Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

ESMO E-Learning: Optimal Management of Oligometastatic Disease in Solid Tumours

New E-Learning module by Dr. Tolia and Dr. Tsapakidis is now available. Watch the presentation and take the CME test today!

Learning objectives

  1. To understand the concept of definition of oligometastatic disease
  2. To provide an update on different considerations relevant in oligometastatic disease, including biology, frequency in different tumour types, impact of imaging, limited number of clinical trials and potential for cure
  3. To understand the goals of the treatment and provide the update on management strategies
Title Duration Content CME Points CME Test
Optimal Management of Oligometastatic Disease in Solid Tumours 52 min. 71 slides 1 Take test

This E-Learning module elaborates in a concise way different issues important for making advances in oligometastatic disease in solid tumours, such as understanding oligometastasis hypothesis, biological spectrum, problems with definition, precision in targeting oligometastasis in terms of imaging, treatments and biomarkers.

The module elaborates management strategies through the illustration of newer techniques, but also in different tumour sites and argues for a need of randomised clinical trials in oligometastatic disease. It also provides a prospect in terms of clinical outcomes and promises from future research in combining local ablative techniques and immunotherapy.

Only a tiny proportion of cancer cells have clonogenic potential to successfully colonise secondary organs. ​Specific mechanisms of oligometastasis are relatively underinvestigated. There are different reasons behind, like the use of different definitions of oligometastases, insufficient tumour models, limited human clinical trials and relevant databases.

Patients with metastasis limited in number and organ site might be cured by ablative therapies. The aim is to replace, delay, or complement the introduction of systemic treatments, relieve symptoms and/or extend overall and disease-free survival​. Newer radiotherapy techniques combined with advancements in imaging and systemic therapy can allow the use of radiation as an effective local ablative treatment​.

Stereotactic body radiotherapy can treat metastases in multiple organs in a patient, including some metastases not eligible for surgery. Some patients achieve long-term survival after ablative treatment and local control benefit.  The authors urge that the randomised trials should be conducted now, before increasing clinical experience and expert opinion alter the balance of equipoise and render accrual impossible.  

There is an open question, if the treatment of patients with oligometastatic disease extends the survival, or whether their long survival is merely due to the presence of slow-growing, indolent disease. Furthermore, better predictive and prognostic biomarkers are urgently required to determine which patients harbour micrometastases that will progress and render the treatment futile.  

One potential solution to the problem of disease burden and heterogeneity within metastasis is ablative types of treatments combined with systemic treatments​. There is a potential synergic effect between immunotherapy and ablative radiotherapy within the tumour microenvironment. Improvements in the molecular staging of metastasis, immunotherapy strategies, and radiotherapy delivery techniques could lead to improved disease outcomes.

Last update: 05 May 2020

The authors have reported no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings