S809
Clinical - Lung
ESTRO 2026
Results: 155 patients developed progression, 129 (83%) with new lesions and 26 (27%) had progression in their preexisting sites of disease. Widespread progression was observed in 57 patients (37%) while 98 patients (63%) experienced OPD. 84% of patients treated with chemo-only and 54% of patients treated with (chemo)- ICI had progression. Progression patterns were not influenced by first-line systemic therapy type (chemotherapy alone vs immune checkpoint inhibitor– based). In fact, among patients treated with chemo- only, 62% developed OPD and 38% developed widespread progression, versus 70% and 30% respectively in the (chemo)-ICI group. Significant differences between the OPD and widespread disease groups were observed in performance status (WHO-PS 0: 62% vs 42%), tumor histology (squamous: 13% vs 28%), KRAS mutation presence (36% vs 26%), N-stage (N0-1: 40% vs 21%), number of metastases (1 metastasis: 72% vs 53%), and metastasis location. In the group of patients with OPD, 60 (61%) received another course of local treatment at time of OPD and in this subgroup of patients, a second progression was observed in 4 patients (7%). Median PFS and OS were significantly longer in the OPD group compared to widespread PD: PFS 10.52 vs 8.12 months (p<0.001) and OS 30.97 vs 15.16 months (p<0.001) (Figure 2).Figure 2. PFS and OS
Conclusion: In this cohort, most of the patients with sOMD NSCLC treated with systemic therapy and LRT developed progression in new disease sites and 63% of progressive patients developed OPD. Approximately two-thirds underwent an additional course of LRT, delaying the need for second-line systemic therapy. Prospective studies integrating translational research and biological factors are needed to better identify patients likely to develop OPD and who may benefit from repeated LRT. References: 1. Dingemans A-MC, Hendriks LEL, Berghmans T, Levy A, Hasan B, Faivre-Finn C, et al. Definition of Synchronous Oligometastatic Non–Small Cell Lung Cancer—A Consensus Report. J Thorac Oncol. December 1, 2019;14(12):2109–2119. 2. Guckenberger M, Lievens Y, Bouma AB, Collette L, Dekker A, deSouza NM, et al. Characterisation and classification of oligometastatic disease: a European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus recommendation. Lancet Oncol. January 1, 2020;21(1):e18–e28. Keywords: NSCLC, oligometastatic, LRT
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