Dr. Chmura on the Management of Oligometastatic Breast Cancer

Steven J. Chmura, MD, PhD, professor of Radiation and Cellular Oncology, professor of Medicine, the University of Chicago, Medical Director, Comprehensive Cancer Center director, Clinical and Translational Research for Radiation Oncology, UChicago Medicine, discusses the current management strategies for oligometastatic breast cancer.

The idea of utilizing various types of local therapies, such as radiation or surgery, in patients with limited metastatic disease has been considered for a long time, Chmura begins. The rationale for this type of approach is to improve overall outcomes for patients in terms of progression-free survival (PFS) and overall survival (OS), Chmura adds. However, over the past 25 years, much of the research conducted in the oligometastatic breast cancer realm has been done with the constraints of single-institution studies and through retrospective data, Chmura explains.

To address these approaches on a larger scale, the phase 2/3 NRG-BR002 trial (NCT02364557) was designed to test whether treating breast cancer metastases with local therapies such as surgery or high-dose radiation improved survival. NRG-BR002 was the first trial to test the hypothesis of whether local intervention therapy could help patients in this setting, Chmura adds.

However, NRG-BR002 was a negative trial, with the addition of ablation to standard of care failing to improve PFS or OS outcomes compared with standard of care alone. Despite these findings, researchers still want to understand what effect local therapy has on this patient population and how findings from NRG-BR002 could help inform the path forward in terms of using these local interventions, Chmura concludes.