For patients who develop oligometastatic renal cell carcinoma amenable to local therapies (i.e. ablation, radiation therapy, or surgery), how do you integrate systemic therapy, if at all?
For patients who developed oligometastases while off systemic treatment, do you start systemic therapy following local therapy or return to active surveillance?
For patients who developed oligometastases while on a systemic treatment, do you switch therapies or wait for further evidence of progression?
Answer from: Medical Oncologist at Academic Institution
With full disclosure that the answer to this question is in the relm of a data free zone, for patients with oligometastatic disease not on systemic therapy, the answer is of course dependent upon site of disease i.e. CNS vs bone vs liver etc. That said if the solitary site of disease is ...
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Answer from: Medical Oncologist at Academic Institution
I agree with @Robert Dreicer. If NED otherwise, I would observe after local therapy to mets. If on systemic tx, then we will sometimes use local therapy to progressing lesions (CNS, bone for sure but sometimes even other sites with SBRT). In that case continuing systemic tx depends on the state of o...