Evolutionary and resistance dynamics in oligometastatic and oligoprogressive cancer treated with stereotactic radiotherapy and systemic therapies: A systematic review and focused meta-analysis.
Semin Cancer BiolJul 28, 2026 (epub)
Marilina García-Aranda, Juan Zafra-Martín, Alba Rodríguez-Martínez et al.
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In 30 seconds
This systematic review and meta-analysis examined the evolutionary dynamics and resistance mechanisms in 1527 patients with oligometastatic and oligoprogressive cancer treated with stereotactic ablative radiotherapy (SABR). The findings revealed that anatomically defined oligometastatic states represent biologically distinct subgroups, influencing systemic progression risks and treatment responses.
Key findings
- Anatomically defined oligometastatic states include biologically distinct subgroups with varying systemic progression risks.
- Baseline adverse genomic signatures and circulating biomarkers correlated with poorer progression outcomes.
- Longitudinal biomarkers indicated early treatment response and systemic control signals.
- Immune remodeling post-SABR exhibited both systemic immune activation and treatment-related immunosuppression.
Why it matters
Understanding the biological diversity within oligometastatic and oligoprogressive cancers can enhance treatment strategies and patient stratification, potentially improving outcomes through tailored therapeutic approaches.