The trial we’re most excited to see is E2108. Currently, local therapy is mostly reserved for palliative purposes in women with de novo metastatic breast cancer. E2108 looked at the benefit of local therapy (surgery and radiation) after chemotherapy in these women. Patients had to have resectable primary disease and a good response or stable disease after initial planned chemo They then went on to receive either standard local therapy based on extent of disease or local therapy for palliative purposes only. We’re thinking there’s gonna be a positive outcome here that may change our practice for metastatic breast cancer (i.e., this may be the STAMPEDE of breast cancer). But it will be important to see details about patterns of progression and subset analyses of how well the approach works in different breast cancer subtypes. The Betting Line: Surgery and/or radiation after response to initial chemotherapy will improve overall survival for women with de novo metastatic breast cancer and resectable primary disease—but this may be driven by certain receptor subtypes. | Khan, ASCO 2020


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