Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2017

01-07-2017 | Review

Ablative Therapies in Metastatic Breast Cancer: A Systematic Review

Authors: Michael Jonathan Kucharczyk, Sameer Parpia, Cindy Walker-Dilks, Laura Banfield, Anand Swaminath

Published in: Breast Cancer Research and Treatment | Issue 1/2017

Login to get access

Abstract

Purpose

Patients with oligometastatic breast cancer are being increasingly offered ablative therapies, yet it is unclear which subpopulations may derive long-term benefit. This study sought to explore factors that could define a clinically relevant oligometastatic breast cancer population that benefits from ablative therapies.

Methods

A systematic review using MEDLINE for English language articles published between 1985 and April 2014 was undertaken. Criteria for review included studies that reported overall survival (OS) or progression-free survival (PFS) in breast cancer patients with distant metastases which also: quantified the extent of disease, had metachronous presentation of metastases, and reported on at least 5 patients.

Results

Of 59 674 screened studies, 41 studies of 1813 individual patients were identified. All studies were observational cohort studies (level 2B or 4 evidence) and underwent critical review. All outcomes pertaining to OS and PFS were extracted. Extracted data were too heterogeneous to facilitate a meta-analysis. The only factor that suggested worse outcomes was positive margins post-metastasectomy. There was no clear signal for improved outcomes in regards to age, disease extent, disease-free interval, or receptor status.

