Designing clinical trials based on modern imaging and metastasis-directed treatments in patients with oligometastatic breast cancer: a consensus recommendation from the EORTC Imaging and Breast Cancer Groups

Breast cancer remains the most common cause of cancer death among women. Despite its considerable histological and molecular heterogeneity, those characteristics are not distinguished in most definitions of oligometastatic disease and clinical trials of oligometastatic breast cancer. After an exhaustive review of the literature covering all aspects of oligometastatic breast cancer, 35 experts from the European Organisation for Research and Treatment of Cancer Imaging and Breast Cancer Groups elaborated a Delphi questionnaire aimed at offering consensus recommendations, including oligometastatic breast cancer definition, optimal diagnostic pathways, and clinical trials required to evaluate the effect of diagnostic imaging strategies and metastasis-directed therapies. The main recommendations are the introduction of modern imaging methods in metastatic screening for an earlier diagnosis of oligometastatic breast cancer and the development of prospective trials also considering the histological and molecular complexity of breast cancer. Strategies for the randomisation of imaging methods and therapeutic approaches in different subsets of patients are also addressed.

Automated summary

Breast cancer is the most common cause of cancer death among women, but the current definitions and clinical trials of oligometastatic breast cancer do not consider the histological and molecular heterogeneity of breast cancer. A Delphi questionnaire developed by 35 experts from the European Organisation for Research and Treatment of Cancer Imaging and Breast Cancer Groups provides recommendations for the definition, optimal diagnostic pathways, and clinical trials of oligometastatic breast cancer. The main recommendations include introducing modern imaging methods for early diagnosis and conducting prospective trials considering the complexity of breast cancer.