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SABR-COMET’s tail’s tail

Top Line : What’s better than long-term outcomes from SABR-COMET? The Study : Longer-term outcomes . Again, this phase 2 trial included 99 patients with 1-3 (n= 92) or up to 4-5 (n= 7) mets from any cancer without progression at the primary site at least 3 months after definitive treatment. So far we’ve seen that those randomized to stereotactic ablative radiation (SABR) had improvements in overall survival at 5 years from 18 → 42% and in median survival time from 28 → 50 months. While that’s nothing to scoff at, it does bring up the unique question in this setting of long-term toxicity. As such, prior to initial analysis, planned follow-up was extended from 5 to 10 years. Here we learn that rates of grade 2+ toxicity at 8 years were 30% in the SABR arm—mostly pain after treatment of bone mets—and 9% without. There was no grade 3+ toxicity emerging after 2 years. Of practical concern, patients were significantly less likely to require cytotoxic chemo after SABR (33%) than without (5

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