Conclusion

Existing evidence does not provide meaningful direction on which metastatic breast cancer patients should have ablation of their residual disease due to heterogeneous reporting of disease factors, patient factors, and outcomes. Thorough demonstration of the absence of high- or moderate-level evidence and the absence of clinical data to guide patient selection suggests that metastatic breast cancer patients being treated with ablative modalities should be placed on clinical trial.
Appendix
Available only for authorised users
Literature
1.
2.
Rahman ZU, Frye DK, Smith TL et al (1999) Results and long term follow-up for 1581 patients with metastatic breast carcinoma treated with standard dose doxorubicin-containing chemotherapy: a reference. Cancer 85(1):104–111CrossRefPubMed
3.
Mauri D, Pavlidis N, Polyzos NP, Ioannidis JP (2006) Survival with aromatase inhibitors and inactivators versus standard hormonal therapy in advanced breast cancer: meta-analysis. J Natl Cancer Inst 98(18):1285–1291CrossRefPubMed
4.
Gennari A, Conte P, Rosso R, Orlandini C, Bruzzi P (2005) Survival of metastatic breast carcinoma patients over a 20-year period: a retrospective analysis based on individual patient data from six consecutive studies. Cancer 104(8):1742–1750CrossRefPubMed
5.
Hortobagyi GN, Smith TL, Legha SS et al (1983) Multivariate analysis of prognostic factors in metastatic breast cancer. J Clin Oncol 1(12):776–786CrossRefPubMed
6.
Leivonen MK, Kalima TV (1991) Prognostic factors associated with survival after breast cancer recurrence. Acta Oncol (Stockholm, Sweden). 30(5):583–586
7.
Dawood S, Broglio K, Buzdar AU, Hortobagyi GN, Giordano SH (2010) Prognosis of women with metastatic breast cancer by HER2 status and trastuzumab treatment: an institutional-based review. J Clin Oncol 28(1):92–98CrossRefPubMed
8.
Kobayashi T, Ichiba T, Sakuyama T et al (2012) Possible clinical cure of metastatic breast cancer: lessons from our 30-year experience with oligometastatic breast cancer patients and literature review. Breast Cancer 19(3):218–237CrossRefPubMed
9.
Wei AC, Greig PD, Grant D, Taylor B, Langer B, Gallinger S (2006) Survival after hepatic resection for colorectal metastases: a 10-year experience. Ann Surg Oncol 13(5):668–676CrossRefPubMed
10.
Treasure T, Fiorentino F, Scarci M, Moller H, Utley M (2012) Pulmonary metastasectomy for sarcoma: a systematic review of reported outcomes in the context of Thames Cancer Registry data. BMJ Open 2(5). doi:10.​1136/​bmjopen-2012-001736
11.
Timmerman RD, Bizekis CS, Pass HI et al (2009) Local surgical, ablative, and radiation treatment of metastases. CA Cancer J Clin 59(3):145–170CrossRefPubMed
12.
Robertson DJ, Stukel TA, Gottlieb DJ, Sutherland JM, Fisher ES (2009) Survival after hepatic resection of colorectal cancer metastases: a national experience. Cancer 115(4):752–759CrossRefPubMedPubMedCentral
13.
Pastorino U, Buyse M, Friedel G et al (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 113(1):37–49CrossRefPubMed
14.
Nordlinger B, Sorbye H, Glimelius B et al (2013) Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 14(12):1208–1215CrossRefPubMed
15.
Morris EJ, Forman D, Thomas JD et al (2010) Surgical management and outcomes of colorectal cancer liver metastases. Brit J Surg 97(7):1110–1118CrossRefPubMed
16.
17.
Weichselbaum RR, Hellman S (2011) Oligometastases revisited. Nat Rev Clin Oncol 8(6):378–382PubMed
18.
Meimarakis G, Ruttinger D, Stemmler J et al (2013) Prolonged overall survival after pulmonary metastasectomy in patients with breast cancer. Ann Thorac Surg 95(4):1170–1180CrossRefPubMed
19.
Friedel G, Pastorino U, Ginsberg RJ et al (2002) Results of lung metastasectomy from breast cancer: prognostic criteria on the basis of 467 cases of the International Registry of Lung Metastases. Eur J Cardio-thorac Surg 22(3):335–344CrossRef
20.
Elias D, Maisonnette F, Druet-Cabanac M et al (2003) An attempt to clarify indications for hepatectomy for liver metastases from breast cancer. Am J Surg 185(2):158–164CrossRefPubMed
