Answer from: Radiation Oncologist at Community Practice
"Absence of evidence is not evidence of absence."
The negative trials have put a damper on enthusiasm for these patients. This is interesting in light of past training and thinking where breast cancer patients with solitary or few metastases were thought to be emblematic of those that we could pote...
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Radiation Oncologist at Mary Bird Perkins Cancer Center I don't think BR002 and CURB trials are very usefu...
Answer from: Radiation Oncologist at Community Practice
For patients with asymptomatic oligoprogressive/oligometastatic breast cancer and without any high-risk lesions that can potentially cause significant morbidities in the future, I do not routinely treat them with SBRT now given the negative findings of CURB and NRG BR002 (although I cannot emphasize...
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Radiation Oncologist at Mon Health Do you think the CURB trial breast cancer subgroup...
Answer from: Radiation Oncologist at Academic Institution
As with many cases, treatment should be individualized and multidisciplinary. If the medical oncologist is about to start systemic therapy or switch to the next line therapy, then I would not offer SBRT and would monitor for response on systemic therapy. Exceptions are for palliative RT for bone met...
Answer from: Radiation Oncologist at Community Practice
Metastatic breast cancer patients are such a diverse population overall and not all clinical scenarios may have been captured in the BR002 and CURB trial. While acknowledging that metastatic breast cancer is a systemic disease, I think there is still a role of SBRT in select cases and a number of re...
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Radiation Oncologist at West Virginia University Treating locoregional disease and metastatic disea...
Answer from: Radiation Oncologist at Community Practice
It is always a challenge when the question is asked as broadly as this one in the absence of clear prospective clinical trial data. Our answers are often best tempered with nuance. In doing so, we might seem "wishy washy" but it truly reflects the dynamic state of our knowledge and practice. Dr. @Si...
Answer from: Radiation Oncologist at Academic Institution
BR002 results definitely cause me to hesitate. On the other hand, I have encountered quite a few breast cancer patients who developed 1-2 metastases (usually bone) and were treated with SBRT and are now >5 years NED. Maybe a deeper dive into patterns of failure in BR002 will allow us to understan...
Answer from: Radiation Oncologist at Community Practice
I am a community physician. I would first like to see an analysis of the CURB and BR002 trial for signals. I would also like to see a retrospective review with the following considerations
Stratify patients based on the recent proposal for De-novo metastatic breast cancer (Plichta et al., PMID 3694...
I don't think BR002 and CURB trials are very usefu...