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Gregory J. Riely, MD, PhD


ASTRO 2022: Can Clinical Variables Predict Polymetastasis in Oligometastatic NSCLC?

By: Kayci Reyer
Posted: Monday, November 14, 2022

Findings presented at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 150) suggest that certain clinical variables may be prognostic factors in non–small cell lung cancer (NSCLC) oligometastatic disease. The study sought to determine whether some variables predicted the early progression of polymetastatic disease following definitive local treatment.

“For NSCLC patients undergoing comprehensive local treatment for synchronous [oligometastatic disease], bone metastasis, N stage, and number of metastases are associated with early polymetastatic progression, likely reflecting the disparate biologies among patients with synchronous oligometastatic disease as well as the difficulty of identifying small bone metastases with typical imaging studies,” concluded James Henry Laird, Jr, MD, of the Yale School of Medicine, New Haven, Connecticut, and colleagues. “Strategies to intensify upfront imaging and systemic treatment may benefit this subset of patients.”

The single-center study included 2,884 patients with metastatic NSCLC who received treatment between 2010 and 2019. Of them, a cohort of 84 patients with synchronous oligometastatic disease among who had received definitive disease site–specific treatment was identified.

At a median follow-up of 25.4 months, the 2-year rates of overall survival, freedom from polymetastasis, freedom from new metastasis, and progression-free survival were 55.1%, 55.0%, 27.8%, and 20.9%, respectively. A multivariate analysis identified a potential association between freedom from polymetastasis and N2 stage, number of metastases, and bone metastasis, but it did not indicate a link between any clinical variable and freedom from new metastasis. Progression-free survival was associated with brain metastasis and N2 stage, and N2 stage and age corresponded with overall survival. Bone metastasis and N2 disease were more likely to be found among patients who developed polymetastasis within 1 year (n = 20) than those who experienced freedom from polymetastasis for more than 1 year (n = 55).

Disclosure: Dr. Laird reported no conflicts of interest.

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