Oligoprogression

Oligoprogression describes the situation in which only one or two lesions grow while the rest of the cancer remains controlled on a targeted therapy. In ALK- and EGFR-driven non-small-cell lung cancer the usual response is local ablative treatment of the progressing lesions, with stereotactic radiotherapy or surgery, while the tyrosine kinase inhibitor continues, which extends the time a patient stays on an effective systemic therapy. It is distinct from oligometastatic disease at diagnosis, where the whole burden is limited from the start. The concept is linked from the bottlenecks on tumour heterogeneity and on metastasis biology, from the resistance-routes map, and from the idea of a test to tell true oligometastatic disease from hidden widespread spread.