nach oben

Erschienen in:

29.09.2016 | Review

The 2016 Assisi Think Tank Meeting on breast cancer: white paper

verfasst von: Cynthia Aristei, Orit Kaidar-Person, Meritxell Arenas, Charlotte Coles, Birgitte V. Offersen, Celine Bourgier, Giovanni Frezza, Maria Cristina Leonardi, Vincenzo Valentini, Philip M. P. Poortmans

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To identify weak points in daily routine use of radiation therapy (RT) for non-metastatic breast cancer patients, particularly when data are lacking or equivocal, a “think tank” of experts met in Assisi.

Methods

Before the meeting, controversial issues on non-metastatic breast cancer were identified and reviewed, and clinical practice investigated by means of an online questionnaire. During the 3-day meeting, topics were discussed in-depth with attendees and potential sponsors that are involved in breast cancer treatment.

Results

Three issues were identified as needing further investigation: (1) Regional lymph node treatment in early-stage breast cancer; (2) Combined post-mastectomy RT and breast reconstruction; (3) RT in patients treated with primary systemic therapy. Future research proposals included the following: (1) Participating in appropriately selected on-going clinical trials; (2) Designing new randomized controlled clinical trials and prospective population cohort studies; (3) Setting-up large database(s) to generate predictive response models and detect biomarkers for tailored loco-regional treatments.

Conclusions

It is hoped that the ATTM findings, as described in the present white paper, will stimulate a new generation of radiation oncologists to focus on research in these areas, and that the white paper will become a tool for multidisciplinary groups to help them design research proposals and strategies.

Nur mit Berechtigung zugänglich

Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, Baratella P, Chifu C, Sargenti M, Intra M et al (2013) Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol 14(4):297–305PubMedPubMedCentralCrossRef

Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, Leitch AM, Saha S, McCall LM, Morrow M (2011) Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 305(6):569–575PubMedCrossRef

Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJ, Mansel RE, Cataliotti L, Westenberg AH, Klinkenbijl JH, Orzalesi L et al (2014) Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 15(12):1303–1310PubMedPubMedCentralCrossRef

Jagsi R, Chadha M, Moni J, Ballman K, Laurie F, Buchholz TA, Giuliano A, Haffty BG (2014) Radiation field design in the ACOSOG Z0011 (Alliance) Trial. J Clin Oncol 32(32):3600–3606PubMedPubMedCentralCrossRef

Whelan TJ, Olivotto IA, Parulekar WR, Ackerman I, Chua BH, Nabid A, Vallis KA, White JR, Rousseau P, Fortin A et al (2015) Regional nodal irradiation in early-stage breast cancer. N Engl J Med 373(4):307–316PubMedPubMedCentralCrossRef

Poortmans PM, Collette S, Kirkove C, Van Limbergen E, Budach V, Struikmans H, Collette L, Fourquet A, Maingon P, Valli M et al (2015) Internal mammary and medial supraclavicular irradiation in breast cancer. N Engl J Med 373(4):317–327PubMedCrossRef

Thorsen LB, Offersen BV, Dano H, Berg M, Jensen I, Pedersen AN, Zimmermann SJ, Brodersen HJ, Overgaard M, Overgaard J (2016) DBCG-IMN: a population-based cohort study on the effect of internal mammary node irradiation in early node-positive breast cancer. J Clin Oncol 34(4):314–320PubMedCrossRef

OPTimizing irradiation through molecular assessment of lymph node (OPTIMAL). https://clinicaltrials.gov/ct2/show/NCT02335957. Accessed 13 Sept 2016

Sentinel node biopsy in breast cancer: omission of axillary clearance after macrometastases. A randomized Trial. https://clinicaltrials.gov/ct2/show/NCT02240472. Accessed 13 Sept 2016

10.

Goyal A, Dodwell D (2015) POSNOC: a randomised trial looking at axillary treatment in women with one or two sentinel nodes with macrometastases. Clin Oncol (R Coll Radiol) 27(12):692–695CrossRef

11.

Early Breast Cancer Trialists’ Collaborative G, McGale P, Taylor C, Correa C, Cutter D, Duane F, Ewertz M, Gray R, Mannu G, Peto R et al (2014) Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet 383(9935):2127–2135CrossRef

12.

Frasier LL, Holden S, Holden T, Schumacher JR, Leverson G, Anderson B, Greenberg CC, Neuman HB (2016) Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in national comprehensive cancer network guidelines. JAMA Oncol 2(1):95–101PubMedPubMedCentralCrossRef

13.

Krueger EA, Wilkins EG, Strawderman M, Cederna P, Goldfarb S, Vicini FA, Pierce LJ (2001) Complications and patient satisfaction following expander/implant breast reconstruction with and without radiotherapy. Int J Radiat Oncol Biol Phys 49(3):713–721PubMedCrossRef

14.

Seth AK, Silver HR, Hirsch EM, Kim JY, Fine NA (2015) Comparison of delayed and immediate tissue expander breast reconstruction in the setting of postmastectomy radiation therapy. Ann Plast Surg 75(5):503–507PubMedCrossRef

15.

Jhaveri JD, Rush SC, Kostroff K, Derisi D, Farber LA, Maurer VE, Bosworth JL (2008) Clinical outcomes of postmastectomy radiation therapy after immediate breast reconstruction. Int J Radiat Oncol Biol Phys 72(3):859–865PubMedCrossRef

16.

Momoh AO, Ahmed R, Kelley BP, Aliu O, Kidwell KM, Kozlow JH, Chung KC (2014) A systematic review of complications of implant-based breast reconstruction with prereconstruction and postreconstruction radiotherapy. Ann Surg Oncol 21(1):118–124PubMedCrossRef

17.

Kelley BP, Ahmed R, Kidwell KM, Kozlow JH, Chung KC, Momoh AO (2014) A systematic review of morbidity associated with autologous breast reconstruction before and after exposure to radiotherapy: are current practices ideal? Ann Surg Oncol 21(5):1732–1738PubMedPubMedCentralCrossRef

18.

Motwani SB, Strom EA, Schechter NR, Butler CE, Lee GK, Langstein HN, Kronowitz SJ, Meric-Bernstam F, Ibrahim NK, Buchholz TA (2006) The impact of immediate breast reconstruction on the technical delivery of postmastectomy radiotherapy. Int J Radiat Oncol Biol Phys 66(1):76–82PubMedCrossRef

19.

Blitzblau RC, Horton JK (2013) Treatment planning technique in patients receiving postmastectomy radiation therapy. Pract Radiat Oncol 3(4):241–248PubMedCrossRef

20.

Dundas KL, Pogson EM, Batumalai V, Boxer MM, Yap ML, Delaney GP, Metcalfe P, Holloway L (2015) Australian survey on current practices for breast radiotherapy. J Med Imaging Radiat Oncol 59(6):736–742PubMedCrossRef

21.

Petit JY, Lohsiriwat V, Clough KB, Sarfati I, Ihrai T, Rietjens M, Veronesi P, Rossetto F, Scevola A, Delay E (2011) The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study—Milan–Paris–Lyon experience of 646 lipofilling procedures. Plast Reconstr Surg 128(2):341–346PubMedCrossRef

22.

Ho A, Cordeiro P, Disa J, Mehrara B, Wright J, Van Zee KJ, Hudis C, McLane A, Chou J, Zhang Z et al (2012) Long-term outcomes in breast cancer patients undergoing immediate 2-stage expander/implant reconstruction and postmastectomy radiation. Cancer 118(9):2552–2559PubMedCrossRef

23.

Cordeiro PG, Albornoz CR, McCormick B, Hu Q, Van Zee K (2014) The impact of postmastectomy radiotherapy on two-stage implant breast reconstruction: an analysis of long-term surgical outcomes, aesthetic results, and satisfaction over 13 years. Plast Reconstr Surg 134(4):588–595PubMedCrossRef

24.

Kaidar-Person O, Kuten A, Belkacemi Y (2014) Arome: primary systemic therapy and whole breast irradiation for locally advanced breast cancer: a systematic review. Crit Rev Oncol Hematol 92(2):143–152PubMedCrossRef

25.

