Now here is a Christmas present-A trial-Is oligometastic bc curable with stereot rads

[Lani]

Instead of repeating the old mantra that there is no point in looking for mets early, but rather waiting for bones to break,seizures to occur, etc at least someone is not going along with the nihilistic status quo and is looking at whether with vigilance and diligence ,finding mets early when they are few, there is still a possibility of curing breast cancer

Since her2 has a "tell tale marker" which might make serum biomarker testing and/or imaging with herceptin-contrast/radioisotope/magnetic nanoparticles constructs able to spot early metastases sooner than, for example, is possible with triple-negative breat cancer how about pushing to see if her2+ patients aren't once again, those chosen few, where real progress can't be made to
either cure it or make it a treatable chronic disease.

Merry Christmas!:
: Cancer. 2007 Dec 10 [Epub ahead of print] Links
A prospective pilot study of curative-intent stereotactic body radiation therapy in patients with 5 or fewer oligometastatic lesions.

Milano MT, Katz AW, Muhs AG, Philip A, Buchholz DJ, Schell MC, Okunieff P.
Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York.
BACKGROUND.: It is hypothesized that oligometastatic disease represents a state of potentially curable, limited metastases. Stereotactic body radiation therapy (SBRT) is an option for patients who are not amenable to or do not want resection. METHODS.: From 2001 to 2006, 121 patients with </=5 detectable metastases were enrolled in 2 prospective studies that used curative-intent SBRT. Most patients were treated with 10 fractions of 5 Gray. Stereotactic radiosurgery was offered to patients with brain metastases. RESULTS.: The 2-year overall survival (OS), progression-free survival (PFS), local control (LC), and distant control (DC) rates were 50%, 26%, 67%, and 34%, respectively; and the respective 4-year rates values were 28%, 20%, 60%, and 25%. A greater net tumor volume predicted significantly worse OS, PFS, LC, and DC. Patients with breast cancer fared significantly better with respect to OS, PFS, LC, and DC; and patients with adrenal metastases had significantly worse OS, PFS, and DC despite the small number of such patients enrolled. Neither the number of metastatic lesions nor the number of organs involved was a significant predictor of outcome. Among 45 patients who remained alive at the last follow-up, 29 patients had no evidence of disease, including 23 patients with >/=2 years of follow-up. CONCLUSIONS.: Oligometastatic disease is a potentially curable state of distant cancer spread. In this hypothesis-generating analysis, patients with less volume burden of their metastatic disease and those with primary breast cancer fared better. SBRT delivered with curative intent in patients with limited metastases should be investigated further. The Southwest Oncology Group is developing a prospective protocol to treat women who have limited breast cancer metastases with SBRT. Cancer 2008. (c) 2007 American Cancer Society.
PMID: 18072260 [PubMed - as supplied by publisher]

[Sherryg683]

Lani, what is steriotatic rads? Is that just normal radiation? Just wondering because my mets were very limited, so any hope is good..sherryg

[Lani]

Cyberknife or gamma knife I believe

Hope this helps!

[dlaxague]

Hi all,

This is most interesting. I hope that it proves to be true. It goes against the follow-up guidelines, as we've heatedly discussed previously. But it backs up Brenda's thinking and adds weight to her eloquent arguments. (I'd already begun to see your side of it, Brenda, before this study - I wish that I'd found you at SABCS but time went by so quickly and my poor little brain was so full).

The trouble that I see with this is the logistics and the COST! It usually annoys me to see analysis of cost effectiveness r/t cancer treatment - we are people not beans for the bean counter, fcol. But the implications of this information, indicating that in some instances, oligomets can be cured or better-treated, could start an avalanche of ultra vigilance using scans and other extremely expensive modalities on so many, to benefit so few. I hope to see work on finding simpler ways to screen for oligomets, like reliable tumor markers, so that this vigilance is not only improving lives but being fiscally sustainable.

Debbie Laxague