Table 2.
Outcomes of local ablative therapy for oligoprogressive disease.
| Authors | Driver Mutation | Design | n | Induction Tx | Intervention | Mainte. Tx | mPFS1 (m) |
TTP from Intervention (m) | Duration of Treatment (m) | MST (m) | MST from Intervention (m) | Comment | Ref |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gan et al. | ALK fusion+ | retro | 14 | crizo | local ablative Tx (RT or OP) | crizotinib | 14 | 5.5 | 28 | NA | NA | [21] | |
| 13 | not eligible for LAT | 7.2 | NA | NA | |||||||||
| Yu et al. | EGFR m+ | retro | 18 | gef or erlo | local ablative Tx (RT or OP) | gefitinib or erlotinib | 19 | 10.0 | NA | NA | 41.0 | TTF from intervention: 22 m | [6] |
| Weickhardt et al. | ALK fusion+ (n = 38) EGFR m+ (n = 27) | retro | ALK rearrange (n = 15) EGFR m+ (n = 10) |
crizo erlo |
local Tx (RT or OP) | crizotinib erlotinib |
9.0 12.0 |
6.2 | NA | NA | NA | [7] | |
| 26 | crizo or erlo | Pts without LAT | 12.8 | NA | |||||||||
| Qiu et al. | EGFR m+ | retro | 46 | EGFR-TKI | local ablative Tx (RT or RFA) | EGFR-TKI | NA | 7.0 | NA | 35.0 | 13.0 | [8] | |
| Chan et al. | EGFR m+ | retro | 25 | EGFR-TKI | local ablative Tx (RT) | same TKI | NA | 7 *1 | NA | NA | 28.2 *2 | *1: p = 0.0017. *2: HR:0.4 4[95%CI:0.21–0.92], p = 0.030 | [9] |
| 25 (matched cohort) | chemotherapy | 4.1 | 14.7 | ||||||||||
| Rossi et al. | EGFR m+ | retro | 30 | EGFR-TKI | local ablative Tx (RT) | same TKI | 13.8 | 6.7 *3 | NA | 37.3 *4 | NA | *3: HR: 0.54 [95%CI:0.24–1.18], p = 0.06. *4: p < 0.0001. *5: p = 0.0015 | [10] |
| 13 | same TKI | 12.3 | 3.1 | 20.1 | |||||||||
| 88 | 2nd line treatment or BSC | 8.9 | NA | 15.1 | |||||||||
| EGFR m+ without intrinsic resistance to EGFR-TKI |
retro | 29 | EGFR-TKI | local ablative Tx (RT) | same TKI | NA | 37.3 *5 | NA | |||||
| 12 | same TKI | NA | NA | 20.1 | |||||||||
| 64 | 2nd line treatment or BSC | 21.9 | |||||||||||
| Santarpia et al. | EGFR m+ | retro | 36 | EGFR-TKI | high-dose radiation therapy | EGFR-TKI | 12.5 | 6.3 | 38.7 | [11] | |||
| Schmid et al. | EGFR T790M+ | retro | 13 | osim | local ablative Tx (RT or OP) | osimertinib | NA | 6.7 | 19.6 | 28.0 | NR *6 | *6: p = 0.2 | [23] |
| 13 | osimertinib | 20.2 | |||||||||||
| Weiss et al. | EGFR m+ at least 6 m without PD | P2 | 25 | erlo | SRT | erlotinib | NA | 6.0 | NA | NA | 29.0 | [12] | |
| Xu et al. | EGFR m+ | retro | 206 | EGFR-TKI | local ablative Tx (RT or OP) | EGFR-TKI | 10.7 | 18.3 | 37.4 | [13] | |||
| Friedes et al. | NSCLC | retro | 253 | chemo or TKI | definitive RT | same systemic Tx | NA | 7.9 | NA | NA | NA | TTF from intervention was 8.8 months. | [22] |
| Kagawa et al. | NSCLC | retro | 10 | ICI | local ablative Tx (RT or OP) | ICI beyond PD (n = 6) | 10.4 | NA | NA | NA | NR *7 | *7: p = 0.456 | [14] |
| 28 | no local therapy | NA | NR | ||||||||||
BSC: best supportive care; chemo: chemotherapy; CNS: central nervous system; crizo: crizotinib; erlo: erlotinib; gef: gefitinib; ICI: immune checkpoint inhibitor; NA: not available; NR: not reached; NSCLC: non-small cell lung cancer; m+: mutation; m: month; mainte.: maintenance; MST: median survival time; OP: operation; osim: osimertinib; P2: phase II study; PD: progression disease; retro: retrospective study; RT: radiation therapy; TKI: tyrosine kinase inhibitor; TTF: time to treatment failure; TTP; time to progression; Tx: treatment; WT: wild type. The * superscript numbers indicate the test of comparison of each outcome in the corresponding clinical trials.