Treatment of Oligometastatic GI Cancers.

Clayton T Marcinak, Patrick B Schwartz, Mustafa M Basree, Newton Hurst, Michael Bassetti, Jeremy D Kratz, Nataliya V Uboha
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Abstract

Oligometastatic state is believed to potentially represent a transitional stage between early, locoregional state disease and widely metastatic disease. Historically, locoregional approaches, particularly in advanced colorectal cancers, have demonstrated efficacy in select patients with limited burden of metastatic disease. Recent strides in systemic therapies, including biomarker-based treatments and immunotherapy, alongside innovations in surgical techniques and novel locoregional approaches such as stereotactic radiotherapy and ablation, have ushered in a new era of therapeutic possibilities across all oligometastatic GI cancers. Despite these advancements, there remains a significant gap in high-quality prospective evidence guiding patient selection and treatment decisions across various disease types. Ongoing clinical trials are anticipated to provide crucial insights into oligometastatic states, fostering the refinement of disease-specific oligometastatic state definitions and treatment algorithms. This article reviews existing data on the management of oligometastatic GI cancer, summarizes current state of knowledge for each disease state, and provides updates on ongoing studies in this space.

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治疗寡转移性消化道癌症。
少转移状态被认为可能代表早期局部状态疾病与广泛转移疾病之间的过渡阶段。从历史上看,局部治疗方法,尤其是晚期结直肠癌的局部治疗方法,已在转移性疾病负担有限的特定患者中显示出疗效。最近,全身疗法(包括基于生物标记物的治疗和免疫疗法)取得了长足进步,外科技术和新型局部方法(如立体定向放射治疗和消融术)也有了创新,这为所有寡转移性消化道癌症的治疗开创了新纪元。尽管取得了这些进展,但在指导不同疾病类型的患者选择和治疗决策方面,高质量的前瞻性证据仍存在巨大差距。正在进行的临床试验预计将为寡转移状态提供重要的见解,促进疾病特异性寡转移状态定义和治疗算法的完善。本文回顾了有关寡转移消化道癌症管理的现有数据,总结了每种疾病状态的知识现状,并提供了该领域正在进行的研究的最新情况。
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期刊介绍: The Ed Book is a National Library of Medicine–indexed collection of articles written by ASCO Annual Meeting faculty and invited leaders in oncology. Ed Book was launched in 1985 to highlight standards of care and inspire future therapeutic possibilities in oncology. Published annually, each volume highlights the most compelling research and developments across the multidisciplinary fields of oncology and serves as an enduring scholarly resource for all members of the cancer care team long after the Meeting concludes. These articles address issues in the following areas, among others: Immuno-oncology, Surgical, radiation, and medical oncology, Clinical informatics and quality of care, Global health, Survivorship.
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