Oligoprogression and the Potential Role of Local Ablative Therapy

Happy New Year to the growing #radonc community. As we start the new decade, we welcome everyone to the re-establishment of our journal club!

Oligoprogressive Disease in Cancer

We will be discussing an article on oligoprogressive disease (OPD) this month for #radonc journal club:

The Dandelion Dilemma Revisited for Oligoprogression: Treat the Whole Lawn or Weed Selectively?

DOI: https://doi.org/10.1016/j.clon.2019.05.015

The article is a review that provides a timely insight into the relatively new concept of oligoprogression as being clinically distinct from oligometastatic disease.  In the era of rapidly growing targeted agents, it is logical to conceive the rising resistance to therapy. As such, the local ablative therapy may play a significant role in overcoming these resistant sites as opposed to switching systemic therapies. Due to paucity of published prospective data to guide management in this scenario, the authors discuss the available relevant retrospective clinical evidence and the current trials in treating this group of patients.

Getting Started with Dr. Alison Tree

Please join Dr. Alison Tree at Royal Marsden and colleagues as we discuss the significance of oligoprogressive disease in the modern era and local ablative therapy as a potential management.

Our chat will begin 8 AM Central Standard Time on Saturday January 18^th and carry through into Sunday. We will have a “live hour” on 2 PM Central Standard Time on Sunday January 19^th.  This Clinical Oncology article is open access for the journal club this weekend.

Here are our topic questions:

T1.  Is there a difference between oligoprogressive (OPD) and oligometastatic (OMD) disease? Explain the different disease patterns and time points when local therapy can be considered.

T2.   What are the implications of the recent rise in targeted systemic agents in terms of drug resistance? Why should we consider continuing the same systemic therapy despite oligoprogression and what role can ablative therapy play in this scenario?

T3.  Describe the challenges associated with diagnosing and assessing the frequency of oligoprogressive (OPD) disease. 

T4.  What is the benefit of local ablative therapy in the oligoprogressive (OPD) setting? Based on data, is there an increased toxicity?

T5.  Describe the current studies looking at stereotactic body radiotherapy (SBRT) for oligoprogressive (OPD) disease? Share your thoughts about the design of trials that will pick out the cohort of patients likely to benefit from SBRT in an OPD setting.

• Here are guidelines on how to sign up and participate
• Read our disclaimer for ways to keep it rewarding and professional. If you’re not ready, just lurk and tune into the conversation.

Any suggestions? Leave a comment or tweet us at @Rad_Nation. We look forward to having you join us!