AO spine clinical practice recommendations: current systemic oncological treatments with the largest impact on patients with metastatic spinal disease
Czyz, Marcin Wensink, Emerens G Coimbra, Brian Galgano, Michael Patel, Shreyaskumar Redmond, Kristin Rutges, Joost Tan, Jiong Hao Jonathan Barzilai, Ori Dea, Nicolas
Czyz, Marcin
Wensink, Emerens G
Coimbra, Brian
Galgano, Michael
Patel, Shreyaskumar
Redmond, Kristin
Rutges, Joost
Tan, Jiong Hao Jonathan
Barzilai, Ori
Dea, Nicolas
Affiliation
University Hospitals Birmingham NHS Foundation Trust; University Medical Center Utrecht; ICESP Hospital das Clínicas da Universidade De São Paulo; University of North Carolina; University of Texas MD Anderson Cancer center; Johns Hopkins University School of Medicine; Erasmus University Medical Center; National University Hospital; Memorial Sloan Kettering Cancer Center; University of British Columbia; IRCCS Istituto Ortopedico Rizzoli; New York University Langone Health; National Center for Spinal Disorders Budapest; Universitätspital Basel; Oxford University Hospitals NHS Foundation Trust; Sunnybrook Health Science Center
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Publication date
2025-03-28
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Abstract
Study Design: Literature review with clinical recommendation.
Objective: To provide the readers with a concise curation of the latest literature in recent advances in systemic oncological therapies and their implications for decision-making in patients with metastatic spinal disease. This review aims to enhance spine specialist's understanding of modern oncological treatments to facilitate optimal timing and planning of local interventions.
Methods: The latest literature in the topic of advances in oncology was reviewed by a multidisciplinary group of experts in metastatic spinal disease and clinical recommendations were formulated. The recommendations were dichotomously graded into strong and conditional (weak) based on the integration of scientific methodology and content expert opinion. This opinion considered experience and practical issues such as risks, burdens, costs, patient values, and circumstances.
Results: Four high-impact studies were reviewed, demonstrating significant advancements in systemic treatments for metastatic cancers commonly affecting the spine. These studies showed improved survival outcomes and efficacy across breast cancer, colorectal cancer, prostate cancer, and renal cell carcinoma. The findings have important implications for surgical/radiotherapy planning, including considerations for timing of interventions, wound healing, and the potential for extended survival affecting construct durability requirements.
Conclusions: Recent advances in systemic oncological treatments have important implications for managing metastatic spinal disease. Understanding these developments is crucial for spine specialists to optimize decision-making through a multidisciplinary approach, particularly regarding timing of local interventions, strategy of the surgical approach and reconstruction.
Citation
Czyz M, Wensink EG, Coimbra B, Galgano M, Patel S, Redmond K, Rutges J, Tan JHJ, Barzilai O, Dea N, Gasbarrini A, Laufer I, Lazary A, Netzer C, Reynolds JJ, Rhines LD, Sahgal A, Fisher CG, Verlaan JJ. AO Spine Clinical Practice Recommendations: Current Systemic Oncological Treatments with the Largest Impact on Patients with Metastatic Spinal Disease. Global Spine J. 2025 May;15(4):1884-1889. doi: 10.1177/21925682251324138. Epub 2025 Mar 28.
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Article