Giacalone PL, Rathat G, Daures JP, Benos P, Azria D, Rouleau C (2010) New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study. Breast Cancer Res Treat 122(2):439–451PubMedCrossRef

26.

Monrigal E, Dauplat J, Gimbergues P, Le Bouedec G, Peyronie M, Achard JL, Chollet P, Mouret-Reynier MA, Nabholtz JM, Pomel C (2011) Mastectomy with immediate breast reconstruction after neoadjuvant chemotherapy and radiation therapy. A new option for patients with operable invasive breast cancer. Results of a 20 years single institution study. Eur J Surg Oncol 37(10):864–870PubMedCrossRef

27.

Proton radiation therapy for invasive breast cancer following mastectomy. https://clinicaltrials.gov/ct2/show/NCT01340495. Accessed 10 Sept 2016

28.

Study assessing the potential for reduced rates of implant failure using multi-beam intensity-modulated radiation therapy for locally advanced breast cancer patients with implant reconstructions. https://clinicaltrials.gov/ct2/show/NCT02086578. Accessed 15 sept 2016

29.

Skin sparing mastectomy and immediate breast reconstruction with latissimus dorsi flap after neoadjuvant chemotherapy and radiotherapy (M-RIC) (M-RIC). https://clinicaltrials.gov/ct2/show/NCT01199354. Accessed 15 Sept 2016

30.

Kaufmann M, von Minckwitz G, Mamounas EP, Cameron D, Carey LA, Cristofanilli M, Denkert C, Eiermann W, Gnant M, Harris JR et al (2012) Recommendations from an international consensus conference on the current status and future of neoadjuvant systemic therapy in primary breast cancer. Ann Surg Oncol 19(5):1508–1516PubMedCrossRef

31.

Cortazar P, Zhang L, Untch M, Mehta K, Costantino JP, Wolmark N, Bonnefoi H, Cameron D, Gianni L, Valagussa P et al (2014) Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 384(9938):164–172PubMedCrossRef

32.

Bossuyt V, Provenzano E, Symmans WF, Boughey JC, Coles C, Curigliano G, Dixon JM, Esserman LJ, Fastner G, Kuehn T et al (2015) Recommendations for standardized pathological characterization of residual disease for neoadjuvant clinical trials of breast cancer by the BIG-NABCG collaboration. Ann Oncol 26(7):1280–1291PubMedPubMedCentral

33.

Kuehn T, Bauerfeind I, Fehm T, Fleige B, Hausschild M, Helms G, Lebeau A, Liedtke C, von Minckwitz G, Nekljudova V et al (2013) Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study. Lancet Oncol 14(7):609–618PubMedCrossRef

34.

Boughey JC, Suman VJ, Mittendorf EA, Ahrendt GM, Wilke LG, Taback B, Leitch AM, Kuerer HM, Bowling M, Flippo-Morton TS et al (2013) Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: the ACOSOG Z1071 (Alliance) clinical trial. JAMA 310(14):1455–1461PubMedPubMedCentralCrossRef

35.

Mamounas EP, Brown A, Anderson S, Smith R, Julian T, Miller B, Bear HD, Caldwell CB, Walker AP, Mikkelson WM et al (2005) Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer: results from national surgical adjuvant breast and bowel project protocol B-27. J Clin Oncol 23(12):2694–2702PubMedCrossRef

36.

Straver ME, Loo CE, Alderliesten T, Rutgers EJ, Vrancken Peeters MT (2010) Marking the axilla with radioactive iodine seeds (MARI procedure) may reduce the need for axillary dissection after neoadjuvant chemotherapy for breast cancer. Br J Surg 97(8):1226–1231PubMedCrossRef

37.

Donker M, Straver ME, Wesseling J, Loo CE, Schot M, Drukker CA, van Tinteren H, Sonke GS, Rutgers EJ, Vrancken Peeters MJ (2015) Marking axillary lymph nodes with radioactive iodine seeds for axillary staging after neoadjuvant systemic treatment in breast cancer patients: the MARI procedure. Ann Surg 261(2):378–382PubMedCrossRef

38.

Caudle AS, Yang WT, Krishnamurthy S, Mittendorf EA, Black DM, Gilcrease MZ, Bedrosian I, Hobbs BP, DeSnyder SM, Hwang RF et al (2016) Improved axillary evaluation following neoadjuvant therapy for patients with node-positive breast cancer using selective evaluation of clipped nodes: implementation of targeted axillary dissection. J Clin Oncol 34(10):1072–1078PubMedCrossRef

39.

Liedtke C, Thill M, Committee AGOB (2016) AGO recommendations for the diagnosis and treatment of patients with early breast cancer: update 2016. Breast Care (Basel) 11(3):204–214CrossRef

40.

Berruti A, Generali D, Kaufmann M, Puztai L, Curigliano G, Aglietta M, Gianni L, Miller WR, Untch M, Sotiriou C et al (2011) International expert consensus on primary systemic therapy in the management of early breast cancer: highlights of the fourth symposium on primary systemic therapy in the management of operable breast cancer, Cremona, Italy (2010). J Natl Cancer Inst Monogr 2011(43):147–151PubMedCrossRef

41.

Honig A, Rieger L, Sutterlin M, Wallwiener D, Dietl J, Solomayer EF (2005) State of the art of neoadjuvant chemotherapy in breast cancer: rationale, results and recent developments. Ger Med Sci. doi:10.1016/j.ejcsup.2013.07.043 PubMedPubMedCentral

42.

Early Breast Cancer Trialists’ Collaborative G, Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, Cutter D, Davies C, Ewertz M et al (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378(9804):1707–1716CrossRef

43.

White J, Mamounas E (2014) Locoregional radiotherapy in patients with breast cancer responding to neoadjuvant chemotherapy: a paradigm for treatment individualization. J Clin Oncol 32(6):494–495PubMedCrossRef

44.

Marks LB, Prosnitz LR (2014) Reducing local therapy in patients responding to preoperative systemic therapy: are we outsmarting ourselves? J Clin Oncol 32(6):491–493PubMedCrossRef

45.

Senkus E, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rutgers E, Zackrisson S, Cardoso F, Committee EG (2015) Primary breast cancer: Esmo clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 26(Suppl 5):v8–v30PubMedCrossRef

46.

Huang EH, Tucker SL, Strom EA, McNeese MD, Kuerer HM, Buzdar AU, Valero V, Perkins GH, Schechter NR, Hunt KK et al (2004) Postmastectomy radiation improves local-regional control and survival for selected patients with locally advanced breast cancer treated with neoadjuvant chemotherapy and mastectomy. J Clin Oncol 22(23):4691–4699PubMedCrossRef

47.

McGuire SE, Gonzalez-Angulo AM, Huang EH, Tucker SL, Kau SW, Yu TK, Strom EA, Oh JL, Woodward WA, Tereffe W et al (2007) Postmastectomy radiation improves the outcome of patients with locally advanced breast cancer who achieve a pathologic complete response to neoadjuvant chemotherapy. Int J Radiat Oncol Biol Phys 68(4):1004–1009PubMedPubMedCentralCrossRef

48.

Mamounas EP, Anderson SJ, Dignam JJ, Bear HD, Julian TB, Geyer CE Jr, Taghian A, Wickerham DL, Wolmark N (2012) Predictors of locoregional recurrence after neoadjuvant chemotherapy: results from combined analysis of national surgical adjuvant breast and bowel project B-18 and B-27. J Clin Oncol 30(32):3960–3966PubMedPubMedCentralCrossRef

49.

Rusthoven CG, Rabinovitch RA, Jones BL, Koshy M, Amini A, Yeh N, Jackson MW, Fisher CM (2016) The impact of postmastectomy and regional nodal radiation after neoadjuvant chemotherapy for clinically lymph node-positive breast cancer: a national cancer database (NCDB) analysis. Ann Oncol 27(5):818–827PubMedCrossRef

50.

Radiotherapy after primary chemotherapy for breastcancer (RAPCHEM). https://clinicaltrials.gov/ct2/show/NCT01279304. Accessed 13 Sept 2016

51.

Standard or comprehensive radiation therapy in treating patients with early-stage breast cancer previously treated with chemotherapy and surgery. http://www.cancer.gov/about-cancer/treatment/clinical-trials/search/view?cdrid=750327. Accessed 13 Sept 2016

52.

Lymph node dissection and radiation therapy in treating patients with breast cancer previously treated with chemotherapy and surgery. http://www.cancer.gov/about-cancer/treatment/clinical-trials/search/view?cdrid=751211. Accessed 13 Sept 2016

53.

Gaui MF, Amorim G, Arcuri RA, Pereira G, Moreira D, Djahjah C, Biasoli I, Spector N (2007) A phase II study of second-line neoadjuvant chemotherapy with capecitabine and radiation therapy for anthracycline-resistant locally advanced breast cancer. Am J Clin Oncol 30(1):78–81PubMedCrossRef

54.

Alvarado-Miranda A, Arrieta O, Gamboa-Vignolle C, Saavedra-Perez D, Morales-Barrera R, Bargallo-Rocha E, Zinser-Sierra J, Perez-Sanchez V, Ramirez-Ugalde T, Lara-Medina F (2009) Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer. Radiat Oncol 4:24PubMedPubMedCentralCrossRef

55.

Shaughnessy JN, Meena RA, Dunlap NE, Jain D, Riley EC, Quillo AR, Dragun AE (2015) Efficacy of concurrent chemoradiotherapy for patients with locally recurrent or advanced inoperable breast cancer. Clin Breast Cancer 15(2):135–142PubMedCrossRef

56.

Offersen BV, Boersma LJ, Kirkove C, Hol S, Aznar MC, Sola AB, Kirova YM, Pignol JP, Remouchamps V, Verhoeven K et al (2016) ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer, version 1.1. Radiother Oncol 118(1):205–208PubMedCrossRef

57.

Lambin P, Rios-Velazquez E, Leijenaar R, Carvalho S, van Stiphout RG, Granton P, Zegers CM, Gillies R, Boellard R, Dekker A et al (2012) Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer 48(4):441–446PubMedPubMedCentralCrossRef

58.

Lambin P, van Stiphout RG, Starmans MH, Rios-Velazquez E, Nalbantov G, Aerts HJ, Roelofs E, van Elmpt W, Boutros PC, Granone P et al (2013) Predicting outcomes in radiation oncology-multifactorial decision support systems. Nat Rev Clin Oncol 10(1):27–40PubMedCrossRef

59.

Meldolesi E, van Soest J, Damiani A, Dekker A, Alitto AR, Campitelli M, Dinapoli N, Gatta R, Gambacorta MA, Lanzotti V et al (2016) Standardized data collection to build prediction models in oncology: a prototype for rectal cancer. Future Oncol 12(1):119–136PubMedCrossRef

Titel: The 2016 Assisi Think Tank Meeting on breast cancer: white paper
verfasst von: Cynthia Aristei
Orit Kaidar-Person
Meritxell Arenas
Charlotte Coles
Birgitte V. Offersen
Celine Bourgier
Giovanni Frezza
Maria Cristina Leonardi
Vincenzo Valentini
Philip M. P. Poortmans
Publikationsdatum: 29.09.2016
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 2/2016
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-016-3998-2

Neu im Fachgebiet Onkologie

25.04.2024 | Nierenkarzinom | Nachrichten

Springer Medizin

The 2016 Assisi Think Tank Meeting on breast cancer: white paper

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2016

Cabozantinib for metastatic breast carcinoma: results of a phase II placebo-controlled randomized discontinuation study

Treatment with aromatase inhibitors and markers of cardiovascular disease

Use of a prospective surveillance model to prevent breast cancer treatment-related lymphedema: a single-center experience

Impact of neoadjuvant therapy on eligibility for and frequency of breast conservation in stage II–III HER2-positive breast cancer: surgical results of CALGB 40601 (Alliance)

Prognostic value of endocrine treatment-related symptoms in patients with breast cancer: a meta-analysis

Integrated analysis of gene expression and methylation profiles of 48 candidate genes in breast cancer patients

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie