Personalized treatment based on driver molecular alterations, such as ALK rearrangement, has revolutionized the therapeutic management of advanced oncogene addicted NSCLC patients. Multiple effective ALK tyrosine kinase inhibitors (TKIs), with the amelioration of the activity at central nervous system level, are now available, leading to substantial prognosis improvement. The exposure to TKIs triggers resistance mechanisms and the sequential administration of other TKIs and chemotherapy is, for the most part, not targeted. In this context, extending the benefit deriving from precision medicine is paramount, above all when disease progression occurs in a limited number of sites. Retrospective data indicate that, in oligoprogressive disease, targeted therapy beyond progression combined with definitive local treatment of the progressing site(s) is an effective alternative. In these cases, multidisciplinary approach becomes essential for an integrated treatment strategy, depending on the s..... READ ARTICLE
Preprints DOI:10.20944/preprints202112.0145.v1
Authors: Pisano, C.; De Filippis, M.; Jacobs, F.; Novello, S.; Reale, M.L.
When early-stage metastases appear, what is the evidence comparing the utility of systemic drug treatment versus focused radiation? "Oligoprogressive disease is a relatively new clinical concept describing progression at only a few sites of metastasis in patients with otherwise controlled widespread disease. Local ablative therapy for oligoprogressive disease may allow the continuation of systemic treatments by overcoming the few sub-clones that have developed resistance." READ ARTICLE
Clinical Oncology; DOI: 10.1016/j.clon.2019.05.015;
Authors: P.H. Patel, D. Palma, F. McDonald, A.C. Tree
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