Dr. Mix on Local Consolidative Therapy in Oligometastatic NSCLC

Michael D. Mix, MD, assistant professor of radiation oncology at Upstate University Hospital, discusses the use of local consolidative therapy in patients with oligometastatic non—small cell lung cancer (NSCLC).

Aggressive local therapy with radiation is a common approach that Mix has used in practice in an attempt to improve a patient’s overall prognosis. However, the field has had limited evidence to support the clinical benefit of this approach. To date, there has only been 1 prospective study that has demonstrated that physicians may be able to improve not only progression-free survival (PFS), but also overall survival (OS) with the addition of aggressive local therapy. This is typically done with stereotactic body radiation therapy (SBRT) to 3 or fewer sites of metastases, adds Mix.

The trial was presented at the 2018 ASTRO Annual Meeting by Daniel Gomez, MD, of The University of Texas MD Anderson Cancer Center. The multi-institution, randomized, phase II trial enrolled patients with 3 or fewer metastases after 4 cycles of standard systemic therapy. Patients were randomized to standard-of-care maintenance or observation, or aggressive local therapy with what was termed local consolidative therapy. Results from the trial showed a significant and durable benefit in PFS. Moreover, patients who received SBRT experienced a median OS of 41 months.