1296P - Radical treatment of non-small cell lung cancer patients with synchronous oligometastases: long-term results of a prospective phase II trial (NCT012...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Surgery and/or Radiotherapy of Cancer
Presenter Dirk De Ruysscher
Authors D. De Ruysscher1, R. Wanders2, A. van Baardwijk2, A.C. Dingemans3, B. Reymen2, G. Bootsma4, C. Pitz5, W. Geraedts6, B. Baumert2, P. Lambin2
  • 1Radiation Oncology, Maastricht University Medical Center (MUMC), 6202 AZ - Maastricht/NL
  • 2Maastro Clinic, Maastricht University Medical Center (MUMC), 6202 AZ - Maastricht/NL
  • 3Pulmonology, Maastricht University Medical Center (MUMC), NL-6202 AZ - Maastricht/NL
  • 4Pulmonology, Atrium Medical Center Heerlen, Heerlen/NL
  • 5Pulmonology, Laurentius Hospital, Roermond/NL
  • 6Pulmonology, Orbis MC, Sittard/NL

Abstract

Background

Stage IV non-small cell lung cancer (NSCLC) patients with oligometastases (< 5 metastatic lesions) may experience long-term survival when all macroscopic tumour sites are treated radically, but no prospective data on NSCLC with synchronous metastases are available.

Methods

Prospective single-arm phase II trial. Main inclusion criteria: pathological proven NSCLC stage IV with less than 5 metastases at primary diagnosis, amendable for radical local treatment (surgery or radiotherapy). The study is listed in clinicaltrials.gov number NCT01282450.

Results

39 patients (18 males, 21 females) with a mean age of 62.1 ± 9.2 years, range 44-81) were analysed. 29 (74 %) had “local” stage III; 17 (44 %) brain, 7 (18 %) bone and 4 (10 %) adrenal gland metastases. 34 (87 %) had a single metastatic lesion. 37 (95 %) of patients received chemotherapy as part of their primary treatment. Median overall survival (OS) was 13.5 months (95 % CI 7.6-19.4); 1-, 2- and 3-year OS 56.4 %, 23.3 % and 17.5 %, respectively. Median progression-free survival (PFS) was 12.1 months (95 % CI 9.6-14.3); 1-year PFS was 51.3 %, both 2- and 3 year PFS 13.6 %. Only 2 patients (5 %) had a local recurrence. No patient or tumour parameter, including volume and FDG uptake was significantly correlated with OS or PFS. The treatment was well tolerated.

Conclusion

In this phase II study, long-term PFS was found in a subgroup of NSCLC patients with synchronous oligometastases when treated radically. Identification of this favourable subgroup before therapy is needed.

Disclosure

All authors have declared no conflicts of interest.