The Oligopro-Breast trial is a Phase II study targeting women with ER+/HER2- metastatic breast cancer who have been on endocrine therapy and/or CDK4/6 inhibitors for at least 6 months, and show progressive disease at 1-3 extracranial metastases, which are treatable locally. The trial aims to investigate if treating these resistant metastases with SBRT (or other local treatments if SBRT is not possible) can extend the use of the current systemic therapy. Patients will continue their existing systemic treatment while receiving SBRT on all progressive lesions. If new oligoprogression occurs, SBRT will be performed again. A new systemic treatment line will start if there is polyprogression (more than 3 lesions at once), progression of more than 6 lesions over 12 months, intracranial progression, or lesions that cannot be treated locally. The scientific question is whether local treatment of resistant metastases can prolong the effectiveness of ongoing systemic therapy, which is particularly beneficial if the treatment is well-tolerated. The primary objective is to measure the proportion of patients surviving without changing their systemic treatment line at 6 months after SBRT. This trial is significant for patients as it explores a method to potentially extend the duration of effective and well-tolerated treatments, offering hope for better management of metastatic breast cancer.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
48
SBRT of all oligoprogressive metastases (or other local therapy if SBRT not advisable), followed by continuation of the same systemic therapy.
Jules Bordet Institute
Brussels, Belgium
RECRUITINGUZ Gent
Ghent, Belgium
RECRUITINGAZ Groeninge
Kortrijk, Belgium
RECRUITINGAZ Sint-Maarten
Mechelen, Belgium
RECRUITINGCHU UCL Namur - Site Saint Elisabeth
Namur, Belgium
RECRUITINGNExt Systemic Treatment-Free Survival (NEST-FS)
Time frame: At 6 months
Time to next line of systemic therapy (NEST)
Time frame: 3 years
Progression-free survival (PFS)
Time frame: 3 years
Modified Progression-free survival (mPFS)
Defined as the survival in the absence of any of the following : (1) polyprogression (progressive disease of more than 3 lesions at the same time), (2) progression of more than 6 lesions over a 12-month rolling period, (3) intracranial progression, (4) progressing lesion that cannot be treated locally, or (5) death.
Time frame: 3 years
Chemotherapy-free survival
Time frame: 3 years
Progression-free survival after start of the subsequent line of systemic treatment (PFS2)
Time frame: 3 year
Patterns of metastatic progression
We defined four patterns of progression: stable disease, progression on untreated pre-existing lesions, progression on treated lesions, or development of new lesions. In case of progression, it will also be determined whether it is oligoprogression (progression of 3 lesions or less) or polyprogression (progression of more than 3 lesions).
Time frame: 3 years
Overall survival (OS)
Time frame: 3 years
Acute and late physician-scored toxicity of the local intervention
Acute and late physician-scored toxicity of the local intervention (CTCAE 5.0, Early: within 90 days; late: 90 or more days after SBRT);
Time frame: 3 years
Quality of life (QoL)
Evolution of QoL measured with the EORTC QLQ-C30
Time frame: 3 years
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