Metastasis-Directed Therapy: A Moving Target Advancing Progress Forward
Mené entre 2018 et 2021 sur 78 patients présentant 122 métastases osseuses à haut risque de récidive et asymptomatiques, cet essai randomisé multicentrique de phase II évalue l'efficacité, du point de vue d'une réduction des événements indésirables concernant le squelette, d'une radiothérapie prophylactique
Management of metastatic disease is rapidly changing. Novel systemic treatments such as immunotherapy and targeted agents have improved patient prognosis and tolerability of therapy. In conjunction with novel systemic therapies, the role of local therapies in metastatic disease is also rapidly evolving. Once thought to play little role beyond palliation of symptoms, local therapies, especially radiation in the form of stereotactic ablative radiation (SABR), are increasingly being used to aggressively manage patients with metastatic disease.1 Much of this is driven by the spectrum theory of metastasis, a postulation that cancer represents a spectrum of diseases composed of many states, some of which behave more akin to a locoregional process rather than a widely systemic disease,2 meaning that such lesions might benefit from metastasis-directed therapies (MDTs).3 In support of such a theory, several prospective trials have now demonstrated that MDT in oligometastases can prolong time to disease progression, initiation of systemic therapy, and even overall survival (OS; Table 1).
Journal of Clinical Oncology , éditorial en libre accès, 2022