Abstract
The elimination of metastases remains one of the major challenges in the curative treatment of patients with cancer. Therefore, most patients with metastatic disease typically receive systemic agents, which prolong survival and alleviate symptoms but are rarely curative. The oligometastatic paradigm challenges the prevailing view of metastasis as a disseminated process and proposes the existence of a spectrum of biological virulence within metastatic lesions. In this Perspectives article, we present evidence supporting our hypothesis that integrated clinical and molecular classification of metastases along the spectrum of disease influences the staging and treatment of patients with cancer.
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Acknowledgements
This work was supported by the Virginia and D. K. Ludwig Fund for Cancer Research, an NIH National Cancer Institute (NCI) R21 grant (CA195075-01A1) and a generous gift from the Foglia Family Foundation.
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Nature Reviews Clinical Oncology thanks P. Ost, S. Siva and the other anonymous reviewer(s) for their contribution to the peer review of this work.
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R.R.W. is a consultant and/or adviser for Aettis, AstraZeneca, Genus, ImmunoVir, Merck Serono, Nano Proteagen, Reflexion Pharmaceuticals, RiMO and Shuttle Pharmaceuticals, has been a guest speaker sponsored by Boehringer Ingelheim and has equity and/or intellectual property rights with Boost Therapeutics, Oncosenescence, Reflexion Pharmaceuticals and RiMO. S.P.P. and R.R.W. have a patent entitled “Methods and kits for diagnosis and triage of patients with colorectal liver metastases” pending.
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Pitroda, S.P., Weichselbaum, R.R. Integrated molecular and clinical staging defines the spectrum of metastatic cancer. Nat Rev Clin Oncol 16, 581–588 (2019). https://doi.org/10.1038/s41571-019-0220-6
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DOI: https://doi.org/10.1038/s41571-019-0220-6
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