The Effect of Primary Surgery in Patients with De Novo Stage IV Breast Cancer with Bone Metastasis Only (Protocol BOMET MF 14-01): A Multi-Center, Prospective Registry Study

Soran, Atilla; Doğan, Lütfi; Işık, Arda; Özbaş, Serdar; Trabulus, Didem Can; Demırcı, Umut; Karanlık, Hasan; Soyder, Aykut; Dağ, Ahmet; Bılıcı, Ahmet; Doğan, Mutlu; Köksal, Hande; Şendur, Mehmet Ali Nahit; Gülçelik, Mehmet Ali; Maralcan, Göktürk; Cabıoğlu, Neslihan; Yenıay, Levent; Utkan, Zafer; Şimşek, Turgay; Karadurmuş, Nuri; Dağlar, Gül; Yıldız, Birol; Uras, Cihan; Tükenmez, Mustafa; Yıldırım, Ahmet; Kutun, Suat; Özaslan, Cihangir; Karaman, Niyazi; Akçay, Müfide Nuran; Toktaş, Osman; Sezgın, Efe

doi:10.1245/s10434-021-09621-8

Cited by 45 publications

(28 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…More than half of the patients in both groups were alive at 4.5 years, and no quality-of-life advantage was shown with better local control. 44 In a prospective multicenter patient registry analysis by Soran et al 45 (BOMET MF14-01), for the patients with boneonly metastasis at diagnosis, locoregional therapy prolonged OS and decreased locoregional recurrence.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Breast Cancer at the Extremes of Age

et al. 2021

View full text Add to dashboard Cite

Background. Inflammatory breast cancer (IBC) is a rare breast malignancy with poor outcomes compared with non-IBC. Age-related differences in tumor biology, treatment, and clinical outcomes have been described in non-IBC. This study evaluated age-related differences in IBC. Methods. From an institutional prospective database, patients with an IBC diagnosed from 2010 to 2019 were identified. Age was categorized as 40 years or younger, 41 to 64 years, and 65 years or older. Demographics, clinicopathologic features, and treatment received were compared. Recurrence and survival outcomes were analyzed using the log-rank test and the Cox proportional hazards model. Results. Of 523 IBC patients, 113 (21.6%) were age 40 years or younger, and 72 (13.8%) were age 65 years or older. The groups did not differ statistically by race/ethnicity, N stage, clinical stage, or tumor subtype. The younger patients included a higher proportion of Hispanic and Asian patients, triple-negative breast cancer (TNBC), and clinical N2/N3. Trimodality therapy was received by 92% of the stage 3 patients, with no difference in pathologic complete response (pCR) by age (23.3% vs 28.6%; p = 0.46). During a median follow-up period of 40 months, 17% of the patients experienced locoregional recurrence and 42.8% had distant metastasis. No difference in 3-year recurrence-free survival (57.9% vs 42.6% vs 54%; p = 0.42, log rank) or overall survival (OS) (75.6% vs 77.1% vs 64.4%; p = 0.31, log rank) by age was observed, and no difference in OS by age in de novo stage 4 disease was observed. In the multivariate analysis, worse OS was associated with TNBC (hazard ratio [HR], 1.99, 95% confidence interval [CI], 1.31-3.05) and no pCR (HR, 4.45; 95% CI,. Conclusion. No significant differences were observed in demographics, treatment patterns, or clinical outcomes for IBC patients age 40 years or younger compared with those age 65 years or older treated by a specialized multidisciplinary team. These findings do not support age-related treatment de-escalation in IBC.Inflammatory breast cancer (IBC) is a clinically distinct and aggressive form of breast cancer characterized by diffuse erythema and edema without an underlying mass in up to 50% of cases. 1 Although IBC accounts for only 2% to 6% of all breast cancers, it results in 10% of breast cancerrelated deaths, and nearly 40% of patients are stage 4 at presentation. [2][3][4] Compared with locally advanced non-IBC, the prognosis for IBC is significantly worse, with the 5-year overall survival rate ranging from 34 to 61% compared with 41% to 86% for patients with stage 3 disease. [5][6][7]

show abstract

Section: Discussionmentioning

confidence: 99%

Inflammatory Breast Cancer at the Extremes of Age

et al. 2021

View full text Add to dashboard Cite

show abstract

“…

We read with interest the article by Soran et al, 1 which evaluated the role of locoregional treatment (LRT) in breast cancer patients with bone-only metastasis. While the significance of LRT in stage IV breast cancer has been generally recognized as low, 2,3 the authors revealed that LRT prolonged overall survival.

…”

mentioning

confidence: 99%

Re: The Effect of Primary Surgery in Patients with De Novo Stage IV Breast Cancer with Bone Metastasis Only (Protocol BOMET MF 14-01): A Multicenter, Prospective Registry Study

Ishizuka

Horimoto

2021

Ann Surg Oncol

View full text Add to dashboard Cite

We read with interest the article by Soran et al., 1 which evaluated the role of locoregional treatment (LRT) in breast cancer patients with bone-only metastasis. While the significance of LRT in stage IV breast cancer has been generally recognized as low, 2,3 the authors revealed that LRT prolonged overall survival. Their data are meaningful in terms of showing the effectiveness of LRT in some populations with metastatic breast cancer. While their data are impressive, there is one aspect of this study that requires further consideration.In their non-randomized study, some clinicopathological factors significantly differed between patients with systemic therapy alone compared with those with LRT (e.g., age, tumor size, number of bone metastasis). The LRT group was shown to have a prolonged overall survival (Fig. 1), however this univariate Kaplan-Meier analysis does not eliminate the aforementioned confounding factors. A better interpretation of these data should adjust for these factors. We believe propensity score methods should be employed, particularly for Fig. 1, as the number of participants is large enough. Re-analysis of these key data is critical to deliver more precise information to the readers.DISCLOSURES Yumiko Ishizuka and Yoshiya Horimoto have no conflicts of interest to declare.

show abstract

“…These results might be explained by differences in tumor characteristics between study groups, a higher representation of patients with of solitary bone metastases and fewer patients with visceral disease in the LRT group. Of note, the BOMER MF 14-01, recently published by Soran et al [9], is another randomized trial comprising only patients with bone metastases, and was not included in our study as it was published after our meta-analysis was submitted. In the BOMER MF 14-01, LRT was associated with significant improvement is overall survival [9].…”

mentioning

confidence: 99%

“…Of note, the BOMER MF 14-01, recently published by Soran et al [9], is another randomized trial comprising only patients with bone metastases, and was not included in our study as it was published after our meta-analysis was submitted. In the BOMER MF 14-01, LRT was associated with significant improvement is overall survival [9]. Potential limitations of this study include unbalanced characteristics between the investigational and the control arms.…”

mentioning

confidence: 99%