Prise en charge des formes oligométastatiques: l'avis de l'oncologue thoracique

The concept of oligometastatic disease applies to a subpopulation of patients with a low tumor burden clinically characterized by a limited number of metastases. 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. Patients’ identification who could be suitable candidates for such therapeutic strategies remains difficult in order to achieve 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…) would be useful to optimize management of oligometastatic patients.