ASCO20: Can Local Therapy Improve Survival in Newly Diagnosed Advanced Breast Cancer?
Posted: Tuesday, June 2, 2020
About 6% of newly diagnosed patients with breast cancer present with de novo stage IV disease and an intact primary tumor. Whether early locoregional treatment with radiation and surgery for the primary tumor, after initial optimal systemic therapy, contributes to longer survival has been a matter of question. The primary endpoint outcomes of the phase III E2108 trial, presented in a Plenary Session during the ASCO20 Virtual Scientific Program (Abstract LBA2), reported that early local therapy did not improve survival. Furthermore, although there was “a 2.5-fold higher risk of local disease progression without locoregional therapy,” noted Seema Ahsan Khan, MD, MPH, of Northwestern Memorial Hospital, Chicago, and colleagues, “locoregional therapy of the primary tumor did not lead to improved health-related quality of life.”
The initial population included 390 patients enrolled over 4 years who received optimal systemic therapy. Then, 256 eligible patients—those who did not experience disease progression during 4 to 8 months of that therapy—were randomly assigned to either continued systemic therapy + locoregional therapy (n = 125) or systemic therapy alone (n = 131). The 3-year overall survival rate was 68.4% and 67.9% in the two arms, respectively (P = .63); after a median follow-up of 59 months, the progression-free survival difference between the arms was not statistically significant either (P = .40).
During follow-up, a total of 121 deaths and 43 locoregional disease progression events occurred in the 256 patients. “The locoregional recurrence/disease progression was significantly higher in the systemic therapy–alone arm (3-year rate, 25.6% vs. 10.2%; P = .003),” reiterated Dr. Khan and co-investigators.
“When combined with the results of an earlier trial [published by Badwe et al in The Lancet Oncology], these results tip the scales against the possibility that local therapy to the breast tumor will help women live longer,” stated Dr. Khan in an ASCO press release.
Disclosure: The study authors’ disclosure information can be found at coi.asco.org.
