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- Title
Stereotactic ablative radiotherapy for the comprehensive treatment of 4-10 oligometastatic tumors (SABR-COMET-10): study protocol for a randomized phase III trial.
- Authors
Palma, David A.; Olson, Robert; Harrow, Stephen; Correa, Rohann J. M.; Schneiders, Famke; Haasbeek, Cornelis J. A.; Rodrigues, George B.; Lock, Michael; Yaremko, Brian P.; Bauman, Glenn S.; Ahmad, Belal; Schellenberg, Devin; Liu, Mitchell; Gaede, Stewart; Laba, Joanna; Mulroy, Liam; Senthi, Sashendra; Louie, Alexander V.; Swaminath, Anand; Chalmers, Anthony
- Abstract
<bold>Background: </bold>Stereotactic ablative radiotherapy (SABR) has emerged as a new treatment option for patients with oligometastatic disease. SABR delivers precise, high-dose, hypofractionated radiotherapy, and achieves excellent rates of local control for primary tumors or metastases. A recent randomized phase II trial evaluated SABR in a group of patients with a small burden of oligometastatic disease (mostly with 1-3 metastatic lesions), and found that SABR was associated with benefits in progression-free survival and overall survival. The goal of this phase III trial is to assess the impact of SABR in patients with 4-10 metastatic cancer lesions.<bold>Methods: </bold>One hundred and fifty-nine patients will be randomized in a 1:2 ratio between the control arm (consisting of standard of care palliative-intent treatments), and the SABR arm (consisting of standard of care treatment + SABR to all sites of known disease). Randomization will be stratified by two factors: histology (Group 1: prostate, breast, or renal; Group 2: all others), and type of pre-specified systemic therapy (Group 1: immunotherapy/targeted; Group 2: cytotoxic; Group 3: observation). SABR is to be completed within 2 weeks, allowing for rapid initiation of systemic therapy. Recommended SABR doses are 20 Gy in 1 fraction, 30 Gy in 3 fractions, or 35 Gy in 5 fractions, chosen to minimize risks of toxicity. The primary endpoint is overall survival, and secondary endpoints include progression-free survival, time to development of new metastatic lesions, quality of life, and toxicity. Translational endpoints include assessment of circulating tumor cells, cell-free DNA, and tumor tissue as prognostic and predictive markers, including assessment of immunological predictors of response and long-term survival.<bold>Discussion: </bold>This study will provide an assessment of the impact of SABR on clinical outcomes and quality of life, to determine if long-term survival can be achieved for selected patients with 4-10 oligometastatic lesions.<bold>Trial Registration: </bold>Clinicaltrials.gov identifier: NCT03721341 . Date of registration: October 26, 2018.
- Subjects
STEREOTACTIC radiotherapy; PROGRESSION-free survival; QUALITY of life; TUMORS; METASTASIS
- Publication
BMC Cancer, 2019, Vol 19, Issue 1, pN.PAG
- ISSN
1471-2407
- Publication type
journal article
- DOI
10.1186/s12885-019-5977-6