Possible clinical cure of metastatic breast cancer: lessons from our 30-year experience with oligometastatic breast cancer patients and literature review

Kobayashi, Tadashi; Ichiba, Tamotsu; Sakuyama, Toshikazu; Arakawa, Yasuhiro; Nagasaki, Eijiroh; Aiba, Keisuke; Nogi, Hiroko; Kawase, Kazumi; Takeyama, Hiroshi; Toriumi, Yasuo; Uchida, Keiji; Kobayashi, Masao; Kanehira, Chihiro; Suzuki, Masafumi; Ando, Naomi; Natori, Kazuhiko; Kuraishi, Yasushi

doi:10.1007/s12282-012-0347-0

Cited by 108 publications

(86 citation statements)

References 43 publications

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“…Prolonged, relapse-free survival has previously been documented in a small subset (∼2–3%) of MBC patients, regardless of HER2 status (Greenberg et al , 1996; Kobayashi et al , 2012); however, there is a paucity of data characterising long-term survival within the HER2-positive MBC population. In our study, baseline demographic and clinical characteristics in the LTS and STS patient cohorts classified by LCM were generally similar, although there were notable exceptions, suggesting that biological differences exist between these groups.…”

Section: Discussionmentioning

confidence: 99%

Long-term survivor characteristics in HER2-positive metastatic breast cancer from registHER

et al. 2014

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Background:Data characterising long-term survivors (LTS) with human epidermal growth factor receptor 2 (HER2)–positive metastatic breast cancer (MBC) are limited. This analysis describes LTS using registHER observational study data.Methods:A latent class modelling (LCM) approach was used to identify distinct homogenous patient groups (or classes) based on progression-free survival (PFS), overall survival, and complete response. Demographics, clinicopathologic factors, first-line treatment patterns, and clinical outcomes were described for each class. Class-associated factors were evaluated using logistic regression analysis.Results:LCM identified two survivor groups labelled as LTS (n=244) and short-term survivors (STS; n=757). Baseline characteristics were similar between groups, although LTS were more likely to be white (83.6% vs 77.8%) with oestrogen receptor–positive (ER+) or progesterone receptor–positive (PgR+) disease (59.4% vs 50.9%). Median PFS in LTS was 37.2 (95% confidence interval (CI): 32.9–40.5) vs 7.3 months (95% CI: 6.8–8.0) in STS. Factors associated with long-term survival included ER+ or PgR+ disease, metastasis to node/local sites, first-line trastuzumab use, and first-line taxane use.Conclusions:Prognostic variables identified by LCM define a HER2-positive MBC patient profile and therapies that may be associated with more favourable long-term outcomes, enabling treatment selection appropriate to the patient's disease characteristics.

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Section: Discussionmentioning

confidence: 99%

Long-term survivor characteristics in HER2-positive metastatic breast cancer from registHER

et al. 2014

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“…Different patients’ and tumor characteristics are related to different patterns of distant relapse: bone metastases are more likely to be diagnosed in patients with HR-positive disease, while lung and liver metastases are more common in patients with a more advanced stage at the time of diagnosis; finally, brain metastases were mostly observed in patients with HR-negative disease 29,30. Currently, restaging of breast cancer patients is predominately based on physical examination, blood parameters, computed tomography (CT), MRI, US and X-rays (XR) as well as bone scintigraphy.…”

Section: Summary Of Current Diagnostic Methodsmentioning

confidence: 99%

Comparative diagnostic accuracy of <sup>18</sup>F-FDG PET/CT for breast cancer recurrence

Piva¹,

Ticconi²,

Ceriani³

et al. 2017

BCTT

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In the last decades, in addition to conventional imaging techniques and magnetic resonance imaging (MRI), 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) has been shown to be relevant in the detection and management of breast cancer recurrence in doubtful cases in selected groups of patients. While there are no conclusive data indicating that imaging tests, including FDG PET/CT, produce a survival benefit in asymptomatic patients, FDG PET/CT can be useful for identifying the site of relapse when traditional imaging methods are equivocal or conflicting and for identifying or confirming isolated loco-regional relapse or isolated metastatic lesions. The present narrative review deals with the potential role of FDG PET in these clinical settings by comparing its accuracy and impact with conventional imaging modalities such as CT, ultrasound, bone scan, 18F-sodium fluoride PET/CT (18F-NaF PET/CT) as well as MRI. Patient-focused perspectives in terms of patients’ satisfaction and acceptability are also discussed.