21.
Gomez DR, Blumenschein GR Jr, Lee JJ et al (2016) Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study. Lancet Oncol 17(12):1672–1682CrossRefPubMed
22.
Jain SK, Dorn PL, Chmura SJ, Weichselbaum RR, Hasan Y (2012) Incidence and implications of oligometastatic breast cancer. ASCO Meet Abstr 30(15_suppl):e11512
23.
Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ (Clinical research ed). 339:b2700CrossRefPubMedCentral
24.
Haynes RB, Wilczynski NL (2004) Optimal search strategies for retrieving scientifically strong studies of diagnosis from Medline: analytical survey. BMJ (Clinical research ed). 328(7447):1040CrossRefPubMedCentral
25.
26.
Geiger S, Cnossen JA, Horster S, DiGioia D, Heinemann V, Stemmler HJ (2011) Long-term follow-up of patients with metastatic breast cancer: results of a retrospective, single-center analysis from 2000 to 2005. Anticancer Drugs 22(9):933–939CrossRefPubMed
27.
Milano MT, Zhang H, Metcalfe SK, Muhs AG, Okunieff P (2009) Oligometastatic breast cancer treated with curative-intent stereotactic body radiation therapy. Breast Cancer Res Treat 115(3):601–608CrossRefPubMed
28.
Amersi FF, McElrath-Garza A, Ahmad A, et al (2006) Long-term survival after radiofrequency ablation of complex unresectable liver tumors. Arch Surg (Chicago, Ill: 1960). 141(6):581–587; discussion 587–588
29.
Bortolotto C, Macchi S, Veronese L, Dore R, Draghi F, Rossi S (2012) Radiofrequency ablation of metastatic lesions from breast cancer. J Ultrasound 15(3):199–205CrossRefPubMedPubMedCentral
30.
Caballero JA, Sneed PK, Lamborn KR et al (2012) Prognostic factors for survival in patients treated with stereotactic radiosurgery for recurrent brain metastases after prior whole brain radiotherapy. Int J Radiat Oncol Biol Phys 83(1):303–309CrossRefPubMed
31.
Corona-Cruz JF, Dominguez-Parra LM, Saavedra-Perez D et al (2012) Lung metastasectomy: long-term outcomes in an 18-year cohort from a single center. Surg Oncol 21(3):237–244CrossRefPubMed
32.
Dyer MA, Kelly PJ, Chen YH et al (2012) Importance of extracranial disease status and tumor subtype for patients undergoing radiosurgery for breast cancer brain metastases. Int J Radiat Oncol Biol Phys 83(4):e479–486CrossRefPubMed
33.
Flickinger JC, Kondziolka D, Lunsford LD et al (1994) A multi-institutional experience with stereotactic radiosurgery for solitary brain metastasis. Int J Radiat Oncol Biol Phys 28(4):797–802CrossRefPubMed
34.
Golden DW, Lamborn KR, McDermott MW et al (2008) Prognostic factors and grading systems for overall survival in patients treated with radiosurgery for brain metastases: variation by primary site. J Neurosurg 109(Suppl):77–86PubMed
35.
Gunabushanam G, Sharma S, Thulkar S et al (2007) Radiofrequency ablation of liver metastases from breast cancer: results in 14 patients. J Vasc Interv Radiol 18(1 Pt 1):67–72CrossRefPubMed
36.
Hoffmann K, Franz C, Hinz U et al (2010) Liver resection for multimodal treatment of breast cancer metastases: identification of prognostic factors. Ann Surg Oncol 17(6):1546–1554CrossRefPubMed
37.
Jakobs TF, Hoffmann RT, Fischer T et al (2008) Radioembolization in patients with hepatic metastases from breast cancer. J Vasc Interv Radiol 19(5):683–690CrossRefPubMed
38.
Jakobs TF, Hoffmann RT, Schrader A et al (2009) CT-guided radiofrequency ablation in patients with hepatic metastases from breast cancer. Cardiovasc Interv Radiol 32(1):38–46CrossRef
39.
Kondziolka D, Kano H, Harrison GL et al (2011) Stereotactic radiosurgery as primary and salvage treatment for brain metastases from breast cancer. Clinical article. J Neurosurg. 114(3):792–800CrossRefPubMed
40.
Koodziejski L, Goralczyk J, Dyczek S, Duda K, Nabiaek T (1999) The role of surgery in lung metastases. Eur J Surg Oncol 25(4):410–417CrossRefPubMed
41.
Matsunaga S, Shuto T, Kawahara N, Suenaga J, Inomori S, Fujino H (2010) Gamma Knife surgery for metastatic brain tumors from primary breast cancer: treatment indication based on number of tumors and breast cancer phenotype. J Neurosurg 113(Suppl):65–72PubMed
