SABR: Stereotactic Ablative Radiotherapy is delivered to all metastatic lesions.
Study summary
TAORMINA is an international, multicentre, randomised phase 3 trial for patients with oligometastatic breast cancer (OMBC) that will be allocated to combined stereotactic ablative radiotherapy (SABR) + systemic therapy (investigational arm) versus systemic therapy alone (control arm) as 1st line therapy.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
1. Histologically or cytological confirmed recurrent OMBC.
2. Age ≥18 years old.
3. OMBC defined as 1-5 metastases in a maximum of two organs confirmed by PET-CT.
4. Patients already on 1st line systemic treatment can be enrolled if repeated tumour evaluations show stable disease.
5. Patients with de novo stage IV OMBC must have a controlled primary tumour regardless of primary surgery or primary systemic treatment.
6. Patients with local recurrence and OMBC must have a controlled local recurrence.
7. ECOG/WHO 0-2.
8. Life expectancy \> 6 months.
9. Known ER, PgR and HER2 status of either primary tumour or metastasis (preferred).
10. Symptomatic bone metastases are allowed if ablative therapy can be delivered.
11. Adequate organ function for the planned treatment according to local guide-lines.
12. For patients with liver metastasis:
* No cirrhosis or hepatitis
* Hepatic function:
* Total bilirubin level \< 3.0 x institutional ULN
* ALT, AST, GGT, and alkaline phosphatase levels \< 3.0 x institutional ULN
* Albumin \> 2.5 mg/dL
* Metastasis not adjutant to stomach or small bowel.
13. For patients with abdominal metastases: adequate renal function with a calculated creatinine clearance of \> 60mL/min.
14. Toxicities from previous adjuvant therapies (excluding alopecia) must have recovered to grade 1 (defined by CTCAE 5.0). Stable grade 2 peripheral neuropathy are considered individually by the investigator.
15. Negative pregnancy test within 14 days prior to start of treatment\*.
16. If childbearing potential, willing to use an effective form of contraception\*.
17. No other malignancy during the last 5 years except for radically treated basal or squamous cell carcinoma of the skin or CIS of the cervix.
18. Signed informed consent and willingness to follow the trial procedures.
Exclusion Criteria:
1. \> 1 line of systemic treatment for OMBC due to previous progressing disease (previous treatment of isolated local recurrences with a 2nd adjuvant treatment not included). Change due to toxicity allowed.
2. Oligometastases in brain.
3. Malignant pleural effusion or ascites.
4. Metastasis growth that involves \> 3 vertebra and adjacent spinal cord, spine instability or neurological deficit resulting from compression, 25% spinal canal compromise or progressive neurological deficit.
5. Unable to undergo imaging by either CT scan or MRI.
6. Evidence of any other medical conditions (such as psychiatric illness, infectious diseases, neurological conditions, physical examination or laboratory findings) that may interfere with the planned treatment or affect patient compliance.
7. Pregnancy or breast-feeding.
8. Concurrent malignancy requiring therapy (excluding non-invasive carcinoma or carcinoma in situ).
Primary outcome measure(s)
Progression-free survival (PFS) — 3 years after the last patient inclusion Time from the date of randomisation to the date of disease-progression at any site or death from any cause.
Trial sites (19)
Facility
City
Region
Status
Cork University Hospital
Cork
Ireland
Recruiting
Bon Secours Cork In Partnership with UPMC Hillman Cancer Centre
Cork
Ireland
Recruiting
St Luke's Radiation Oncology Network (SLRON) at St Luke's Hospital Dublin, St James Hospital Dublin and Beaumont Hospital Dublin
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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