ACTIVE monitoring may be a safe and effective treatment option for patients with low-risk ductal carcinoma in situ (DCIS), according to the findings of the COMET trial presented at the San Antonio Breast Cancer Symposium (SABCS) 2024. This landmark study, which included 995 patients with hormone receptor (HR)-positive, HER2-negative, low-risk DCIS, revealed that patients who underwent active monitoring had similar 2-year invasive ipsilateral breast cancer recurrence rates compared to those who received surgery with or without adjuvant radiation.
The results showed a 5.9% recurrence rate in the guideline-concordant care group and a 4.2% rate in the active monitoring group. This difference met the threshold for noninferiority, suggesting that active monitoring is not inferior to conventional treatment. When only patients who adhered to their assigned treatment were analyzed, the 2-year recurrence rate was 3.1% for the active monitoring group versus 8.7% for the surgery group.
Active monitoring, a strategy where patients are closely monitored and only undergo surgery if the tumor shows signs of progression, could reduce overtreatment in low-risk DCIS cases. “Our findings provide reassuring evidence that active monitoring can be an option for some patients,” said study presenter Dr. E. Shelley Hwang, emphasizing the importance of careful patient selection in determining the best approach.
These findings may influence future DCIS treatment guidelines, providing patients and healthcare providers with more options to reduce unnecessary interventions. Further long-term follow-up will be crucial to fully assess the impact of active monitoring on DCIS outcomes.
Reference: San Antonio Breast Cancer Symposium. (2024, December 12). COMET Trial Finds Active Monitoring Is a Viable Option for Some Patients With Low-risk DCIS. Presented at SABCS 2024.
Anaya Malik | AMJ
