Local ablative therapy (LAT): Surgical metastasectomy, stereotactic ablative radiotherapy, thermal ablation, or electroporation to all oligometastatic lesions
Study summary
This prospective national multicenter observational and interventional study aims to assess the longitudinal disease trajectory of patients with oligometastatic disease (OMD) who receive local metastasis-directed therapy. Patients with any category of OMD from any non-hematological cancer are eligible for inclusion. Local ablative therapy (LAT) includes surgical metastasectomy, radiotherapy, thermal ablation, and electroporations.
The primary objective is to assess the time to failure of LAT strategy in patients with OMD from any primary cancer treated with all LAT modalities.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Histology or cytology proven non-haematological cancer
* Stage IV disease
* ECOG performance status ≤ 2
* Life expectancy \> 6 months
* A baseline scan within 42 days of inclusion (PET-CT or CT or MRI scan) is required, preferably within 28 days for optimal prospective evaluation
* Primary tumor must be controlled, defined by the radiographical response of the primary tumor by systemic or local treatment. If progressing, it is planned to be treated with local ablative therapy (LAT)
* Oligometastatic disease according to the ESTRO-EORTC classification, both de-novo and induced, including oligoprogression
* A maximum of five oligometastases or oligopersistent/oligoprogressive lesions. More than five metastases are allowed in the following cases, 1) location in a defined anatomical entity or 2) location in immediate proximity and as such, cannot be treated separately
* All oligometastatic lesions must be planned for definitive LAT. If all visible/progressive/persistent disease is not treated, the patient cannot be included
* Local ablative therapy must be deemed clinically relevant for the individual patient by the treating team of physicians, or a multidisciplinary team and discussion must be documented in the patient chart
* Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
* Pregnancy
* Diffuse cancer disease, which cannot be locally ablated, i.e., leptomeningeal carcinomatosis, malignant pleural effusions, lymphangitic carcinomatosis, or peritoneal carcinomatosis
* If LAT is deemed unsafe by the MDT (e.g., tumor perforation of hollow organs)
In addition, the patients receiving SBRT to oligometastatic sites should comply with the following criteria.
* The size of the target is limited by the ability to safely deliver locally ablative doses to the metastatic lesions. Generally, an upper limit of 5 cm is recommended
* If the patient has received previous radiotherapy, the combined dose at the radiation site must not exceed the dose constraints according to Appendix 2 - Radiotherapy Recommendations
Primary outcome measure(s)
Time to failure of local ablative therapy (LAT) strategy — Assessed every 3-6 months for 5 years or life-long Defined as time from first day of LAT to progression of disease, locally or metastatically, not amenable to new LAT or progression of disease leading to initiation of or change in systemic treatment
Trial sites (11)
Facility
City
Region
Status
Copenhagen University Hospital Rigshospitalet
Copenhagen
Capital Region of Denmark
Not Yet Recruiting
Copenhagen University Hospital Herlev and Gentofte
Herlev
Capital Region of Denmark
Recruiting
Hillerød Hospital
Hillerød
Capital Region of Denmark
Not Yet Recruiting
Aarhus University Hospital
Aarhus
Central Jutland
Not Yet Recruiting
Gødstrup Hospital
Herning
Central Jutland
Not Yet Recruiting
Danish Center for Particle Therapy
Aarhus
Central Region Denmark
Not Yet Recruiting
Aalborg University Hospital
Aalborg
Northern Region of Denmark
Not Yet Recruiting
Zealand University Hospital, Roskilde and Næstved
Roskilde
Region Sjælland
Not Yet Recruiting
Odense University Hospital
Odense
Southern Denmark Region
Not Yet Recruiting
Sønderborg Hospital
Sønderborg
Southern Denmark Region
Not Yet Recruiting
Vejle Hospital
Vejle
Southern Denmark Region
Not Yet Recruiting
More Gitte Fredberg Persson MD PhD trials in Denmark
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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