paradigm shift in the conceptualization of cancer metastasis
Posted: Thu Mar 19, 2015 12:36 pm
We first heard this Oligo term when we found our brain tumors in December.
Wanted to share this well presented article-
"Oligometastases and Oligo-recurrence: The New Era of Cancer Therapy"Yuzuru Niibe* and
Kazushige Hayakawa
Abstract
Recurrence or metastasis of cancer has been considered to occur in the last stage of the patient's life. However, the new notions of oligometastases and oligo-recurrence have been proposed and the paradigm shift in the conceptualization of cancer metastasis or cancer recurrence. Oligometastases is the state in which the patient shows distant relapse in only a limited number of regions. Local therapy such as surgery, radiotherapy and radiofrequency ablation for the relapsed sites could thus improve patient's survival. On the other hand, oligo-recurrence is a notion similar to oligometastases. However, the conditions of oligo-recurrence has a primary site of the cancer controlled, meaning that all gross recurrent or metastatic sites could be treated using local therapy.
I find the future of local control plus systemic treatments very intriguing in metastic cancers.
SYSTEMIC THERAPY AND LOCAL THERAPY
Improvement of systemic chemotherapy including molecular-targeted therapy has allowed micrometastases to be almost completely absent clinically. Theoretically, if several gross metastatic or recurrent sites could be eradiated by local therapy, these patients could be cured with concomitant systemic chemotherapy. Punglia et al. (5) reported that if systemic therapy improved, the role of local therapy would improve and proposed a figure for this correlation. Here, a new figure of the correlation between local therapy and systemic therapy is proposed (Fig. 3), showing that the role of local therapy is initially increasingly important as systemic therapy improves, depending on the sigmoid curve. The current status of cancer therapy lies in the range between 0 and A. However, in the future, extreme improvements in systemic therapy will decrease the importance of local therapy, because cancers will be diminished by systemic therapy alone such as intravenous anti-cancer drug infusion or oral anti-cancer drugs. All cancerous lesions including gross tumors and microinvasive tumors could be eradicated with systemic therapy alone. This desirable state is shown as B in Fig. 3. In the present status (range: 0–A in Fig. 3), systemic therapy is not yet powerful enough that local therapy is not required for eradication, particularly for gross tumor.
http://jjco.oxfordjournals.org/content/40/2/107.full#F3
Wanted to share this well presented article-
"Oligometastases and Oligo-recurrence: The New Era of Cancer Therapy"Yuzuru Niibe* and
Kazushige Hayakawa
Abstract
Recurrence or metastasis of cancer has been considered to occur in the last stage of the patient's life. However, the new notions of oligometastases and oligo-recurrence have been proposed and the paradigm shift in the conceptualization of cancer metastasis or cancer recurrence. Oligometastases is the state in which the patient shows distant relapse in only a limited number of regions. Local therapy such as surgery, radiotherapy and radiofrequency ablation for the relapsed sites could thus improve patient's survival. On the other hand, oligo-recurrence is a notion similar to oligometastases. However, the conditions of oligo-recurrence has a primary site of the cancer controlled, meaning that all gross recurrent or metastatic sites could be treated using local therapy.
I find the future of local control plus systemic treatments very intriguing in metastic cancers.
SYSTEMIC THERAPY AND LOCAL THERAPY
Improvement of systemic chemotherapy including molecular-targeted therapy has allowed micrometastases to be almost completely absent clinically. Theoretically, if several gross metastatic or recurrent sites could be eradiated by local therapy, these patients could be cured with concomitant systemic chemotherapy. Punglia et al. (5) reported that if systemic therapy improved, the role of local therapy would improve and proposed a figure for this correlation. Here, a new figure of the correlation between local therapy and systemic therapy is proposed (Fig. 3), showing that the role of local therapy is initially increasingly important as systemic therapy improves, depending on the sigmoid curve. The current status of cancer therapy lies in the range between 0 and A. However, in the future, extreme improvements in systemic therapy will decrease the importance of local therapy, because cancers will be diminished by systemic therapy alone such as intravenous anti-cancer drug infusion or oral anti-cancer drugs. All cancerous lesions including gross tumors and microinvasive tumors could be eradicated with systemic therapy alone. This desirable state is shown as B in Fig. 3. In the present status (range: 0–A in Fig. 3), systemic therapy is not yet powerful enough that local therapy is not required for eradication, particularly for gross tumor.
http://jjco.oxfordjournals.org/content/40/2/107.full#F3