Locoregional Treatment of Primary Tumor in Metastatic Breast Cancer Not Beneficial

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There is no evidence to support that locoregional treatment of the primary tumor provides any overall survival benefit.
There is no evidence to support that locoregional treatment of the primary tumor provides any overall survival benefit.

Researchers concluded that there is no evidence to support locoregional treatment of the primary metastatic breast cancer tumor .1

It does not affect overall survival in patients with metastatic breast cancer at initial presentation who have responded to front-line chemotherapy, and this procedure should not be used in routine practice, according to an article published online ahead of print in the Lancet Oncology.

Locoregional treatment in women with metastatic breast cancer at first presentation is controversial. Preclinical evidence suggests that it may help the growth of metastatic disease, while retrospective analyses in clinical cohorts suggest a favorable effect.

In this study, previously untreated patients younger than 65 years with de novo metastatic breast cancer were recruited.

A total of 350 patients were randomly assigned to receive locoregional treatment directed at the primary breast tumor and axillary lymph nodes or no locoregional treatment. Data cutoff occurred at a median follow-up of 23 months. There were 235 deaths.

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Median overall survival was 19.2 months (95% CI: 15.98-22.46) in the locoregional treatment group and 20.5 months in (16.96 to 23.98) in the no locoregional treatment group (HR=1.04; 95% CI: 0.81-1.34; P=0.79).  The corresponding 2-year overall survival rate was 41·9% (95% CI: 33.9–49·7) in the locoregional treatment group and 43.0% (35.2–50.8) in the no locoregional treatment group.

In regard to safety, there was one adverse event noted that was wound-related to surgery in a patient in the locoregional treatment group.

Reference

  1. Badwe R, Hawalaar R, Nair N, et al. Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial. [published online ahead of print September 9, 2015]. Lancet Oncol. doi: 10.1016/S1470-2045(15)00135-7.

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