Frequency and Prognostic Impact of Local Ablation Therapy for Oligoprogression in Non-Small Cell Lung Cancer.

Background: During the systemic treatment of patients with non-small cell lung cancer (NSCLC), oligoprogression (OP), a condition in which most lesions remain controlled while a few progress or develop, has recently attracted attention. Traditionally, systemic therapy is continued after disease progression; however, advancements in local ablation therapy (LAT), such as radiotherapy and surgery, have demonstrated clinical efficacy in patients with OP. The characteristics of patients who may benefit from LAT or their genetic background remain unclear. This study evaluated the frequency, clinicopathological characteristics, and efficacy of LAT in the treatment of OP.

Methods: A retrospective review was conducted of 510 patients with NSCLC who experienced disease progression after systemic therapy.

Results: Overall, 106/510 (23.6%) patients exhibited OP; among these, six patients who received only the best supportive care after OP were excluded. Systemic therapy alone was administered to 79 patients (79.0%), while 21 (21.0%) received LAT. Median local progression-free survival was numerically longer in the LAT group than in the systemic therapy-only group (8.3 and 6.7 months, respectively; p = 0.38). In addition, overall survival was also numerically longer in the LAT group than in the systemic therapy-only group (78.1 and 55.1 months, respectively; p = 0.57). Ribonucleic acid sequencing revealed an increase in extracellular matrix-related gene expression after OP, providing potential molecular insights.

Conclusions: Although this study found no significant prognostic benefit of LAT in patients with OP, future research integrating clinical and molecular data may identify patients most likely to benefit from LAT.