Dr. Bauml on Locally Ablative Therapy in Oligometastatic NSCLC

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

Retrospective data first addressed the question of the prevalence of this patient population. Bauml says that oligometastatic disease makes up 7% of patients with NSCLC, which is as rare as ALK-positive NSCLC. Data have examined the use of locally ablative therapy, which consists of surgery and radiation to all metastatic sites, and have shown that this approach improves outcomes for patients compared with historical controls. More recently, randomized trials have confirmed this benefit.

Bauml notes there are limitations to these trials such as the small sample size. While there seems to be a benefit with locally ablative therapy, where exactly this approach fits into the treatment paradigm is not yet clear. While researchers wait for phase III data to read out, Bauml urges providers to carefully consider which patients should get locally ablative therapy.