The document summarizes two studies on surgery for stage IV breast cancer - the Tata Memorial study from India and a Turkish study. The Tata Memorial study involved 350 patients from 2005-2012 and examined whether initial therapy including surgery and chemotherapy improved median survival from 18 to 24 months. The Turkish study involved 271 patients from 2008-2012 and examined whether primary site local therapy improved overall survival. Both studies stratified patients and planned subset analyses to examine effects on different patient groups. The document compares characteristics of the two studies such as patient demographics, tumor characteristics, and metastatic burden between study arms.

1. San Antonio Breast Cancer Symposium-
2013
The Future of Metastatic Breast Cancer
Stephen C. Malamud MD
Medical Oncology
Beth Israel Medical Center-Comprehensive Cancer Center

2. Breast Cancer:
Surgery for Stage IV ?

4. Tata Memorial Study
Tata Memorial (India)- 350 patients from 2005-2012
Endpoint- overall survival
Projected benefit: median survival- increase in
survival from 18 to 24 months
Initial therapy in experimental arm- CAF+/- T
Stratifications: number and type of metastases,
ER status, age, menopause
Subset analysis: age, ER status, HER2 status,
number and type of metastases

10.  Study size: 271 (2008-12)
 Endpoint: overall survival
 Initial therapy: primary site local therapy
 Stratification: none described
 Inclusion of radiotherapy: yes
 Subset analysis planned: age,
ER/Her2/triple negative, one organ site;
bone only; all other solitary bone lesions;
multiple bone lesions
Turkish Study:

15. Tata Memorial Study:

16.  Turkey: both groups median age 52
 Tata Memorial: 47 and 48
 Turkey: tumor size- more T2 and T4 tumors in ST arm; grade similar
between 2 arms
 Tata Memorial: tumor size: not described; grade not described
 Both studies: Lymph node involvement not described
 Tata Memorial: ER+: 51% and 49%
 Turkey- fewer ER+ and more Triple Negative patients on the ST arm
 Metastatic burden: Tata- balanced for >3 lesions, Turkey- single organ
site more frequent in surgical arm
 Bone only metastases- Tata- balanced between arms; Turkey- fewer in
ST arm, non-bone metastases more frequent in ST arm
Study characteristics:
Comparative Analysis