Combining Metastasis-Directed Therapy with Chemotherapy Improves Outcomes in Oligometastatic Pancreatic Cancer

The multicenter, randomized phase II EXTEND trial, published in the Journal of Clinical Oncology, demonstrated significant clinical benefits from combining metastasis-directed therapy (MDT) with systemic chemotherapy in patients with oligometastatic pancreatic ductal adenocarcinoma (PDAC). With a median follow-up of 17 months, patients receiving MDT plus chemotherapy achieved a median progression-free survival (PFS) of 10.3 months, compared to only 2.5 months for chemotherapy alone (hazard ratio: 0.43). Importantly, MDT was well-tolerated with no high-grade adverse events reported, and evidence suggested that improved outcomes correlated with systemic immune activation triggered by MDT. These promising results indicate MDT as a valuable addition to standard care for selected PDAC patients, warranting further confirmatory clinical studies.