A RECENT multicenter Phase II trial has demonstrated that combining chemoradiotherapy (CRT) with aggressive local consolidative therapy (LCT) can improve survival rates in patients with Stage IV non-small cell lung carcinoma (NSCLC) presenting with oligometastases. This approach targets both the primary thoracic tumor and limited metastatic sites, offering a potential advancement in the management of this challenging condition.
The study enrolled 19 patients between June 2016 and May 2020, with a median age of 68 years (range: 51–74). Histological subtypes included adenocarcinoma (12 patients) and squamous cell carcinoma (6 patients). Metastatic sites were diverse, involving the brain (9 patients), bone (7), adrenal gland (2), lung (1), and cervical lymph node (1). All participants completed CRT alongside LCT for their respective oligometastases.
The treatment regimen yielded a partial response in 11 patients, resulting in a response rate of 58% (95% confidence interval [CI]: 33.5–79.7%). Median progression-free survival was reported at 8.6 months (95% CI: 7.0–10.2), while median overall survival reached 42.1 months (80% CI: 13.6–not reached). Notably, the 2-year survival rate stood at 68.4% (80% CI: 52.6%–79.9%), indicating improvement compared to historical data for this patient population.
Disease progression occurred in 14 patients (74%), primarily due to the emergence of new lesions. The treatment was well-tolerated, with no severe adverse events reported.
These findings suggest that integrating CRT with aggressive LCT may offer a viable strategy to enhance survival and achieve local control in patients with Stage IV NSCLC and limited metastatic disease. Further research is warranted to validate these results and refine patient selection criteria to optimize outcomes.
