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ASCO 2016: Locoregional Surgery Followed by Standard Therapy Improves Survival vs Standard Therapy Alone in Stage IV Breast Cancer

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Key Points

  • At about 40 months after diagnosis, women who received surgery plus standard therapy lived an average of 9 months longer than their counterparts who received standard therapy alone.
  • Nearly 42% of the women who received surgery lived for 5 years after diagnosis, compared with less than 25% of the women who did not receive surgery.
  • Surgery in younger women with less aggressive cancers resulted in longer average survival than in women with more aggressive cancers that had spread to the liver or lungs.

Surgery to remove the primary tumor in women diagnosed with stage IV breast cancer followed by standard combination therapies improved survival over standard therapy alone, an international clinical trial revealed. The results of the phase III randomized, controlled trial were presented today at the 2016 ASCO Annual Meeting by Soran et al (Abstract 1005).

“Our findings will change the standard of care for women newly diagnosed with stage IV breast cancer,” said principal investigator Atilla Soran, MD, MPH, Clinical Professor of Surgery at the University of Pittsburgh School of Medicine and breast surgical oncologist with the University of Pittsburgh Medical Center Cancer Center. “We've shown that surgery to remove the primary tumor—either through lumpectomy or mastectomy—followed by standard therapy is beneficial over no surgery.”

Study Findings

Dr. Soran began the trial in 2007, ultimately recruiting 274 women newly diagnosed with stage IV breast cancer from 25 institutions. Half of the women received standard therapy, which avoids surgery and consists of a combination of chemotherapy, hormonal therapy, and targeted therapy, whereas the other half had logoregional surgery followed by standard therapy.

At about 40 months after diagnosis, the women who received locoregional surgery plus standard therapy lived an average of 9 months longer than their counterparts who received standard therapy alone. Nearly 42% of the women who received locoregional surgery lived for 5 years after diagnosis, compared with less than 25% of the women who did not receive surgery.

The trial also showed that surgery in younger women with less aggressive cancers resulted in longer average survival than in women with more aggressive cancers that had spread to the liver or lungs.

“Our thinking is similar to how you might approach a battle against two enemies,” said Dr. Soran. “First you quickly dispatch one army—the primary tumor—leaving you to concentrate all your efforts on battling the second army—any remaining cancer.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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