The results of a recent phase 2 trial, which were published in The Lancet Oncology, indicate that local consolidative therapy may be an effective option for patients with non-small cell lung cancer with few metastases (oligometastatic NSCLC).1
Disease progression in NSCLC typically occurs in already-existent sites, suggesting that localized therapy may be clinically beneficial. This study was conducted to determine the relative efficacy of local consolidative therapy against that of maintenance therapy or observation.
Researchers enrolled 74 patients with stage IV disease who had fewer than 4 metastases after first-line systemic treatment. Twenty-five of these patients were not eligible for randomization, 25 were randomized to local therapy, and 24 were randomized to maintenance therapy.
Progression-free survival was 11.93 months in the local therapy group; this figure was only 3.9 for those in the maintenance group. One-year progression-free survival rates were 48% and 20% for those in the local therapy and maintenance groups, respectively.
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Adverse events were similar between the groups.
The authors conclude that among patient with oligometastatic disease, local therapy is efficacious and well-tolerated, and should be further explored in phase 3 studies.
- Gomez DR, Blumenschein Jr GR, Lee JJ, et al. Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study. Lancet Oncol. In press. doi: 10.1016/S1470-2045(16)30532-0