WCLC 2025 - Posters & ePosters-P3.18.23 Management of Synchronous Oligometastatic NSCLC With Surgical Resection of the Primary Tumor: Preliminary Results From the Prospective Trial

P3.18.23 Management of Synchronous Oligometastatic NSCLC With Surgical Resection of the Primary Tumor: Preliminary Results From the Prospective Trial

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This prospective phase 2 trial at the N.N. Alexandrov National Cancer Centre of Belarus investigates a multimodal treatment approach for patients with synchronous oligometastatic non-small cell lung cancer (NSCLC), focusing on surgical resection of the primary tumor combined with systemic and local therapies. From January 2021, 32 patients meeting strict criteria—age 18-75, NSCLC without driver mutations, limited metastases (1-5), and feasibility for local treatment—were enrolled. Most had a single metastatic site, predominantly adenocarcinoma (68.7%) or squamous cell carcinoma (31.3%), and no lymph node involvement.<br /><br />The treatment protocol involved two cycles of platinum-based induction chemotherapy, followed by surgical resection of the primary lung tumor—mandating lobectomy or pneumonectomy with systematic lymph node dissection—and local consolidation for metastases via surgery, stereotactic body radiation therapy (SBRT), or radiosurgery. Two further cycles of platinum-based chemotherapy were administered postoperatively.<br /><br />Interim results showed that after induction chemotherapy, 21.4% had partial responses and 71.4% stable disease. Twenty-seven patients underwent surgical resection with a majority lobectomies, including minimally invasive video-assisted thoracoscopic surgeries (VATS). Pathological complete response (pCR) was observed in 2 patients and major pathological response (MPR) in 7. The treatment was well tolerated with no mortality related to therapy.<br /><br />Survival outcomes are promising: median event-free survival (EFS) was 12.0 months, and median overall survival (OS) was 34.0 months, exceeding historical expectations for this patient population. These preliminary findings suggest that integrating induction chemotherapy, primary tumor resection, local metastatic treatment, and adjuvant chemotherapy constitutes a tolerable and effective multimodal strategy, potentially improving long-term outcomes in synchronous oligometastatic NSCLC. Further follow-up is ongoing to confirm these benefits.

Asset Subtitle

Pavel Karatkevich

Meta Tag

Speaker Pavel Karatkevich

Topic Clinical Trials in Progress

Keywords

synchronous oligometastatic NSCLC

multimodal treatment

surgical resection

induction chemotherapy

platinum-based chemotherapy

lobectomy

pneumonectomy

stereotactic body radiation therapy (SBRT)

pathological complete response (pCR)

event-free survival (EFS)