When to Treat First in Metastatic NSCLC?
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By
January 13, 2026
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5 min
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1
Both upfront and delayed LRT combined with ICI achieved ~45% 3-year OS.
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2
Important factors for favorable outcomes include brain metastasis, good performance status, and high PD-L1 expression.
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3
Squamous histology correlates with poorer survival.
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4
Study designed to guide multidisciplinary discussions in clinical practice.
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5
Limitations include selection bias and retrospective design, stressing individual patient characteristics over fixed sequencing.
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A study evaluating treatment sequencing for patients with synchronous oligometastatic non-small cell lung cancer (NSCLC) without actionable genetic alterations shows that both upfront and delayed local radical treatment (LRT) combined with immune checkpoint inhibitors (ICIs) yield a comparable three-year overall survival of approximately 45%. Conducted on patients treated between 2018-2022, this analysis underscores the significance of patient selection over strict adherence to treatment sequences, emphasizing the need for multidisciplinary discussions amidst existing uncertainties.
-
1
Both upfront and delayed LRT combined with ICI achieved ~45% 3-year OS.
-
2
Important factors for favorable outcomes include brain metastasis, good performance status, and high PD-L1 expression.
-
3
Squamous histology correlates with poorer survival.
-
4
Study designed to guide multidisciplinary discussions in clinical practice.
-
5
Limitations include selection bias and retrospective design, stressing individual patient characteristics over fixed sequencing.
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