ASTRO 2018: Survival Benefit Reported With Local Consolidative Therapy in Oligometastatic NSCLC
Posted: Friday, October 26, 2018
Based on the final analysis of a randomized phase II trial, local consolidative therapy (defined as radiation therapy or surgery to all remaining active disease sites) offers a survival advantage over standard maintenance therapy/observation in patients with oligometastatic non–small cell lung cancer (NSCLC). In fact, the median overall survival of 41.2 months was more than doubled the 17 months with standard treatment. These findings were presented by principal investigator Daniel R. Gomez, MD, of the MD Anderson Cancer Center, Houston, at the 2018 Annual Meeting of the American Society for Radiation Oncology (ASTRO) in San Antonio (Abstract LBA3).
“The overall survival difference was even larger than we expected based on our earlier findings of a significant advance in progression-free survival,” said Dr. Gomez, in an institutional press release. “Forty-one months is a survival time longer than typically observed for patients with metastatic disease.”
Back in 2016, the investigators reported a significant progression-free survival advantage with the consolidative approach in 49 patients. During the recent ASTRO meeting, the extended follow-up showed the overall survival benefit with this novel treatment strategy. Reportedly, these data are from the first trial with local consolidative therapy in this patient population, whose disease did not progress after front-line systemic therapy. In addition, the time to new lesion failure “trended toward significance,” with a median of 14.2 months in the local consolidative therapy arm versus 6.0 months in the standard treatment arm.
“These results present a strong signal for the benefit of radiation and surgery for these patients,” Dr. Gomez commented. “However, particularly because the trial was initiated prior to the use of immunotherapy in lung cancer, the findings are being validated in multiple, larger clinical trials.”
