Giuseppe Caruso, Gynecology Oncology Specialist at European Institute of Oncology, shared on LinkedIn:
“A topic I care deeply about. Increasingly important in gynecologic oncology.
How should we think about – and manage – oligorecurrent and oligoprogressive ovarian cancer?
This is a very useful and timely Lancet Oncology Personal View by Gabriella Macchia et al (Nicole Concin, Remi Nout, Prof. Ana Oaknin, Domenica Lorusso, Barbara Jereczek-Fossa, Matthias Guckenberger, Donato Pezzulla, Giuseppe Vizzielli), particularly now that we are in the era of ‘prolonged (maintenance) targeted therapies’ – including PARPi, immunotherapy, and ADCs.
My key takeaways:
- The application of ESTRO–EORTC OligoCare OMD classification in ovarian cancer is challenging. Ovarian cancer may need its own definition of oligometastatic disease. Early and diffuse peritoneal spread makes conventional lesion counting difficult – and potentially misleading.
- Diffuse peritoneal dissemination at diagnosis in high-grade serous ovarian cancer should NOT automatically equal ‘polymetastatic disease’.
- When peritoneal disease is limited at the time of recurrence/progression, classification should be guided by the number of lesions that can be safely and effectively treated, rather than by lesion count alone. And ‘oligo’ should not be defined by imaging alone: treatment-free interval, previous patterns of spread, CA-125, and symptom burden all add important biological context.
I agree with authors that this is more than just semantics – it can directly affect treatment decisions, trial eligibility, patient counselling and access to therapy.
And this is something I try to incorporate systematically into my clinical practice. Before stopping an ongoing treatment or considering eligibility for a clinical trial, there is always one question in my ‘algorithm’, which I bring to multidisciplinary discussion: Can I offer a locoregional treatment?.”
Title: Challenges in the use of the European Society for Radiotherapy and Oncology–European Organisation for Research and Treatment of Cancer oligometastatic disease classification system in ovarian cancer
Authors: Gabriella Macchia, Alessio G. Morganti, Alexandra Taylor, Nicole Concin, Ana Oaknin, Domenica Lorusso, Giuseppe Vizzielli, Remi Nout, Antonio González-Martín, Donato Pezzulla, Francesco Deodato, Fernanda G. Herrera, Barbara Alicja Jereczek-Fossa, Matthias Guckenberger.
Read the Full Article in The Lancet Oncology.
Other articles featuring Giuseppe Caruso on OncoDaily.