Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial

Badwe, Rajendra; Hawaldar, Rohini; Nair, Nita; Kaushik, Rucha Vishal; Parmar, Vani; Siddique, Shabina; Budrukkar, Ashwini; Mittra, Indraneel; Gupta, Sudeep

doi:10.1016/s1470-2045(15)00135-7

Cited by 476 publications

(454 citation statements)

References 28 publications

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“…However, whether the aggressive thoracic therapy (ATT) could potentially improve overall survival (OS) in oligometastatic NSCLC remains unclear. Removal of the primary tumor was shown to improve OS in patients with metastatic renal cancer (9), by contrast, locoregional treatment of the primary tumor did not affect OS in patients with metastatic breast cancer (10). More and more studies reported favorable long-term survivals in oligometastatic NSCLC treated with aggressive local therapy (11)(12)(13).…”

Section: Original Articlementioning

confidence: 99%

Should aggressive thoracic therapy be performed in patients with synchronous oligometastatic non-small cell lung cancer? A meta-analysis

Li¹,

Zhu²,

Wang³

et al. 2017

J. Thorac. Dis.

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Background: We performed a meta-analysis to compare overall survival (OS) outcomes in patients with synchronous oligometastatic non-small cell lung cancer (NSCLC) who underwent aggressive thoracic therapy (ATT) with those who did not. Methods: A systematic review of controlled trials of ATT on survival in synchronous oligometastatic NSCLC was conducted. Hazard ratio (HR) for the main endpoint OS was pooled using a fixed-effects model. Subgroup analysis was performed in patients with single organ metastases, or with different numbers of brain metastases, or with different stages of thoracic disease. Pooled survival curves of OS were constructed. Results: Seven eligible retrospective observational cohort studies were identified including 668 synchronous oligometastatic NSCLC patients, of whom 227 (34.0%) received ATT. For patients with synchronous oligometastatic NSCLC, ATT was associated with a significant improvement of OS (HR, 0.48; 95% CI, 0.39-0.60; P<0.00001). In subgroup analysis, the association with OS was similar or even strengthened, with a HR of 0.42 (95% CI, 0.31-0.56) in single organ metastases group, 0.49 (95% CI, 0.31-0.75) in solitary brain metastasis group, and 0.38 (95% CI, 0.20-0.73) in thoracic stage I-II group, respectively. The pooled cumulative survival rates for patients received ATT were 74.9% at 1 year, 52.1% at 2 years, 23.0% at 3 years, and 12.6% at 4 years. The corresponding pooled survival for patients who did not receive ATT were 32.3%, 13.7%, 3.7%, and 2.0%, respectively. Conclusions: Survival benefit from ATT is common in synchronous oligometastatic patients. Selected patients with synchronous oligometastatic NSCLC could also achieve long-term survival with ATT. Targeted therapy have shown efficacy in the treatment of advanced NSCLC, however, most patients progress after a median survival of 12 months because of resistance (4-6).Hellman and Weichselbaum proposed the existence of a clinically recognisable state termed 'oligometastases', which is an intermediate state of metastases characterized by a limited number and site of metastatic tumors. In these selected patients, eradication of oligometastases could be curative (7,8). However, whether the aggressive thoracic therapy (ATT) could potentially improve overall survival (OS) in oligometastatic NSCLC remains unclear. Removal of the primary tumor was shown to improve OS in patients with metastatic renal cancer (9), by contrast, locoregional treatment of the primary tumor did not affect OS in patients with metastatic breast cancer (10). More and more studies reported favorable long-term survivals in oligometastatic NSCLC treated with aggressive local therapy (11-13). However, these studies are retrospective and the validity of the survival benefit are challenging due to patient selection.Recently, Ashworth et al. did a systematic review of literature considering NSCLC patients with 1-5 metastases treated with local therapy and found that definitive treatment of the primary tumor was a good prognostic factor for survival (14). Moreo...

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Section: Original Articlementioning

confidence: 99%

Should aggressive thoracic therapy be performed in patients with synchronous oligometastatic non-small cell lung cancer? A meta-analysis

Li¹,

Zhu²,

Wang³

et al. 2017

J. Thorac. Dis.

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“…For instance, the 4 weekly cost of trastuzumab was $2761 in India versus $6849 in the U.S [3]. However, despite trastuzumab being a high value drug for HER2 positive breast cancer and costing cheaper in India, more than 99% of patients with HER2+ breast cancer didn't receive trastuzumab in an Indian trial [4]. This is probably because cheaper in comparison to U.S is still too expensive for most Indian patients living on an average Indian salary.…”

Section: Bishal Gyawalimentioning

confidence: 99%

Untitled

2017

Oncotarget

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“…В 2015 г. R. Badwe и соавт. [29] опубликовали результаты исследования NCT00193778, проведенного в Мумбае в 2005-2013 гг., в которое были включены 350 пациенток с ПРРМЖ. В исследуемой группе up-front выполнялось оператив-ное лечение, за исключением случаев, когда опухоль была нерезектабельна.…”

Section: опухоли женской репродуктивной системы Tumors Of Female Reprunclassified

Evaluation of the scientific results of the study entitled “Opportunities for surgical treatment of patients with stage IV breast cancer” performed by Russian Society of Oncomammologists (RSOM)

Bozhok¹,

Топузов²,

Зикиряходжаев³

et al. 2016

Tumors of female reproductive system

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ОПУХОЛИ ЖЕНСКОЙ РЕПРОДУКТИВНОЙ СИСТЕМЫ TUMORS OF FEMALE REPRODUCTIVE SYSTEM Russia; 3 2nd Botkinskiy Proezd, Moscow 125284, Russia; 5 N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia; 23 Kashirskoe Shosse, Moscow 115478, Russia; 6 Rostov Research Institute of Oncology, Ministry of Health of Russia; 63 14th Liniya St., Rostov-on-Don 344037, Russia; 7 N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia; 68, Leningradskaya St., Pesochnyi Settlement, Saint Petersburg 197758, Russia

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Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial

Cited by 476 publications

References 28 publications

Should aggressive thoracic therapy be performed in patients with synchronous oligometastatic non-small cell lung cancer? A meta-analysis

Should aggressive thoracic therapy be performed in patients with synchronous oligometastatic non-small cell lung cancer? A meta-analysis

Untitled

Evaluation of the scientific results of the study entitled “Opportunities for surgical treatment of patients with stage IV breast cancer” performed by Russian Society of Oncomammologists (RSOM)

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