TY - JOUR
T1 - Metastasis-directed therapy for oligometastasis and beyond
AU - Beckham, Thomas H.
AU - Yang, T. Jonathan
AU - Gomez, Daniel
AU - Tsai, C. Jillian
N1 - Funding Information:
Competing interests Dr Tsai serves as a consultant to Varian Medical, Inc. Dr Gomez reported grants from Merck, AstraZeneca, Bristol Myers Squibb, Varian, and Elekta, and personal fees from Merck, AstraZeneca, Bristol Myers Squibb, Varian, Reflexion, Vindico, WebMD, and Medscape outside the submitted work. Dr Yang reported research support from AstraZeneca and Kazia Therapeutics and personal fees from AstraZeneca, Debiopharm, Galera Therapeutics, and resTORbio outside the submitted work.
Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Cancer Research UK.
PY - 2021/1/5
Y1 - 2021/1/5
N2 - Metastasis-directed therapy (MDT)—local therapy that is intended to eradicate specific metastatic lesions—has hitherto been used with varying degrees of clinical efficacy and acceptance as a meaningful therapy for metastatic disease. Over the past 25 years, however, the momentum for using MDT to manage patients with metastatic solid tumours has increased, driven by several factors. Among these factors is the recognition that patients with limited metastatic burden could potentially derive survival benefits from MDT. Furthermore, although current systemic therapies are increasingly effective, they are infrequently curative. In addition, technological advances have broadened the spectrum of metastatic lesions that can be treated with ablative intent. Here we aim to briefly review the status of evidence for the clinical benefit of MDT based on current data mainly from trials in patients with oligometastatic disease, discuss the myriad of clinical states that might fall under and beyond the definition of oligometastasis, review technological advances in MDT and their applications beyond oligometastasis, and discuss the need for the continued co-evolution of MDT and systemic therapy as we seek to understand which patients with metastatic cancer can achieve durable remission and how to optimally manage those who cannot. [Figure not available: see fulltext.]
AB - Metastasis-directed therapy (MDT)—local therapy that is intended to eradicate specific metastatic lesions—has hitherto been used with varying degrees of clinical efficacy and acceptance as a meaningful therapy for metastatic disease. Over the past 25 years, however, the momentum for using MDT to manage patients with metastatic solid tumours has increased, driven by several factors. Among these factors is the recognition that patients with limited metastatic burden could potentially derive survival benefits from MDT. Furthermore, although current systemic therapies are increasingly effective, they are infrequently curative. In addition, technological advances have broadened the spectrum of metastatic lesions that can be treated with ablative intent. Here we aim to briefly review the status of evidence for the clinical benefit of MDT based on current data mainly from trials in patients with oligometastatic disease, discuss the myriad of clinical states that might fall under and beyond the definition of oligometastasis, review technological advances in MDT and their applications beyond oligometastasis, and discuss the need for the continued co-evolution of MDT and systemic therapy as we seek to understand which patients with metastatic cancer can achieve durable remission and how to optimally manage those who cannot. [Figure not available: see fulltext.]
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U2 - 10.1038/s41416-020-01128-5
DO - 10.1038/s41416-020-01128-5
M3 - Review article
C2 - 33204024
AN - SCOPUS:85096091931
SN - 0007-0920
VL - 124
SP - 136
EP - 141
JO - British journal of cancer
JF - British journal of cancer
IS - 1
ER -