Oligo-Metastatic Cancers: Putative Biomarkers, Emerging Challenges and New Perspectives

Abstract

Some cancer patients display a less aggressive form of metastatic disease, characterized by a low tumor burden and involving a smaller number of sites, which is referred to as “oligometastatic disease” (OMD). This review discusses new biomarkers, as well as methodological challenges and perspectives characterizing OMD. Recent studies have revealed that specific microRNA profiles, chromosome patterns, driver gene mutations (ERBB2, PBRM1, SETD2, KRAS, PIK3CA, SMAD4), polymorphisms (TCF7L2), and levels of immune cell infiltration into metastases, depending on the tumor type, are associated with an oligometastatic behavior. This suggests that OMD could be a distinct disease with specific biological and molecular characteristics. Therefore, the heterogeneity of initial tumor burden and inclusion of OMD patients in clinical trials pose a crucial methodological question that requires responses in the near future. Additionally, a solid understanding of the molecular and biological features of OMD will be necessary to support and complete the clinical staging systems, enabling a better distinction of metastatic behavior and tailored treatments.

Hepatic arterial infusion chemotherapy combined with bevacizumab plus a PD-1 inhibitor for gallbladder cancer with hepatic oligometastasis: a real-world study

“…Tumor cells are killed by locoregional chemotherapy and release more specific antigens which were captured by antigen-presenting cells and promote the effect of PD-1. Chemotherapeutic agents have also been shown to induce immunomodulatory effects ( 15 , 16 ). Six patients (22.2%) were successfully converted to resection.…”

“…GBC frequently spreads to the liver ( 15 ). The term oligometastasis indicates that tumors progress to a limited number of metastatic lesions with the potential to benefit from local therapies, such as ablation, resection, and stereotactic radiotherapy ( 16 ). Cases of hepatic oligometastasis without hilar invasion and distant lymphatic metastasis account for a small proportion of GBC patients.…”

Evaluation of secondary cytoreduction surgery in platinum-resistant ovarian cancer patients within three-line recurrent: a multicenter, randomized controlled study

“…First, respectable oligometastatic lesions are the prerequisite for achieving a complete resection. The oligometastatic paradigm, formally defined in the 1990s but anecdotally reported as early as the 1930s, suggests that in some patients, metastatic disease is not widespread, but is constrained to develop in only a small number of sites (typically defined as the presence of 1-5) because of anatomical and physiological factors [ 14 15 16 ]. This paradigm suggests that patients with oligometastases should be amenable to a curative treatment approach.…”

Oligo-Metastatic Disease in Oncology: Exploring the Limits and the Potential of Genetic Assessment

“…Metastasis, the spread of cancer cells from the primary tumor site to distant organs, represents a pivotal hallmark of advanced cancer. In contrast to widespread metastatic disease, oligo-metastases constitute a unique clinical entity characterized by a limited number of metastatic lesions, typically fewer than five, and a notably less aggressive disease course [1]. Patients with oligo-metastatic disease (OMD) often exhibit prolonged survival, offering a distinct therapeutic window for intervention [2].…”