42.
Milano MT, Katz AW, Zhang H, Okunieff P (2012) Oligometastases treated with stereotactic body radiotherapy: long-term follow-up of prospective study. Int J Radiat Oncol Biol Phys 83(3):878–886CrossRefPubMed
43.
Muacevic A, Kreth FW, Tonn JC, Wowra B (2004) Stereotactic radiosurgery for multiple brain metastases from breast carcinoma. Cancer 100(8):1705–1711CrossRefPubMed
44.
Vlastos G, Smith DL, Singletary SE et al (2004) Long-term survival after an aggressive surgical approach in patients with breast cancer hepatic metastases. Ann Surg Oncol 11(9):869–874CrossRefPubMed
45.
Yamamoto M, Kawabe T, Higuchi Y et al (2012) Validity of three recently proposed prognostic grading indexes for breast cancer patients with radiosurgically treated brain metastases. Int J Radiat Oncol Biol Phys 84(5):1110–1115CrossRefPubMed
46.
47.
Chen F, Fujinaga T, Sato K et al (2009) Clinical features of surgical resection for pulmonary metastasis from breast cancer. Eur J Surg Oncol 35(4):393–397CrossRefPubMed
48.
Cianni R, Pelle G, Notarianni E et al (2013) Radioembolisation with (90)Y-labelled resin microspheres in the treatment of liver metastasis from breast cancer. Eur Radiol 23(1):182–189CrossRefPubMed
49.
de la Haba Rodriguez JR, Algar Algar J, Mendez Vidal MJ et al (2002) Surgical treatment of pulmonary metastases: experience with 40 patients. Eur J Surg Oncol 28(1):49–54CrossRefPubMed
50.
Firlik KS, Kondziolka D, Flickinger JC, Lunsford LD (2000) Stereotactic radiosurgery for brain metastases from breast cancer. Ann Surg Oncol 7(5):333–338CrossRefPubMed
51.
Kased N, Binder DK, McDermott MW et al (2009) Gamma Knife radiosurgery for brain metastases from primary breast cancer. Int J Radiat Oncol Biol Phys 75(4):1132–1140CrossRefPubMed
52.
Kycler W, Laski P (2012) Surgical approach to pulmonary metastases from breast cancer. Breast J 18(1):52–57CrossRefPubMed
53.
Lawes D, Chopada A, Gillams A, Lees W, Taylor I (2006) Radiofrequency ablation (RFA) as a cytoreductive strategy for hepatic metastasis from breast cancer. Ann R Coll Surg Engl 88(7):639–642CrossRefPubMedPubMedCentral
54.
Lederman G, Wronski M, Fine M (2001) Fractionated radiosurgery for brain metastases in 43 patients with breast carcinoma. Breast Cancer Res Treat 65(2):145–154CrossRefPubMed
55.
Lubrano J, Roman H, Tarrab S, Resch B, Marpeau L, Scotte M (2008) Liver resection for breast cancer metastasis: does it improve survival? Surg Today 38(4):293–299CrossRefPubMed
56.
Martinez SR, Young SE, Giuliano AE, Bilchik AJ (2006) The utility of estrogen receptor, progesterone receptor, and Her-2/neu status to predict survival in patients undergoing hepatic resection for breast cancer metastases. Am J Surg 191(2):281–283CrossRefPubMed
57.
Selzner M, Morse MA, Vredenburgh JJ, Meyers WC, Clavien PA (2000) Liver metastases from breast cancer: long-term survival after curative resection. Surgery. 127(4):383–389CrossRefPubMed
58.
Staren ED, Salerno C, Rongione A, Witt TR, Faber LP (1992) Pulmonary resection for metastatic breast cancer. Arch Surg 127(11):1282–1284CrossRefPubMed
59.
Sundaresan N, Rothman A, Manhart K, Kelliher K (2002) Surgery for solitary metastases of the spine: rationale and results of treatment. Spine (Phila Pa 1976) 27(16):1802–1806
60.
van Walsum GA, de Ridder JA, Verhoef C et al (2012) Resection of liver metastases in patients with breast cancer: survival and prognostic factors. Eur J Surg Oncol 38(10):910–917CrossRefPubMed
61.
Yhim HY, Han SW, Oh DY et al (2010) Prognostic factors for recurrent breast cancer patients with an isolated, limited number of lung metastases and implications for pulmonary metastasectomy. Cancer 116(12):2890–2901CrossRefPubMed
62.
Zegarac M, Nikolic S, Gavrilovic D et al (2013) Prognostic factors for longer disease free survival and overall survival after surgical resection of isolated liver metastasis from breast cancer. J BUON 18(4):859–865PubMed
63.
Gaspar L, Scott C, Rotman M et al (1997) Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37(4):745–751CrossRefPubMed
