S3027
Invited Speaker
ESTRO 2026
5403 SABR for oligometastatic breast cancer: Understanding patients’ perspectives Sukhdeep K Nagpal Breast Unit, The Royal Marsden NHS Trust, London, United Kingdom Stereotactic body radiotherapy (SABR) for oligometastatic breast cancer provides excellent local control and durable pain relief, despite conflicting evidence regarding its impact on survival outcomes [1- 3]. This raises an important question: which outcomes are most important to patients when considering SABR? Understanding patient perspectives is essential to support decision-making and to guide the design of future clinical trials with endpoints that are meaningful to patients. This presentation reports on a qualitative study [4] examining how patients with oligometastatic breast cancer understand and interpret SABR as a treatment option. It will discuss the factors that influence patient decision-making and the outcomes patients prioritise when evaluating SABR as a treatment approach. The findings provide guidance for clinicians in facilitating patient-centred discussions and for researchers designing trials that reflect patient priorities rather than relying solely on traditional clinical endpoints. Attendees will gain insight into how qualitative research can inform patient-centred care and help integrate patient perspectives into both clinical practice and future trial design. References: [1] Palma DA, Olson R, Harrow S, Gaede S, Louie A V., Haasbeek C, et al. The Lancet 2019;393:2051–8. https://doi.org/10.1016/S0140-6736(18)32487-5. [2] Khoo V, Kirby A, Ahmed M, Dewan M, Van As N, Franks K, et al. Radiotherapy and Oncology 2023;182:S627. https://doi.org/10.1016/S0167- 8140(23)08702-9. [3] Chmura SJ, Winter KA, Woodward WA, Borges VF, Salama JK, Al-Hallaq HA, et al. Journal of Clinical Oncology 2022;40:1007– 1007.https://doi.org/10.1200/JCO.2022.40.16_suppl.10 07. [4] Nagpal SK, Ross G, Cruickshank S, Kirby AM. Clin Oncol 2025;38:103738. https://doi.org/10.1016/j.clon.2024.103738. 5404 SABR in oligometastatic breast cancer: Integrating local therapy into systemic management Barbro K Linderholm Department of Oncology, Sahlgrenska University Hospital, Inst. of Clinical Sciences, Department of Oncology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
A biologically oriented definition of the oligometastatic state is central to clinical decision-making. The ESTRO– EORTC classification system provides a structured framework, yet its discriminatory capacity in daily practice remains variable and dependent on disease- specific contexts. Available evidence supports the role of stereotactic ablative radiotherapy (SABR) as an effective local treatment in carefully selected patients. Prospective data, including phase II experiences such as the MITO- RT3/RAD study in oligometastatic ovarian cancer [3, 4], report high local control rates with minimal grade ≥ 3 toxicity, even in combination with systemic agents. Additional multicenter series confirm favorable safety profiles and durable disease control, reinforcing the role of SABR within a multimodal strategy. However, “oligometastatic” does not represent a homogeneous entity. Ovarian, endometrial, and cervical cancers differ significantly in metastatic patterns, systemic treatment sensitivity, and natural history, requiring disease-adapted selection criteria [1- 4]. Key factors include number and site of metastases, disease-free interval, prior systemic therapy, and molecular profile. Integration with systemic therapy is increasingly relevant, particularly in the era of targeted agents and immunotherapy, where potential synergistic effects with radiotherapy are emerging. At the same time, critical questions remain unresolved, including optimal timing and sequencing, patient selection beyond anatomical criteria, and the identification of predictive biomarkers. Importantly, SABR maintains a favorable toxicity profile and preserves quality of life, supporting its use in patients with prolonged survival expectations. Overall, current evidence supports SABR as a valuable component of personalized treatment strategies for oligometastatic gynecological cancers, while highlighting the need for biologically driven selection and prospective validation. References: Macchia G, et al. Efficacy and safety of stereotactic body radiotherapy in oligometastatic cervical cancer (MITO-RT2/RAD). Int J Gynecol Cancer. 2022. Macchia G, et al. Efficacy and safety of stereotactic body radiotherapy in oligometastatic uterine cancer (MITO-RT2/RAD study): a large multicenter real-world study. Int J Radiat Oncol Biol Phys. 2023. Macchia G, et al. Stereotactic ablative radiation therapy for oligometastatic ovarian cancer: lymph node disease—results of the MITO-RT3/RAD phase II trial. Int J Radiat Oncol Biol Phys. 2025. Macchia G, et al. Stereotactic ablative radiation therapy for oligometastatic ovarian cancer: parenchymal lesions—results of the MITO-RT3/RAD phase II trial. Int J Radiat Oncol Biol Phys. 2025.
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