Personalized Diagnosis and Treatment of Oligometastatic Disease

Dear Colleagues,

In recent years, our scientific community has witnessed a revolution in the management of metastatic patients, with increasing availability of novel systemic agents able to prolong the survival with negligible impact on quality of life. The concept of oligometastatic disease is gaining attractiveness as an intermediate state between localized and disseminated disease that is potentially suitable for local treatments with the intent to ablate the metastatic foci. The oligometastatic status was postulated in 1995 by Hellman and Weichselbaum, who identified a metastatic disease burden limited to 3–5 lesions and suitable for local treatments, either via surgery or radiotherapy.

Recently, several prospective and retrospective studies support the role of radiotherapy, particularly stereotactic body radiotherapy (SBRT), as a safe and effective tool for patients with oligometastastic disease, with proven benefits also in terms of survival, as confirmed by the long-term results of the SABR-COMET trial. To date, SBRT is routinely applied in clinical practice alone or in combination with novel systemic agents, with an increased use of this therapeutic option thanks to the availability of refined diagnostic modalities. The combination of technological progress along with the improved knowledge of biomolecular factors as potential candidates for target therapies, have led clinicians to consider SBRT beyond the consolidated numerical limit of 3–5 metastases and explore other parameters such as the total tumor volume. In this sense, the definition of oligometastatic disease has been reconsidered and recategorized.

Moreover, new endpoints such as time to next systemic treatment or systemic treatment-free survival have been reported as a means to quantify the real impact of SBRT in the treatment of oligometastatic disease.

This Special Issue aims to collect the available evidence and new developments in this complex disease scenario, which is constantly changing shape under the wave of technological and biological advances.

Dr. Francesco Cuccia
Guest Editor

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• oligometastatic disease
• oligorecurrence
• oligoprogression
• oligoconsolidation
• metastasectomy
• stereotactic body radiotherapy (SBRT)
• novel systemic agents
• target therapies
• chemotherapy
• immunotherapy