Table 1.
Retrospective studies of local ablative therapy for oligoprogression
| Reference | Patient tumour type | No. OPD sites included | No. patients with PD | No. patients with EC-OPD | Targeted therapy | Local treatment received | Median PFS 2 (months) | Systemic treatment-free survival (months) | No. patients (%) with grade 3/4 toxicity |
|---|---|---|---|---|---|---|---|---|---|
|
[20] Single centre 2005–2011 |
ALK +, EGFR + NSCLC | ≤4 EC or any number of CNS | n = 25 | n = 15 (3 patients CNS + EC-OPD) | Crizotinib or erlotinib | SBRT: 12 XRT: 2 Surgery: 1 |
4 (CI 2.7–7.4) (3 patients CNS + EC-OPD) | Grade 3 fatigue: 2 (8) | |
|
[32] Single centre |
EGFR + NSCLC |
≤4 EC | n = 184 | n = 18 | Erlotinib or gefitinib | RFA: 2 SBRT: 1 XRT: 2 Surgery: 13 |
10 (95% CI 2–27) | 22 (95% CI 6–30) | Grade 3 pneumonia: 1 (5.5) Grade 4 pneumonia: 1 (5.5) |
|
[52] Cohort analysis two centres 2013–2015 |
EGFR + NSCLC |
SBRT cohort: ≤ 3 EC or CNS No SBRT cohort: any number of sites |
n = 25 TKI + SBRT versus n = 25 SACT switched |
n = 25 (includes CNS disease) | TKI not specified | SRS: 4 SBRT: 15 XRT: 6 |
7 versus 4.1 (CI NR) (TKI + SBRT versus chemotherapy for EC-OPD and CNS) | Grade 3 oesophagitis: 1 (4) | |
|
[51] Single centre 2009–2014 |
EGFR + NSCLC |
≤5 EC or CNS | n = 46 | n = 22 | TKI not specified | SBRT: 8 XRT: 12 RFA: 2 |
7 (CI NR) (CNS and EC-OPD) | Grade 3 pneumonitis: 2 (4.3) Grade 3 neutropenia: 10 (21.7) Grade 4 skin rash: 2 (4.3) |
|
|
[54] Multicentre 2009–2015 |
NSCLC | ≤4 EC (oligometastases or OPD or local control of dominant tumour) | n = 108 | n = 20 | Erlotinib, afatinib, gefitinib, pemetrexed No SACT |
SBRT: 20 | 3.3 (CI NR) | Grade 3 late respiratory events: 2 (10) Bone fracture: 3 (15) |
|
|
[53] Multicentre 2010–2016 |
CRPC | ≤3 EC (bone or LN only) | n = 141 | n = 41 | ADT | SBRT: 41 | 11 (CI NR) | 22 (CI NR) | No grade 3/4 toxicity |
|
[55] Multicentre 2007–2015 |
RCC | ≤3 EC or CNS | n = 55 | n = 51 | Sunitinib, pazopanib, sorafenib |
XRT: 25 Surgery: 25 Cryo/thermo-ablation: 5 |
14 (95% CI 6.9–21) (EC-OPD and CNS) | No toxicity data reported |
ADT, androgen deprivation therapy; ALK, anaplastic lymphoma kinase; CI, confidence interval; CNS, central nervous system; CRPC, castrate-resistant prostate cancer; EC, extra-cranial; EGFR, epidermal growth factor receptor; LN, lymph node; NR, not recorded; NSCLC, non-small cell lung cancer; OPD, oligoprogressive disease; PD, progressive disease; PFS, progression-free survival; RCC, renal cell carcinoma; RFA, radiofrequency ablation; SACT, systemic anti-cancer therapy; SBRT, stereotactic body radiotherapy; SRS, stereotactic radiosurgery; TKI, tyrosine kinase inhibitor; XRT, external beam radiotherapy.