Metastasis-directed stereotactic radiotherapy and systemic treatment continuation for patients with oligoprogressive metastatic breast cancer.

IF 7.6 1区 医学 Q1 ONCOLOGY
Monica Milano, Carmine Valenza, Annamaria Ferrari, Sara Gandini, Dario Trapani, Celeste Santoro, Elena Battaiotto, Ambra Carnevale Schianca, Elisa Giordano, Jalissa Katrini, Grazia Castellano, Beatrice Taurelli Salimbeni, Maria Cristina Leonardi, Samantha Dicuonzo, Carmen Criscitiello, Nadia Bianco, Silvia Dellapasqua, Elisabetta Munzone, Giuseppe Curigliano, Marco Colleoni, Barbara Alicja Jereczek-Fossa
{"title":"Metastasis-directed stereotactic radiotherapy and systemic treatment continuation for patients with oligoprogressive metastatic breast cancer.","authors":"Monica Milano, Carmine Valenza, Annamaria Ferrari, Sara Gandini, Dario Trapani, Celeste Santoro, Elena Battaiotto, Ambra Carnevale Schianca, Elisa Giordano, Jalissa Katrini, Grazia Castellano, Beatrice Taurelli Salimbeni, Maria Cristina Leonardi, Samantha Dicuonzo, Carmen Criscitiello, Nadia Bianco, Silvia Dellapasqua, Elisabetta Munzone, Giuseppe Curigliano, Marco Colleoni, Barbara Alicja Jereczek-Fossa","doi":"10.1016/j.ejca.2024.115164","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>About 15-20 % of patients with metastatic breast cancer (mBC) can experience oligoprogressive disease (OPD) in ≤ 5 sites of disease. Patients with OPD may benefit from metastasis-directed stereotactic radiotherapy (SBRT) to all sites of cancer progression while maintaining the same systemic treatment, aiming to prolong the time to next systemic treatment (NEST). This study aims to assess the outcomes provided by this multimodal strategy.</p><p><strong>Methods: </strong>Prospective-retrospective, single-center, cohort study including consecutive patients who received SBRT to all extracranial OPD sites (≤ 5), from January 2011 to June 2023, without changing systemic therapy, according to the multidisciplinary tumor board's indication. The primary endpoint was post-radiotherapy progression-free survival (pRT-PFS). A sample size of 130 patients was needed to estimate a median pRT-PFS of 8 months with a 95 % confidence interval (95 %CI) ranging from 5.4 (considered clinically significant) to 10.6 months.</p><p><strong>Results: </strong>129 patients were included: 99 (77 %) had hormone receptor-positive/HER2-negative (HR+/HER2-) disease, 116 (90 %) had ≤ 2 oligoprogressive lesions, 118 (91 %) presented with non-visceral OPD involving bones or lymph nodes. Patients experienced OPD after a median PFS on systemic therapy (pre-OPD PFS) of 11.3 months (95 % CI, 8.7-13.0). Median pRT-PFS was 11.3 months (95 % CI, 9.1-13.5) and median NEST was 13.6 months (95 % CI, 11.5-15.2). Only 19 (15 %) patients experienced a subsequent PD in the OPD sites treated with SBRT.</p><p><strong>Conclusion: </strong>Patients with oligoprogressive mBC, especially with HR+/HER2- disease and non-visceral OPD after a durable pre-OPD PFS, benefit from OPD-directed SBRT while maintaining the same systemic treatment, suggesting its broader implementation in clinical practice.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115164"},"PeriodicalIF":7.6000,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ejca.2024.115164","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: About 15-20 % of patients with metastatic breast cancer (mBC) can experience oligoprogressive disease (OPD) in ≤ 5 sites of disease. Patients with OPD may benefit from metastasis-directed stereotactic radiotherapy (SBRT) to all sites of cancer progression while maintaining the same systemic treatment, aiming to prolong the time to next systemic treatment (NEST). This study aims to assess the outcomes provided by this multimodal strategy.

Methods: Prospective-retrospective, single-center, cohort study including consecutive patients who received SBRT to all extracranial OPD sites (≤ 5), from January 2011 to June 2023, without changing systemic therapy, according to the multidisciplinary tumor board's indication. The primary endpoint was post-radiotherapy progression-free survival (pRT-PFS). A sample size of 130 patients was needed to estimate a median pRT-PFS of 8 months with a 95 % confidence interval (95 %CI) ranging from 5.4 (considered clinically significant) to 10.6 months.

Results: 129 patients were included: 99 (77 %) had hormone receptor-positive/HER2-negative (HR+/HER2-) disease, 116 (90 %) had ≤ 2 oligoprogressive lesions, 118 (91 %) presented with non-visceral OPD involving bones or lymph nodes. Patients experienced OPD after a median PFS on systemic therapy (pre-OPD PFS) of 11.3 months (95 % CI, 8.7-13.0). Median pRT-PFS was 11.3 months (95 % CI, 9.1-13.5) and median NEST was 13.6 months (95 % CI, 11.5-15.2). Only 19 (15 %) patients experienced a subsequent PD in the OPD sites treated with SBRT.

Conclusion: Patients with oligoprogressive mBC, especially with HR+/HER2- disease and non-visceral OPD after a durable pre-OPD PFS, benefit from OPD-directed SBRT while maintaining the same systemic treatment, suggesting its broader implementation in clinical practice.

求助全文
约1分钟内获得全文 求助全文
来源期刊
European Journal of Cancer
European Journal of Cancer 医学-肿瘤学
CiteScore
11.50
自引率
4.80%
发文量
953
审稿时长
23 days
期刊介绍: The European Journal of Cancer (EJC) serves as a comprehensive platform integrating preclinical, digital, translational, and clinical research across the spectrum of cancer. From epidemiology, carcinogenesis, and biology to groundbreaking innovations in cancer treatment and patient care, the journal covers a wide array of topics. We publish original research, reviews, previews, editorial comments, and correspondence, fostering dialogue and advancement in the fight against cancer. Join us in our mission to drive progress and improve outcomes in cancer research and patient care.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信