Mapping the current landscape of locoregional therapy de-escalation trials in early breast cancer: a systematic review
Abstract A systematic review undertaken to map the current landscape of locoregional de-escalation trials to inform future research. Online databases and trial registries were searched to identify ongoing, recently completed or published studies de-escalating surgery or radiotherapy in patients with...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-03-01
|
| Series: | npj Breast Cancer |
| Online Access: | https://doi.org/10.1038/s41523-025-00744-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Abstract A systematic review undertaken to map the current landscape of locoregional de-escalation trials to inform future research. Online databases and trial registries were searched to identify ongoing, recently completed or published studies de-escalating surgery or radiotherapy in patients with early breast cancer. 97 trials evaluated de-escalation of surgery or radiotherapy in up to 94,866 participants. Surgery studies more commonly evaluated treatment omission/reduction after neoadjuvant systemic therapy (NST) and de-escalation of nodal treatment. Radiotherapy studies were more frequently biomarker stratified. Patients were rarely involved in study design. Research questions focused on response-adjusted treatment after NST and omission/reduction of locoregional therapy in patients with low- or intermediate-risk disease. Significant duplication was identified with multiple studies addressing similar questions. This systematic review demonstrates that the current de-escalation portfolio is inefficient, lacks patient focus and needs improvement. An internationally collaborative approach using innovative study designs and patient partnership will be essential to address this. |
|---|---|
| ISSN: | 2374-4677 |