Prise en charge des cancers bronchiques non à petites cellules oligométastatiques

The concept of oligometastatic disease applies to a subpopulation of patients with a low tumor burden clinically characterized by a limited number of metastases. The 8^th TNM classification differentiates this subgroup of patients with a single extra-thoracic metastasis (stage M1b) from patients with several extrathoracic metastases in one or more organs (stage M1c). These oligometastatic stages could benefit of intensive therapeutic options combining systemic treatment and radical local treatment of secondary and primary lesions, as surgery, conventional or stereotaxic radiotherapy and interventional radiology. Evaluation of immunotherapy combined with radiotherapy is ongoing in this particular clinical setting. Identification of patients candidates for such therapeutic strategies remains difficult in order to acheve significant clinical benefit without additional toxicities. Besides clinical prognostic factors (PS, stage N, chronology of occurrence and/ or site of metastases…), determination of predictive biomarkers (micro-RNA, genomic signatures, PDL1 status…) would be useful to optimize management of oligometastatic patients.