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“…However, one of the reasons for this could be the fact that the main source considered by the NCCN guidelines is an article published by the American Society of Clinical Oncology, which included evidence-based clinical practice guidelines from the year 2000 (“2000 Update of Recommendations for the Use of Tumor Markers in Breast and Colorectal Cancer: Clinical Practice Guidelines of the American Society of Clinical Oncology”) and was written when the only three blood-based biomarkers discussed as surveillance biomarkers were CEA, CA 15–3 and CA 27.29, which, unfortunately, did not show an improvement in OS despite blood increases of all biomarker levels 2–18 months prior to clinical or radiological recurrence appearance [15, 16, 53, 54]. However, interventional and therapeutic strategies have improved since that time and tend to improve further each year so that diagnosis of a relapse in an early and oligometastatic state could now be beneficial, especially in patients with limited MBC [55-59]. …”

Section: Why There Is a Need For Monitoring Women With Breast Cancermentioning

confidence: 99%

Breast Cancer Recurrence Risk Assessment: Is Non-Invasive Monitoring an Option?

Schunkert

Zhao²,

Zänker

2018

Biomed Hub

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Background: Metastatic breast cancer (MBC) represents a life-threatening disease with a median survival time of 18–24 months that often can only be treated palliatively. The majority of women suffering from MBC are those who had been previously diagnosed with locally advanced disease and subsequently experienced cancer recurrence in the form of metastasis. However, according to guidelines, no systemic follow-up for monitoring purposes is recommended for these women. The purpose of this article is to review current methods of recurrent risk assessment as well as non-invasive monitoring options for women at risk for distant disease relapse and metastasis formation. Methods: We used PubMed and national guidelines, such as the National Comprehensive Cancer Network (NCCN), to find recently published studies on breast cancer recurrence risk assessment and systemic monitoring of breast cancer patients through non-invasive means. Results: The options for recurrence risk assessment of locally invasive breast cancer has improved due to diverse genetic tests, such as Oncotype DX, MammaPrint, the PAM50 (now known as the “Prosigna Test”) assay, EndoPredict (EP), and the Breast Cancer Index (BCI), which evaluate a women’s risk of relapse according to certain cancer-gene expression patterns. Different promising non-invasive urinary protein-based biomarkers with metastasis surveillance potential that have been identified are MMP-2, MMP-9, NGAL, and ADAM12. In particular, ααCTX, ββCTX, and NTX could help to monitor bone metastasis. Conclusion: In times of improved recurrence risk assessment of women with breast cancer, non-invasive biomarkers are urgently needed as potential monitoring options for women who have an increased risk of recurrence. Urine as a bioliquid of choice provides several advantages – it is non-invasive, can be obtained easily and frequently, and is economical. Promising biomarkers that could help to follow up women with increased recurrence risk have been identified. In order for them to be implemented in clinical usage and national guideline recommendations, further validation in larger independent cohorts will be needed.

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Possible clinical cure of metastatic breast cancer: lessons from our 30-year experience with oligometastatic breast cancer patients and literature review

Abstract: The present analyses clearly indicate that OMBC is a distinct subgroup with long-term prognosis superior to MBC, with reasonable provability for clinical cure. Further prospective studies to better characterize OMBC are warranted to improve prognosis in MBC.

Cited by 108 publications

References 43 publications

Long-term survivor characteristics in HER2-positive metastatic breast cancer from registHER

Long-term survivor characteristics in HER2-positive metastatic breast cancer from registHER

Comparative diagnostic accuracy of <sup>18</sup>F-FDG PET/CT for breast cancer recurrence

Breast Cancer Recurrence Risk Assessment: Is Non-Invasive Monitoring an Option?

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