Given the results of LU002 presented at ASCO 2024, are there situations and/or patient subgroups who still derive benefit from local consolidative therapy for oligometastatic NSCLC?
Answer from: Radiation Oncologist at Community Practice
This is a tricky trial to interpret. They allowed a mixture of "stage I" primaries with oligomets and "stage III" locoregional disease with oligomets. The former got SBRT to the primary and the latter got 45 Gy/15 fx to primary and involved LN. There is a huge difference in the "ablativeness" of tho...
Answer from: Radiation Oncologist at Community Practice
What role does local therapy play in the setting of disseminated disease? A deceptively simple question, it belies the evolving therapeutic landscape of personalized care. Local control is a worthy goal for unresectable patients for whom progression would lead to problems regardless of systemic dise...
Answer from: Radiation Oncologist at Academic Institution
Certainly was a disappointing result but I still do believe there are subsets that would demonstrate greater benefit of the addition of local therapies as they transition to maintenance IO. I think MRD ctDNA could play a pivotal role in patient selection for these approaches moving forward, and alte...
Answer from: Radiation Oncologist at Community Practice
Decide if local treatment is indicated, that is the first step, followed by the choice of dose and technique, the former dictated by tumor-related factors, namely target volume and location, and the latter by treatment-related factors, namely, available technology and expertise; RTOG 0617 is, perhap...
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Radiation Oncologist at Lake Huron Medical Center What a great answer. Thanks for that
Answer from: Radiation Oncologist at Academic Institution
I think it's an interesting time for Radiation Oncology in the stage 4 setting. If you've ever seen the Gartner Hype Cycle graph, it's worth seeing and considering in this context (Gartner Hype Cycle). I would say the "Gomez Trial" is the peak of inflated expectations, and LU002 is perhaps the troug...
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Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System Your wise words are spot on once again. My advice ...
Answer from: Radiation Oncologist at Academic Institution
No! Not outside a clinical trial. I also request that folks discussing this issue avoid vague terms like ablation, ablative dose, and ablative intent that have no biological basis.
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Radiation Oncologist at Radiation Oncology Associates I respectfully disagree. Ablate: "To take away, re...
Radiation Oncologist at Turville Bay MRI & Radiation Oncology Center Based on this, you would presumably favor 74 Gy th...
Radiation Oncologist at San Francisco CyberKnife Nothing Dr. Kittel wrote made any reference to RTO...