The main topic of my talk this morning was oligometastatic disease which is, as the name says, a very early form of metastatic spread within the body. It raises interest because it is believed that early treatment of this very new metastatic spread may improve patient outcome and delay, for example, systemic treatment by just addressing those early lesions with specific treatment.

Why is this imaging so important?

The generation of imaging is really important. It is proven that what we call oligometastatic disease will be seen differently according to this generation of imaging. It is now proven that what we call standard imaging modalities may miss some very early metastatic lesions whereas in opposition what we call modern imaging modalities detect these lesions. These modern imaging modalities are, for example, PET, MRI, whole body MR, compared to what is called the previous or standard imaging modalities which were, in the field of cancer, CT and bone scintigraphy, for example.

Why should trials be designed to evaluate this new condition?

We do not know if what I mentioned, that early treatment of oligometastatic disease, really improves patient survival. It is theoretical and it is proven by preliminary studies but it is really important that we prove at large scale, in so-called randomised trials that this is the reality and this specific treatment is really worth being undertaken in these patients. So we need, for example, imaging trials comparing patients left untreated with this early disease and compare patients treated with specific treatments to see if there is any improvement in the outcome of those populations.

What are the next steps?

The wish of the EORTC Imaging Group is to create and bring to real life trials definitely addressing this question of the value of an early diagnosis of oligometastatic disease and of a specific treatment. We are busy putting this trial into… bringing them into reality.