Radical consolidative treatment provides a clinical benefit and long-term survival in patients with synchronous oligometastatic non-small cell lung cancer: A phase II study

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dc.contributor.authorArrieta, Oscar
dc.contributor.authorBarrón, Feliciano
dc.contributor.authorMaldonado, Federico
dc.contributor.authorCabrera, Luis
dc.contributor.authorCorona-Cruz, José Francisco
dc.contributor.authorBlake, Monika
dc.contributor.authorRamírez-Tirado, Laura Alejandra
dc.contributor.authorZatarain-Barrón, Zyanya Lucia
dc.contributor.authorCardona-Mendoza, Andrés Felipe
dc.contributor.authorGarcía, Osvaldo
dc.contributor.authorArén, Osvaldo
dc.contributor.authorDe la Garza, Jaime
dc.contributor.orcidCardona-Mendoza, Andrés Felipe [0000-0002-6697-5471]
dc.date.accessioned2020-05-14T20:40:27Z
dc.date.available2020-05-14T20:40:27Z
dc.date.issued2019
dc.description.abstractenglishObjectives Evidence is rapidly accumulating for the use of radical consolidative treatment (RCT) for patients with oligometastatic non-small cell lung cancer (NSCLC). Nonetheless, published studies have several limitations, including a selection of patients whose favorable characteristics might dictate therapeutic success, as well as scarce prospective data regarding overall survival (OS). The objective of this study was to determine whether RCT increases OS in patients with oligometastatic NSCLC. Materials and methods In this prospective, single-arm phase II study, we sought to evaluate the efficacy of RCT in patients with oligometastatic NSCLC in terms of OS. Patients with pathologically confirmed stage IV NSCLC who presented ≤5 synchronous, any-site metastases (including central nervous system [CNS] metastases), as assessed by PET-CT, were included. All patients received four initial cycles of systemic treatment. Following, those with stable disease/partial response received RCT to the primary site and metastases. The response to RCT was evaluated with PET-CT. The primary end-point was OS. Secondary end-points included progression-free survival (PFS) and best response by PET-CT. The study is registered in clinicaltrials.gov (NCT02805530). Results Thirty-seven patients were included in the analysis. The mean age was 55.8 years (range: 33–75 years). At diagnosis, 43.2% of patients presented with CNS metastases. Following RCT, 19 (51.4%) patients achieved a complete-response (CR) by PET-CT, while 18 (48.6%) had a non-complete response (NON-CR). The median OS was nonreached (NR) and was positively affected by CR on PET-CT (NR vs. 27.4 [95% CI: 16.4–38.3]; p = 0.011). The median PFS was 23.5 months (95% CI: 13.6–33.3) and was positively affected by CR on PET-CT (NR vs. 14.3 [95% CI: 11.7–16.9]; p < 0.001; HR: 0.19 [0.07-0.52]; p=0.001). Conclusion Patients with oligometastatic NSCLC who undergo RCT have a high response rate and favorable OS. Patients with a CR by PET-CT have significantly longer OS, rendering this an important potential prognostic marker.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1016/j.lungcan.2019.02.006.
dc.identifier.issn0169-5002
dc.identifier.urihttps://hdl.handle.net/20.500.12495/2797
dc.language.isoeng
dc.publisherElsevierspa
dc.publisher.journalLung cancerspa
dc.relation.ispartofseriesLung cancer, 0169-5002, Vol 130, 2019, pag 67-75spa
dc.relation.urihttps://www.lungcancerjournal.info/article/S0169-5002(19)30311-3/fulltext
dc.rights.creativecommons2019
dc.rights.localAcceso cerradospa
dc.subject.decsRadioterapiaspa
dc.subject.keywordsNSCLCspa
dc.subject.keywordsOligometastaticspa
dc.subject.keywordsSurvivalspa
dc.subject.keywordsRadical consolidative therapyspa
dc.subject.keywordsRadiotherapyspa
dc.subject.keywordsSurgeryspa
dc.titleRadical consolidative treatment provides a clinical benefit and long-term survival in patients with synchronous oligometastatic non-small cell lung cancer: A phase II studyspa
dc.title.translatedRadical consolidative treatment provides a clinical benefit and long-term survival in patients with synchronous oligometastatic non-small cell lung cancer: A phase II studyspa
dc.typearticlespa
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localartículospa

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