International Journal of Radiation Oncology*Biology*Physics
Oral Scientific SessionStereotactic Ablative Radiation Therapy for the Comprehensive Treatment of Oligometastatic Tumors (SABR-COMET): Results of a Randomized Trial
Section snippets
Purpose/Objective(s)
The oligometastatic paradigm suggests that patients with a limited number of metastases may be curable if all sites of disease are eradicated with ablative therapies, such as surgery or radiation. However, randomized evidence in support of this paradigm is lacking. We assessed the impact of delivering stereotactic ablative radiotherapy (SABR) on survival, oncologic outcomes, toxicity, and quality of life (QOL) in patients with a controlled primary tumor and up to five oligometastatic lesions.
Materials/Methods
We enrolled patients who had a controlled primary malignancy with 1-5 metastatic lesions, all of which were amenable to SABR, with good performance status (ECOG 0-1) and life expectancy >6 months. We stratified by the number of metastases (1-3 vs. 4-5) then randomized in a 1:2 ratio between palliative standard of care (SOC) treatments [Arm 1] vs. SOC plus SABR to all metastatic lesions [Arm 2]. The primary endpoint was overall survival (OS). A randomized phase II screening design was employed
Results
Between February 2012 and August 2016, 99 patients were randomized (33 in Arm 1, 66 in Arm 2) at centers in Canada, Scotland, the Netherlands, and Australia. Median age was 68 (range 43-89) and 59% were male. The most common primary tumor types were breast (n=18), lung (n=18), colorectal (n=18) and prostate (n=16). Most patients (n=92) had 1-3 metastases. There were no significant differences in baseline factors between arms. Median follow-up was 27 months. Median OS was 28 months in Arm 1 (95%
Conclusion
SABR was associated with an improvement in OS, meeting the primary endpoint of this trial, and PFS was doubled. Grade ≥2 toxicities were more common with SABR, but no differences were seen in QOL. (NCT01446744).
References (0)
Cited by (0)
Author Disclosure: D.A. Palma: Research Grant; Ontario Institute for Cancer Research. Patent/License Fees/Copyright; U.S. Patent Pending. R.A. Olson: None. S. Harrow: Research Grant; MSD. Honoraria; Boehringer Ingelheim, AstraZeneca. Consultant; AstraZeneca. Travel Expenses; Boehringer Ingelheim. S. Gaede: None. A.V. Louie: None. C. Haasbeek: Honoraria; Varian Medical Systems Inc. L. Mulroy: None. M.I. Lock: Independent Contractor; London Health Sciences. Speaker's Bureau; AbbVie. Advisory Board; Accuray. G. Rodrigues: Independent Contractor; George Rodrigues Medicine Professional Corporation. Stock; George Rodrigues Medicine Professional Corporation. Royalty; Demos Medical Publishing. B.P. Yaremko: None. D. Schellenberg: Research Grant; Varian Medical Systems. Speaker's Bureau; Varian Medical Systems. Travel Expenses; Varian Medical Systems. Review of applications for new funding. Reviews submitted by oncologists within the BC Cancer Agency; Prioritizes Evaluation Committee-BC Cancer Agency. B. Ahmad: None. G. Griffioen: None. S. Senthi: None. M.C. Liu: None. K. Moore: None. S. Currie: None. G.S. Bauman: Independent Contractor; London Health Sciences Centre. Chair/Chief of Oncology; London Health Sciences Centre. A. Warner: None. S. Senan: Research Grant; Varian Medical Systems, ViewRay Inc. Advisory Board; AstraZeneca.