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Conference/Presentation Title: | Stereotactic radiotherapy (SRT) with maintenance systemic therapy vs. standard-of-care (SOC) systemic therapy for oligoprogressive ER-positive, HER2-negative breast cancer (AVATAR-II). | Authors: | Connolly E.;White M. ;Siva S.;Bressel M.;Tan J.;Byrne K.;Day D. ;McCartney A. ;Webber K. ;David S.P. | Monash Health Department(s): | Oncology | Institution: | (Connolly, Siva, Tan, Byrne, David) Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (White, Day, McCartney, Webber) Department of Oncology, Monash Health, Melbourne, VIC, Australia (Bressel) Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia |
Presentation/Conference Date: | 2-Sep-2024 | Copyright year: | 2024 | Publisher: | Elsevier Inc. | Publication information: | International Journal of Radiation Oncology Biology Physics. Conference: 2024 ASTRO Annual Meeting. Walter E. Washington Convention Center, Washington United States. 120(2 Supplement) (pp e304), 2024. Date of Publication: 01 Oct 2024. | Journal: | International Journal of Radiation Oncology Biology Physics | Abstract: | Purpose/Objective(s): The AVATAR I Trial demonstrated that oligoprogressive luminal (ER positive, HER2 negative) advanced breast cancer patients undergoing established first-line systemic therapy for metastatic disease benefited from SRT as second-line therapy along with their original systemic treatment. A modified PFS, defined as a disease progression not amenable to SRT treatment, was reported as 10.4 months. Given this result, this trial in progress seeks to assess if SRT combined with systemic therapy CDK4/6 inhibitor and Aromatase Inhibitor (CDK4/6+AI) can improve the Quality of Life (QoL) for this cohort of patients. Materials/Methods: AVATAR II is a Phase 2 randomized control trial that enrolls patients with advanced luminal breast cancer who have received first-line systemic treatment in the metastatic setting with a CDK4/6+AI. Patients require at least 1 extracranial oligoprogressing lesion amenable to SRT. Patients who had chemotherapy for metastatic disease, leptomeningeal disease, or prior radiotherapy to an oligoprogressing lesion were excluded. Patients were randomized to Arm A; SRT to all oligoprogressing lesions and continue CDK4/6+AI systemic therapy or Arm B; no SRT and review to assess if a change in systemic therapy is required. If a patient subsequently progresses, further SRT was permitted to delay a change in systemic therapy in patients who had received SRT as part of the trial. At 3-monthly reviews, patient reported outcomes are measured using the EORTC QLQ C30 and FACT-B forms. The trial is expected to recruit 74 patients. The primary endpoint is the area under the curve (AUC) of the Quality of Life/Global Health Status score from the EORTC QLQ-C30 from baseline to the 12-month follow-up visit. The secondary endpoints are to determine Progression-free Survival (PFS) and PFS 2, defined as the time from randomization to the date of first and second evidence of progression, respectively. Other secondary endpoints include ST-PFS, defined as randomization to the first evidence of progression requiring change in systemic therapy, Overall Survival, treatment-related toxicity and further QoL assessment using AUC of the FACT-B Total score from baseline to 12 months. Result(s): TBD. Conclusion(s): Assessing quality of life (QoL) is integral to evaluating the overall impact of cancer treatment. AVATAR II aims to demonstrate that by delaying a change in systemic therapy and potentially more potent side effects, receiving SRT at this stage in a patient's treatment paradigm will have a more positive impact on patients' QoL.Copyright © 2024 | Conference Name: | 2024 ASTRO Annual Meeting | Conference Start Date: | 2024-09-29 | Conference End Date: | 2024-10-02 | Conference Location: | Walter E. Washington Convention Center, Washington, United States | DOI: | http://monash.idm.oclc.org/login?url=https://dx.doi.org/10.1016/j.ijrobp.2024.07.674 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/52453 | Type: | Conference Abstract | Subjects: | breast cancer radiotherapy |
Type of Clinical Study or Trial: | Observational study (cohort, case-control, cross sectional, or survey) |
Appears in Collections: | Conferences |
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