Small progress.
Even if we all agree that consolidative ablative radiation improves outcomes for oligometastatic disease, there’s still no strong consensus on just when it should be added to the mix in the context of immune checkpoint inhibition (ICI). Here is a Mount Sinai retrospective review of 16 patients with “oligoprogression” (progression at no more than 3 extracranial sites) after achieving stable disease on ICI for at least 3 months. Of these, 15 received some form of local therapy (e.g, surgery, ablation, radiation, etc) resulting in a median progression-free (at any site) survival of over 15 months. TBL: Recognizing a big gap in prospective data that may never be filled, this data supports a commonsense approach of attacking ICI-resistant disease with ablative radiation when safe in order to achieve prolonged disease control without adding further systemic therapy. | Sindhu, Cancer Treat Res Commun 2020
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