Modeling the Patterns of Breast Cancer Early Metastases

Purpose

Our long-range, overall hypothesis is that by adding surveillance imaging to standard follow-up care for high-risk breast cancer survivors a meaningfully large subset of patients will achieve dramatically increased overall survival (OS) and disease-free survival (DFS). Our immediate objectives are to gather additional data and better model the patterns of early metastatic spread of breast cancer to provide additional evidence of the efficacy of our approach and to optimize the surveillance imaging protocol to strengthen subsequent applications to the NIH, DOD Breast Cancer Research Program, the Komen Foundation, and/or other external agency. Our collective team recently submitted a $1.4M proposal to the DOD BCR. The goals of this FLACCA award are to strengthen our DOD BCR proposal by advancing our position in each of several key areas. Our primary aims are the following: Aim 1. Initiate a prospective pilot surveillance imaging study of high-risk breast cancer patients at the University of Miami (UM) and at University of Florida Health Cancer Center (UFHCC), Gainesville, FL; this will be patterned on an ongoing pilot study at UFHCC led by Co-PI Walter O?Dell. The objectives are to establish our ability to perform this study in a multi-institutional setting and to gather additional preliminary data related to the (1) prevalence of oligometastases, (2) time to first incidence of new metastases, and (3) variable growth rates of breast cancer metastases in the various target organs. Aim 2. Conduct a retrospective outcomes analysis of patients treated for metastatic breast cancer at UF; this will be patterned on the recently completed study led by Co-PI Cristiane Takita at the University of Miami Sylvester Comprehensive Cancer Center (UM). This analysis will provide additional supporting data on the efficacy of stereotactic body radiation therapy (SBRT) for breast cancer metastases and the expected additional long-term benefit for patients with oligometastatic disease. We will also add to UM?s emerging outcomes data for breast cancer sub-types. Aim 3. Apply the new prospective and retrospective data of Aims 1 & 2 with existing data from UF and UM to the metastasis dissemination model implemented by Coumans et al.1 Our goal is to provide additional statistical support for establishing the (1) high prevalence of oligometastases in our patient population, and the (2) parameters of time to detectability and growth rates of new metastases that are necessary to motivate and optimally conduct a larger investigational study.

Keywords

Breast Cancer, early metastases, surveillance imaging, disease-free survival

Principal Investigator

Walter O'Dell

Sponsoring Group

Department of Radiation Oncology

Contact Information

odelwg@shands.ufl.edu

3522739030


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