><eissn>1097-0215</eissn><abstract>Oligometastatic (OMD) non‐small cell lung cancer (NSCLC) is a distinct but heterogeneous entity. Current guidelines recommend systemic therapy and consolidation with local ablative therapy (LAT). However, evidence regarding the optimal choice of multimodal treatment approaches is lacking, in particular with respect to the integration of immunotherapy. This real‐world study identified 218 patients with OMD NSCLC (2004–2023, prespecified criteria: ≤5 metastases in ≤2 organ systems) from three major German comprehensive cancer centers. Most patients had one (72.5%) or two (17.4%) metastatic lesions in a single (89.9%) organ system. Overall survival (OS) was significantly longer with a single metastatic lesion (HR 0.54, p = .003), and female gender (HR 0.4, p < .001). Median OS of the full cohort was 27.8 months, with 29% survival at 5 years. Patients who had completed LAT to all NSCLC sites, typically excluding patients with early progression, had a median OS of 34.4 months (37.7% 5‐year OS rate) with a median recurrence‐free survival (RFS) of 10.9 months (13.3% at 5 years). In those patients, systemic treatment as part of first‐line therapy was associated with doubling of RFS (12.3 vs. 6.4 months, p < .001). Despite limited follow‐up of patients receiving chemo‐immunotherapy (EU approval 2018/2019), RFS was greatly improved by adding checkpoint inhibitors to chemotherapy (HR 0.44, p = .008, 2‐year RFS 51.4% vs. 15.1%). In conclusion, patients with OMD NSCLC benefitted from multimodality approaches integrating systemic therapy and local ablation of all cancer sites. A substantial proportion of patients achieved extended OS, suggesting a potential for cure that can be further augmented with the addition of immunotherapy.
What's new?
The current treatment recommendations for oligometastatic non‐small cell lung cancer are based on evidence gathered prior to the immunotherapy era. This multicenter cohort study of 218 patients over the 2004–2023 period provides updated evidence that may guide the choice of systemic therapy for patients with oligometastatic non‐small cell lung cancer. The findings provide evidence supporting the benefit of multimodality approaches integrating immunotherapy‐based systemic treatment and local ablation of all cancer sites. Treatment goals should be prolonged disease control, with long‐term survival achievable in a subset of patients.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>39319506</pmid><doi>10.1002/ijc.35199</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-4284-3586</orcidid><orcidid>https://orcid.org/0000-0002-9698-9559</orcidid><orcidid>https://orcid.org/0000-0003-1001-103X</orcidid><orcidid>https://orcid.org/0000-0001-9511-055X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of cancer, 2025-02, Vol.156 (4), p.776-787 |
| issn | 0020-7136 1097-0215 1097-0215 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11661509 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Aged, 80 and over Cancer therapies Carcinoma, Non-Small-Cell Lung - drug therapy Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - therapy Chemotherapy Combined Modality Therapy Female Humans Immune checkpoint inhibitors Immunotherapy Immunotherapy - methods locally ablative treatment Lung cancer Lung Neoplasms - drug therapy Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - therapy Male Metastases Metastasis Middle Aged multimodal concepts Neoplasm Metastasis Non-small cell lung carcinoma observational study oligometastatic NSCLC Patients RESEARCH ARTICLE Retrospective Studies Sensory integration Small cell lung carcinoma Treatment Outcome |
| title | Oligometastatic non‐small cell lung cancer: Impact of local and contemporary systemic treatment approaches on clinical outcome |
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