WCLC 2025 - Posters & ePosters-P3.09.09 Frequency and Prognostic Impact of Local Ablation Therapy for Oligoprogression in Non-Small Cell Lung Cancer

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This retrospective observational study at Hokkaido University Hospital investigated the frequency, genetic characteristics, and prognostic impact of local ablation therapy (LAT) for oligoprogression (OP) in non-small cell lung cancer (NSCLC). OP, defined here as three or fewer progressive lesions during systemic therapy, occurred in 23.6% of NSCLC patients, slightly lower than prior reports possibly due to definition differences. LAT, including surgery or radiation targeting OP lesions, was analyzed for its effect on outcomes.<br /><br />Patient characteristics were similar between the LAT and systemic treatment groups. The addition of LAT to systemic therapy showed minimal overall impact on prognosis; however, some patients receiving LAT achieved long-term survival, suggesting LAT may effectively suppress disease progression in treated organs. Kaplan–Meier survival analyses showed progression-free survival (PFS), local PFS (LPFS), overall survival (OS), and OP-specific OS (OP-OS) by treatment modality, indicating differential effects.<br /><br />RNA sequencing of tumor specimens from patients before and after OP revealed increased expression of extracellular matrix (ECM)-related genes post-OP. Gene ontology analysis identified biological processes associated with disease progression, highlighting the potential relevance of specific genetic expression changes in OP. These genetic insights may help select appropriate treatments for NSCLC patients with OP.<br /><br />The study confirms the clinical relevance of OP in NSCLC, affecting approximately one-quarter of patients, and underscores the limited but promising role of LAT in managing OP lesions. However, prospective trials validating LAT’s efficacy remain few, and data on genetic characteristics of oligometastatic patients are sparse. Elucidating these genetic profiles could guide personalized treatment. The authors acknowledge the need for further research to clarify the prognostic value of LAT and the molecular biology underlying OP in NSCLC.<br /><br />In summary, LAT shows potential benefit in selected NSCLC patients with OP, and increased ECM gene expression post-OP may provide novel therapeutic targets. More prospective studies are necessary to optimize management of oligoprogressive NSCLC.

Asset Subtitle

Daisuke Morinaga

Meta Tag

Speaker Daisuke Morinaga

Topic Metastatic Non-small Cell Lung Cancer – Local Therapies

Keywords

non-small cell lung cancer

oligoprogression

local ablation therapy

Hokkaido University Hospital

progression-free survival

extracellular matrix genes

RNA sequencing

prognostic impact

systemic therapy

gene ontology analysis