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Do you still recommend SBRT for oligometastatic and oligoprogressive breast cancer after the abstracts of the BR002 and CURB, respectively?

NRG-BR002 (Chmura et al., JCO 2022) CURB (Tsai et al., IJROBP 2022)
7 Answers
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Radiation Oncology · Michigan Healthcare Professionals, PC
Answered on · Updated on

"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 poten...

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Radiation Oncology · Princess Margaret Cancer Centre
Answered on

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 Oncology · USC Keck School of Medicine
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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...

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Radiation Oncology · Kingston Health Sciences Centre
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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 Oncology · Bon Secours Mercy Health
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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. @Dr...

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Radiation Oncology · City of Hope
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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 understand w...

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Radiation Oncology · Via Christi Health
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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

  1. Stratify patients based on the recent proposal for De-novo metastatic breast cancer (Plichta et al., PMID 36944...

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