OLIGOCARE an ESTRO-EORTC pragmatic, observational basket study to evaluate radical radiotherapy for Oligo-Metastatic Cancer Patients (EORTC 1822-RP) - PDF version
Oligometastatic disease (OMD) has been proposed as an intermediate state between localised and systemically metastasised disease. In the absence of randomised phase 3 trials, early clinical studies show improved survival when radical local therapy is added to standard systemic therapy for OMD. However, since no biomarker for the identification of patients with true OMD is clinically available, the diagnosis of OMD is based solely on imaging findings. A small number of metastases on imaging could represent different clinical scenarios, which are associated with different prognoses and might require different treatment strategies.
Twenty international experts from ESTRO and EORTC have now developed a comprehensive system for characterisation and classification of OMD. In a paper published in The Lancet Oncology on 2 January 2020 (https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(19)30718-1/fulltext), the researchers describe how they carried out a literature review to identify inclusion and exclusion criteria of prospective interventional OMD clinical trials. They identified and agreed on 17 OMD characteristics that needed to be assessed in all those patients who underwent radical local treatment, both in and outside of clinical trials.
A decision tree for OMD classification was established together with a nomenclature, allowing for much more detailed subclassifications of OMD. In the context of clinical trials, a harmonised characterisation system will contribute to a better understanding and interpretation of study results and facilitate cross-study comparisons, meta-analyses and systematic reviews.
The researchers will follow up their work in the E2-RADIatE (EORTC-ESTRO Radiation Infrastructure for Europe) OligoCare cohort, which will investigate further which treatment is best suited to individual patients with OMD. OligoCare is the the first project on E²-RADIatE, the joint ESTRO-EORTC platform built to host prospective data registries of “real-world” data on patients treated with radiotherapy.
The EORTC-ESTRO radiotherapy registry/platform was launched on 25 June 2019; presently 17 sites are activated in 5 countries in the OligoCare cohort. Another 40-50 sites in 13 countries are planned for activation this year.
Currently almost 100 patients (38% prostate, 27% colorectal, 21% lung and 15% breast cancer patients) are enrolled in the cohort.
ESTRO and EORTC encourage more centres to engage in OligoCare and all future E2-RADIatE cohorts.
- Candidate PI may attend the joint ESTRO-EORTC symposium at ESTRO 2020 in Vienna on 5 April (14:15-15:30 – Room Strauss 1)
This joint ESTRO-EORTC symposium will focus on new approaches to characterize and treat oligometastatic disease (OMD) with radiotherapy (RT). First, the heterogeneity within the metastatic state will be described, followed by an illustration of the value of local consolidative therapies (LCT) and metastasis-directed therapies (MDT). Furthermore, benefits and limitations of RT as LCT / MDT will be described. In addition, OligoCare as a new model will be introduced and a report of the first six months of OligoCare will be given. Challenges of RT planning for OMD will be discussed in addition to image guidance strategies. Finally, the importance of modern imaging techniques for lesion detection, treatment planning and response assessment as well as the key role of imaging to design future trials will be discussed.