(Oligo)metastasis as a Spectrum of Disease

Cancer metastasis is the leading cause of cancer-related mortality, and most patients with metastases from solid tumors have historically been considered incurable. Here, we discuss the evolution of our understanding of the oligometastatic state with an emphasis on the view that cancer metastasis represents a spectrum of disease. We highlight several recently published prospective clinical trials demonstrating improvements in cancer-specific outcomes with the utilization of metastasis-directed local therapies. We discuss biological aspects of oligometastases, including genetic, epigenetic, and immune determinants of the metastatic spectrum. Finally, we propose future considerations regarding clinical trial design for patients with oligometastatic disease.

Automated summary

The understanding of oligometastatic state has evolved, emphasizing that cancer metastasis represents a spectrum of disease. Recent clinical trials have shown improvements in cancer-specific outcomes with the use of metastasis-directed local therapies. Biological aspects of oligometastases, including genetic, epigenetic, and immune determinants, were discussed along with considerations for future clinical trial design for patients with oligometastatic disease.