The use of radiation therapy for oligoprogressive/oligopersistent oncogene-driven non small cell lung cancer: State of the art. (April 2020)

• Record Type: Journal Article
• Authors: Franceschini, D.; De Rose, F.; Cozzi, S.; Franzese, C.; Rossi, S.; Finocchiaro, G.; Toschi, L.; Santoro, A.; Scorsetti, M.
• Is Part Of: Critical reviews in oncology/hematology. Volume 148(2020)
• Publication Date: 2020-04
• Subjects: Lung cancer -- Oncogene-driven -- Oligoprogression -- Oligopersistence -- Radiotherapy; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2020.102894
• Languages: English
• ISSNs: 1040-8428

Abstract

Highlights: Despite high efficacy, resistance to target therapies in NSCLC always occurs. When occurrence is limited to few sites, local therapies can be beneficial. Stereotactic Body Radiation Therapy is an ideal candidate thanks to high efficacy and safety Literature data suggest that local therapies while continuing the same TKI prolong PFS. Consolidation of persisting disease after few months of TKI can change the natural history of the disease. Abstract: Oncogene-driven non small cell lung cancer (NSCLC) is a distinct entity in thoracic oncology. The availability of effective target therapies, like EGFR inhibitors or ALK inhibitors, have revolutionized the prognosis of these patients. However, despite an initial response in the majority of patients, drug resistance ultimately occurs. In some cases, this resistance develops in few clonal cells (oligoprogression), so that a local ablation of these resistant deposits could allow to maintain the same systemic therapy and possibly to prolong patients' survival. For these purposes, stereotactic body radiation therapy (SBRT) is an ideal local ablative treatment, because it is effective, non invasive and with limited side effects. In this review, we aim to analyze available clinical data to verify whether SBRT can allow these patients to continue with existing target therapy longer, delay the switch to other systemic therapies and improve their outcome modifying the natural history of the disease.