ASCO 2020 Regret! Early local therapy failed to improve the overall survival rate of women with primary stage IV breast cancer

The 2020 Annual Meeting of the American Society of Clinical Oncology (ASCO) has been successfully concluded, and this academic feast has won the attention of oncologists around the worldThe most-watched summary of the study (Late-breaking Abstract, LBA) was officially released at 5 p.mEST on May 28, with two entries for abstractoral session and five for LBA plenary sessionFollow in the footsteps of small editors and open the cloud year mode, and take a look at these heavyweight studiesthis issue is shared with you an LBA (summary number LBA2) of plena session, which reports a randomized Phase III trial of women with systemic therapy combined with early local therapy with individual systemic therapy for women with primary stage IV breast cancer1 ASCO 2020 selected LBA study (summary number: LBA2, source: ASCO 2020 website)study background
about 6% of newly diagnosed breast cancer patients have stage IV disease and complete primary tumor (intact primary tumor, IPT)According to retrospective analysis, ipT local area therapy (locoregional treatment, LRT) was supposed to improve survival, but randomized trials provided conflicting dataWe now report the results of E2108, a Phase III trial that tested the value of LRT to IPT after initial systemic treatmentstudy methodsregistered patients with IPT in stage IV, treated with optimal system therapy (optimal therapy, OST) according to patient and tumor characteristics, and patients who did not progress within 4 to 8 months of OST were randomly divided into THE LRT group or the LRT-free group in the IPT groupFigure 4 Study Designthe primary endpoint is total survival rate (OS), and local area disease control is a secondary endpointuses hierarchical nod rank tests and Cox scale hazard models to compare the os between groups The cumulative incidence of recurrence/progress in the local area was estimated and compared with the Gray trial treatment group the test was designed to detect whether a 3-year OS could be increased from 30% of the simple OST to 49.3% (95% power, one-sided alpha 0.05) and 152 deaths with the expected complete information; findings 390 patients received OST treatment from 2 August 2011 to 23 July 2015 Of these, 256 eligible patients were randomly classified as single OST (N-131) or OST-LRT (N-125), with a median follow-up of 59 months (range: 0 to 91), a total of 121 deaths, 43 cases in the local progressperiod figure 8 subjects transfer sites and initial systemic treatment OS (
OST-LRT group 3 years OS rate of 68.4%, alone OST group of 67.9% , stratified logarithmic rank P-0.63, HR-1.09,90% CI: 0.80, 1.49) or no progression survival rate (P-0.40) no significant difference local relapse/progression in the single OST group was significantly higher than that of the control group (3-year recurrence rate was 25.6% vs 10.2%, Gray test P.0.003) Of PFS analysi
s the subjects 18 months after randomization (60% completed, Wilcoxon rank and test P -0.01), the health-related quality of life (health-quality of life, HRQOL) in the OST-LRT group measured by the FACT-B test results index was significantly lower than that of the OST individual group, but did not differ at 6 months (74% completed) or 30 months (56%) of completion conclusion
early local treatment cannot improve the survival rate of patients with recurrent metastatic breast cancer and IPT Although the risk of local disease progression was 2.5 times higher without LRT, THE LRT of IPT did not improve HRQOL author: Tao Ran Source: health