64.
Lobbezoo DJ, van Kampen RJ, Voogd AC et al (2015) Prognosis of metastatic breast cancer: are there differences between patients with de novo and recurrent metastatic breast cancer? Br J Cancer 112(9):1445–1451CrossRefPubMedPubMedCentral
65.
Dawood S, Broglio K, Ensor J, Hortobagyi GN, Giordano SH (2010) Survival differences among women with de novo stage IV and relapsed breast cancer. Ann Oncol 21(11):2169–2174CrossRefPubMedPubMedCentral
66.
Chia SK, Speers CH, D’Yachkova Y et al (2007) The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer. Cancer 110(5):973–979CrossRefPubMed
67.
NRG Oncology (2014) NRG-BR002: a phase IIR/III trial of standard of care therapy with or without stereotactic body radiotherapy (SBRT) and/or surgical ablation for newly oligometastatic breast cancer. NRG Oncology Trials page. Available at: www.​nrgoncology.​org/​Clinical-Trials/​NRG-BR002. Accessed Jan 23, 2017, 2017
68.
Chua TC, Saxena A, Liauw W, Chu F, Morris DL (2011) Hepatic resection for metastatic breast cancer: a systematic review. Eur J Cancer (Oxford, England: 1990) 47(15):2282–2290
69.
Salama JK, Hasselle MD, Chmura SJ et al (2012) Stereotactic body radiotherapy for multisite extracranial oligometastases: final report of a dose escalation trial in patients with 1 to 5 sites of metastatic disease. Cancer 118(11):2962–2970CrossRefPubMed
70.
Tree AC, Khoo VS, Eeles RA et al (2013) Stereotactic body radiotherapy for oligometastases. Lancet Oncol. 14(1):e28–37CrossRefPubMed
71.
Fode MM, Hoyer M (2015) Survival and prognostic factors in 321 patients treated with stereotactic body radiotherapy for oligo-metastases. Radiother Oncol 114(2):155–160CrossRefPubMed
72.
Ashworth AB, Senan S, Palma DA et al (2014) An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer. Clin Lung Cancer 15(5):346–355CrossRefPubMed
73.
Palma DA, Salama JK, Lo SS et al (2014) The oligometastatic state - separating truth from wishful thinking. Nat Rev Clin Oncol 11(9):549–557CrossRefPubMed
74.
75.
Wilczynski NL, McKibbon KA, Haynes RB (2011) Sensitive Clinical Queries retrieved relevant systematic reviews as well as primary studies: an analytic survey. J Clin Epidemiol 64(12):1341–1349CrossRefPubMed
76.
Haynes RB, McKibbon KA, Wilczynski NL, Walter SD, Werre SR (2005) Optimal search strategies for retrieving scientifically strong studies of treatment from Medline: analytical survey. BMJ (Clinical research ed). 330(7501):1179CrossRefPubMedCentral
77.
Yamamoto M, Serizawa T, Shuto T et al (2014) Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol. 15(4):387–395CrossRefPubMed
78.
Hanrahan EO, Broglio KR, Buzdar AU et al (2005) Combined-modality treatment for isolated recurrences of breast carcinoma: update on 30 years of experience at the University of Texas M.D. Anderson Cancer Center and assessment of prognostic factors. Cancer 104(6):1158–1171CrossRefPubMed
Metadata
Title
Ablative Therapies in Metastatic Breast Cancer: A Systematic Review
Authors
Michael Jonathan Kucharczyk
Sameer Parpia
Cindy Walker-Dilks
Laura Banfield
Anand Swaminath
Publication date
01-07-2017
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2017
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-017-4228-2

Other articles of this Issue 1/2017

Breast Cancer Research and Treatment 1/2017 Go to the issue

Clinical trial

MRI predicts pathologic complete response in HER2-positive breast cancer after neoadjuvant chemotherapy

Epidemiology

Sleep quality, duration, and breast cancer aggressiveness

Epidemiology

Which women decide to take tamoxifen?

Preclinical study

MMP11 and CD2 as novel prognostic factors in hormone receptor-negative, HER2-positive breast cancer

Epidemiology

Breast cancer in Asian Americans in California, 1988–2013: increasing incidence trends and recent data on breast cancer subtypes

Letter to the Editor

The value of algorithms predicting the Oncotype DX recurrence score should not be underestimated!
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits