Abstract

Abstract Advances in cancer therapies and technologies have shifted the paradigm for treating metastatic disease. Patients with stage IV disease are living longer and technologic advances enable us to deliver local therapies, such as surgical resection, radiofrequency ablation, or stereotactic radiosurgery, with lower toxicities. Genetic deep sequencing has helped us understand metastases to be genetically heterogeneous with independent subpopulations evolving in response to environmental pressures. We currently understand metastatic progression from primary tumor to disseminated disease to involve multiple stages, raising the possibility of an intermediate, curable, oligometastatic state with limited metastatic potential. The clinical relevance of oligometastases has been validated in multiple, recent randomized clinical trials. Metastasis directed therapies have been demonstrated to improve overall survival, however, this benefit is not seen in all patients, and breast specific data are lacking. This educational presentation will review randomized evidence supporting local treatment of oligometastases. We will also review evidence specific to breast cancer and highlight the critical need to define when local therapies can be effective at disrupting metastatic progression in breast cancer patients. Citation Format: A Xu. Oligo-progressive disease. Treating locally more than systemically [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr ES9-3.

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