Oligometastatic Breast Cancer: Is This a Curable Entity? A Contemporary Review of the Literature

Makhlin, Igor; Fox, Kevin R.

doi:10.1007/s11912-020-0867-2

Cited by 34 publications

(38 citation statements)

References 72 publications

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“…Makhlin et al pointed out that the majority of data in support of surgery strategies is retrospective in nature and hence must be interpreted with caution. 21 In our study, the resection of all metastatic lesions was the only factor associated with an improved prognosis. The 2-year PFS and 5-year OS rates were 65% and 80%, respectively, in the resection group and 20% and 40%, respectively, in the systemic treatment only group.…”

Section: Discussionsupporting

confidence: 49%

“…Kobayashi et al also found that patients who received multidisciplinary aggressive therapies had a better prognosis than those who received systemic therapies only 15 . In a review of literature about oligometastatic breast cancer, Igor Makhlin et al pointed out that the majority of data in support of surgery strategies is retrospective in nature and hence must be interpreted with caution 21 …”

Section: Discussionmentioning

confidence: 99%

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Clinical features and prognostic factors for extracranial oligometastatic breast cancer in China

Lan

Abudureheiyimu

Zhang

et al. 2020

Intl Journal of Cancer

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Evidence of an oligometastatic state in metastatic breast cancer (MBC) is relatively limited. The aim of our study was to investigate the clinical features and prognostic factors for extracranial oligometastatic breast cancer and to identify the best treatment approaches in this select population. Fifty postoperative inpatients diagnosed with extracranial oligometastatic breast cancer at the National Cancer Center in China between 2009 and 2014 were consecutively enrolled. Oligometastatic breast cancer was defined as MBC with three or fewer metastatic lesions confined to one organ; de novo Stage IV disease and local-regional recurrence were excluded. The median progression-free survival (PFS) and overall survival (OS) times were 15.2 and 78.9 months, respectively, and the 2-year PFS and 5-year OS rates were 40% and 58%, respectively. First-line treatment approach with standard systemic treatment + surgical resection for all metastatic lesions was an independent prognostic factor for prolonged PFS (hazard ratio = 0.32; 95% confidence interval [CI], 0.14-0.73; P = .006) and OS (hazard ratio = 0.35; 95% CI, 0.14-0.86; P = .022). Subgroup analysis showed that patients with a disease-free interval (DFI) ≥24 months, one metastatic lesion or the hormone receptor (HR) + subtype were more likely to get benefit from resection. Patients with oligometastatic breast cancer have a relatively good prognosis. Surgical resection for metastatic lesions could significantly improve PFS and OS. Further prospective research is warranted to confirm the results and to develop biomarkers for better patient selection.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Clinical features and prognostic factors for extracranial oligometastatic breast cancer in China

Lan

Abudureheiyimu

Zhang

et al. 2020

Intl Journal of Cancer

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“…An emerging field concerns oligometastatic disease, most often defined as up to five metastases. 212 Although early data show improved outcomes after radical metastases-directed therapy, these data are based upon a widely variable range of clinical scenarios, with diff erent prognoses and requiring different therapeutic approaches. 213 Most patients can be treated with short courses of radiotherapy, ranging between one and five of conventional or stereotactic techniques, with palliative, radical, and even curative intentions.…”

Section: Non-systemic Options For Metastatic Breast Cancer Including Local Therapiesmentioning

confidence: 99%

Breast cancer

et al. 2021

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Breast cancer is still the most common cancer worldwide. But the way breast cancer is viewed has changed drastically since its molecular hallmarks were extensively characterised, now including immunohistochemical markers (eg, ER, PR, HER2 [ERBB2], and proliferation marker protein Ki-67 [MKI67]), genomic markers (eg, BRCA1, BRCA2, and PIK3CA), and immunomarkers (eg, tumour-infiltrating lymphocytes and PD-L1). New biomarker combinations are the basis for increasingly complex diagnostic algorithms. Neoadjuvant combination therapy, often including targeted agents, is a standard of care (especially in HER2-positive and triple-negative breast cancer), and the basis for de-escalation of surgery in the breast and axilla and for risk-adapted post-neoadjuvant strategies. Radiotherapy remains an important cornerstone of breast cancer therapy, but de-escalation schemes have become the standard of care. ER-positive tumours are treated with 5-10 years of endocrine therapy and chemotherapy, based on an individual risk assessment. For metastatic breast cancer, standard therapy options include targeted approaches such as CDK4 and CDK6 inhibitors, PI3K inhibitors, PARP inhibitors, and anti-PD-L1 immunotherapy, depending on tumour type and molecular profile. This range of treatment options reflects the complexity of breast cancer therapy today.

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“…In 1995, Hellman and colleagues rst described oligometastasis and suggested that at this stage the cancer has not yet reached its full metastatic potential and is restricted to certain regions [9]. In other words; the concept of oligometastatic disease implies that few metastases, usually under ve, may be present before tumor cells reach diffuse metastatic potential [11].…”

Section: Discussionmentioning

confidence: 99%

“…However, the de nition of OMBC in the literature varies according to the number and location of metastasis [8]. It is still uncertain whether OMBC corresponds to an intermediate stage between a localized disease and a widespread disease or a genetically unique entity rather than a transition point from primary tumor to metastasis [9].…”

Section: Introductionmentioning

confidence: 99%

Solitary Bone Metastasis and Oligometastatic Bone Disease in Breast Cancer: Are They Two Different Entities?

Zengel¹,

Kılıç²,

Taşlı³

et al. 2021

Preprint

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In this study, we planned to investigate the clinical course of breast cancer patients with oligometastatic bone disease (OMBD).The patients were grouped according to the characteristics and the sites of metastases. Group I included 928 patients without metastasis. Group II, OMBD group, icluded 68 patients. Group III, widespread metastasis group, consisted of 185 patients with multiple bone metastases and/or solid organ metastases.The mean overall survival of the groups were 16.7 ± 0.3 years in Group 1, and 7.8 ± 0.8 and 5.9 ± 0.4 years in Group 2 and 3, respectively (p<0,001 for the comparison of all three groups together; p <0.001 for Group 1 vs 2 & 3) and (p=0.037 for Group 2 vs. Group 3). In the subgroup survival analysis of patients in Group 2 (OMBD), the mean and median survival were 5.5 ± 0.8 and 4.0±0.8 years versus 9.2 ± 0.98 and 9.0 ±1.05 years in more than one bone metastasis and SBM patients, respectively (p = 0.019).As a result; OMBD seems to be a different disease than breast cancer with isolated bone metastases. The high risk of developing OMBD especially following locoregional recurrences increases the importance of locoregional therapy in large T and N stage tumors.

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Oligometastatic Breast Cancer: Is This a Curable Entity? A Contemporary Review of the Literature

Cited by 34 publications

References 72 publications

Clinical features and prognostic factors for extracranial oligometastatic breast cancer in China

Clinical features and prognostic factors for extracranial oligometastatic breast cancer in China

Breast cancer

Solitary Bone Metastasis and Oligometastatic Bone Disease in Breast Cancer: Are They Two Different Entities?

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