Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2022
Early Local Therapy for the Primary Site in De Novo Stage IV Breast Cancer: Results of a Randomized Clinical Trial (EA2108).
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 107 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
107 citing papers in PubMed, 5 syntheses or guidelines pooled it, 168 citations in OpenAlex.
- Effect of locoregional surgery in primary tumors on overall survival in patients withFrontiers in oncology · 2025Pooled it
- Impact of Primary Breast Surgery on Overall Survival of Patients With De Novo Metastatic Breast Cancer: A Systematic Review and Meta-Analysis.The oncologist · 2024Pooled it
- The Japanese Breast Cancer Society Clinical Practice Guidelines for surgical treatment of breast cancer, 2022 edition.Breast cancer (Tokyo, Japan) · 2024Guideline
- Systemic Treatment of Patients With Metastatic Breast Cancer: ASCO Resource-Stratified Guideline.JCO global oncology · 2024Guideline
- Guidelines for breast cancer management in Bosnia and Herzegovina.Biomolecules & biomedicine · 2023Guideline
- The Role of Locoregional Treatment in Non-Progressive De Novo Metastatic Breast Cancer under Systemic Treatment: A Randomized Controlled Trial (LTMBC).Annals of surgical oncology · 2026Trial
- Primary tumour resection plus systemic therapy versus systemic therapy alone in metastatic breast cancer (JCOG1017, PRIM-BC): a randomised clinical trial.British journal of cancer · 2025Trial
- Adding Metastasis-Directed Therapy to Standard-of-Care Systemic Therapy for Oligometastatic Breast Cancer (EXTEND): A Multicenter, Randomized Phase 2 Trial.International journal of radiation oncology, biology, physics · 2025Trial
- A Nomogram and Risk Classification System Predicting the Prognosis of Patients with De Novo Metastatic Breast Cancer Undergoing Immediate Breast Reconstruction: A Surveillance, Epidemiology, and End Results Population-Based Study.Current oncology (Toronto, Ont.) · 2023Trial
- Surgical management in HER2 + de novo metastatic breast cancer: disease progression and survival.Breast cancer research and treatment · 2026Article
- Association Between Axillary Surgical Management and Survival for Patients With De Novo Metastatic Breast Cancer.Annals of surgical oncology · 2026Article
- Association between primary tumor surgery and survival in patients withTranslational cancer research · 2026Article
- Breast skin ulceration in de novo metastatic breast cancer: incidence, predictors, and patterns of occurrence.Breast cancer research and treatment · 2026Article
- Five Decades of Innovation-Tailored Breast Cancer Treatment: 1976-2026.World journal of surgery · 2026Review
- The Role of Primary Tumor Resection in De Novo Bone-Only Metastatic Breast Cancer: A Propensity Score-Matched Analysis.Journal of surgical oncology · 2026Article
- Primary tumor resection is associated with improved survival in de novo lung metastatic breast cancer.Updates in surgery · 2026Article
- Primary tumour resection in de novo stage IV breast cancer: considerations from the PRIM-BC trial.British journal of cancer · 2026Article
- Differences in drug efficacy and prognosis between primary and metastatic sites for de novo stage IV breast cancer: an exploratory analysis of a phase III trial, JCOG1017.Breast cancer (Tokyo, Japan) · 2026Observational
- Effect of Primary Breast Surgery on Prognosis in Breast Cancer Patients Presenting with Isolated Bone Metastases.Cancers · 2026Article
- Impact of axillary surgery on survival in de novo metastatic breast cancer with primary tumor resection.Breast cancer research and treatment · 2026Article
47 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Erratum issuedErratum.2022
Authors and funding
19 authors at 17 institutions in 2 countries.
Funding
Abstract
purposeDistant metastases are present in 6% or more of patients with newly diagnosed breast cancer. In this context, locoregional therapy for the intact primary tumor has been hypothesized to improve overall survival (OS), but clinical trials have reported conflicting results.
methodsWomen presenting with metastatic breast cancer and an intact primary tumor received systemic therapy for 4-8 months; if no disease progression occurred, they were randomly assigned to locoregional therapy for the primary site (surgery and radiotherapy per standards for nonmetastatic disease) or continuing sysmetic therapy. The primary end point was OS; locoregional control and quality of life were secondary end points. The trial design provided 85% power to detect a 19.3% absolute difference in the 3-year OS rate in randomly assigned patients. The stratified log-rank test and Cox proportional hazards model were used to compare OS between arms. Cumulative incidence of locoregional progression was compared using Gray's test. Quality-of-life assessment used standard instruments.
resultsOf 390 participants enrolled, 256 were randomly assigned: 131 to continued systemic therapy and 125 to early locoregional therapy. The 3-year OS was 67.9% without and 68.4% with early locoregional therapy (hazard ratio = 1.11; 90% CI, 0.82 to 1.52;
conclusionEarly locoregional therapy for the primary site did not improve survival in patients presenting with metastatic breast cancer. Although it was associated with improved locoregional control, this had no overall impact on quality of life.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.