H. Jack West, Vice President of Clinical Development at Summit Therapeutics, Inc, shared Christine A. Garcia’s, Associate Vice Chair for Quality and Patient Safety at Weill Cornell Medicine, Medical Oncologist and Hematologist at UPMC, post on X, adding:
“Hugely important work with so many clinical implications that I hope will lead to much more research. Many of us were trained with a mindset that ‘metastatic’ is binary (is it or not?), though mounting work on oligometastatic diseases should lead to revising that concept.
This work suggests greater value than we have traditionally ascribed to ‘debulking’/intensification in metastatic setting, whether it’s consolidation with local therapy or ‘front-loading’ systemic therapy early. Importantly, these concepts imply that even if you can’t eradicate all cancer in face of metastatic cancer, the impact of maximizing therapy early may well be greater than same therapy distributed over time – e.g., even if patients with residual EGFRm+ cancer after surgery or chemoradiation aren’t cured with long duration osimertinib, it is quite plausible that impact will be greater if administered prospectively for micrometastatic rather than deferred until there is clinical, ‘macrometastatic’ disease.
On the other hand, I’ve had many pts with visible but extremely indolent disease for years, who did very well with deferring systemic therapy for years if not forever, with their visible but clinically negligible disease in the background.
I hope and expect that in the coming years, research on ctDNA and other liquid biopsy platforms will make it possible to predict the kinetics of the disease and then customize how intensive treatments should be for an individual patient.”
Quoting Christine A. Garcia‘s post:
“New Nature study: More than 50% of lung cancer metastases are seeded by other metastases, not the primary tumor. This ‘seeding from seeding’ reveals a complex evolutionary cascade that allows cancer to colonize the body.”
Title: Evolutionary characterization of lung cancer metastasis
Authors: Sonya Hessey, Abigail Bunkum, Ariana Huebner, Kerstin Haase, Kristiana Grigoriadis, Cristina Naceur-Lombardelli, Wing Kin Liu, Caitlin F. Harrigan, Charlotte Grieco, Daniele Marinelli, Boyue Ding, Carlos Martínez-Ruiz, Piotr Pawlik, Mark S. Hill, Olivia Lucas, Corentin Richard, Oriol Pich, Kerstin Thol, Takahiro Karasaki, Sophia Ward, Foteini Athanasopoulou, Monica Sivakumar, Selvaraju Veeriah, Antonia Toncheva, Andrew J. Rowan, Paulina Prymas, Hayley Bridger, Miriam Mitchison, Elaine Borg, Mary Falzon, Ian Proctor, Ula Mahadeva, Anna Green, Martin D. Forster, Sarah Benafif, Tanya Ahmad, Siow Ming Lee, Dionysis Papadatos-Pastos, Babu Naidu, Gerald Langman, Matthew G. Krebs, Pedro Oliveira, Fiona H. Blackhall, Yvonne Summers, Jamie Weaver, John Le Quesne, Anne Thomas, Cathy Richards, Dean A. Fennell, Sanjay Jogai, Judith Cave, Patricia Roxburgh, Sioban Fraser, Alan Kirk, Kevin G. Blyth, Peter Russell, Crispin T. Hiley, Allan Hackshaw, TRACERx Consortium, TRACERx EVO Consortium, PEACE consortium, David A. Moore, Simone Zaccaria, Nicholas McGranahan, Charles Swanton and Mariam Jamal-Hanjani
Other articles featuring H. Jack West and Christine A. Garcia on OncoDaily.