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Gustavo Viani: Switching systemic therapy isn’t the only answer for oligoprogressive HCC

Gustavo Viani/sbradioterapia.com.br

Jan 23, 2025, 13:41

Gustavo Viani: Switching systemic therapy isn’t the only answer for oligoprogressive HCC

Gustavo Viani, Professor of Radiation Oncology at Ribeirão Preto Medical School, University of Sao Paulo, shared a post on Linkedin about a recent paper by Boyu Leng, Radiation Oncologist at Shandong Cancer Hospital and Institute, published in International Journal of Radiation Oncology, Biology, Physics:

“Switching systemic therapy isn’t the only answer for oligoprogressive hepatocellular carcinoma (HCC).

Objective: To evaluate whether maintaining 1st-line systemic therapy (FLST) combined with radiotherapy for oligoprogressive lesions result in higher PFS and lower switching to 2nd-line therapy (s-SLST), with or without RT.

Methods:

HCC with oligoprogressive disease, defined as progression limited to a few lesions

Study groups:

m-FLST + RT
s-SLST-only
s-SLST + RT

Results: PFS

Median PFS was higher in the m-FLST + RT group (8.6 mo) and lower (3.1 mo) in the s-SLST-only.

Relapse patterns:

re-enlargement of oligoprogressive lesions in the m-FLST + RT (27.6%), s-SLST + RT (31.8%), s-SLST-only (50.0%)
re-enlargement of non-progressive metastases during FLST (13.8%), s-SLST +RT (27.3%), s-SLST-only (24.4%)

Conclusion: Combining maintenance of first-line systemic therapy with radiotherapy for oligoprogressive lesions:

Prolongs progression-free survival.
Reduces recurrence rates of both oligoprogressive and non-progressive metastases.

Message to fellow radiation oncologists and clinicians:

Oligoprogression does not always require an immediate switch to second-line therapy
Focused RT combined with continued first-line therapy can enhance PFS and control relapse rates
Personalized strategies are essential, guided by ALBI grade and multidisciplinary planning.”

“Maintaining first-line therapy plus radiotherapy may prolong progression-free survival and delay second-line therapy for oligoprogressive hepatocellular carcinoma”

Authors: Boyu Leng, Haohua Wang, Yunfan Ge, Xiang Zhang, Jinbo Yue et al.

Gustavo Viani: Switching systemic therapy isn’t the only answer for oligoprogressive HCC

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Gustavo Viani: Switching systemic therapy isn’t the only answer for oligoprogressive HCC