OnCo

Metastatic cancer (cancer that has spread): lines of therapy

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4 standard-of-care settings across 3 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comers
Advanced, first line1
Special situations2
Other settings1

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersWidespread metastatic diseaseSystemic therapy chosen by the primary cancer and its biomarkers, with early palliative care; see the individual cancer pages.66

Special situations

SubgroupSettingApproachProducts and trialsEvidence
All comersOligometastatic diseaseStereotactic ablative radiotherapy or surgery to all sites in addition to systemic therapy, in selected patients and ideally in trials.40
All comersBrain metastasesStereotactic radiosurgery for limited lesions, surgery for large symptomatic ones, and brain-penetrant targeted drugs where a driver exists.-

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersBone metastasesPalliative radiotherapy for pain, bone-modifying agents (zoledronic acid or denosumab) to prevent fractures, radium-223 in prostate cancer.86

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.