Dr. Bauml on Treatment For Oligometastatic NSCLC

Joshua Bauml, MD, assistant professor, Perelman School of Medicine, University of Pennsylvania, discusses the treatment of patients with oligometastatic non—small cell lung cancer (NSCLC).

Oligometastatic disease has emerged as an important component of care for patients with colorectal cancer. Patients with limited disease of the liver can undergo resection of those metastases and become cured. Researchers are trying to see how this concept can impact lung cancer. There have recently been numerous randomized controlled trials showing that locally ablative therapy to oligometastatic disease in lung cancer improves progression-free survival. However, it’s unclear if outcomes can be improved further. Immunotherapy is an attractive option in this setting because it seems to be more effective when there’s less viable tumor around. After oligometastatic ablation, that would be a good time for immunotherapy.

Researchers took 45 patients with oligometastatic NSCLC and treated them with locally ablative therapy for up to 4 metastases. Patients then received up to 1 year of pembrolizumab (Keytruda) given at the standard dose. The outcomes turned out to be better than historical controls.