About this trial
This is a national multicenter, prospective, randomized controlled trial. The study aims to compare the 5-year overall survival (OS) between patients receiving primary tumor surgery followed by systemic therapy (surgery group) and those receiving systemic therapy alone (non-surgery group) in patients with de novo Stage IV breast cancer who have solitary bone metastases. Secondary objectives include comparing progression-free survival (PFS), breast cancer-specific survival (BCSS), local control rates, patient-reported outcomes (BREAST-Q, QLQ-C30), safety (surgical complications and systemic therapy toxicities), and cost-effectiveness.
Eligibility criteria
Qualifiers
Female patients aged 18 to 70 years (inclusive);
Histopathologically confirmed (by core needle biopsy) invasive breast cancer;
Diagnosed with de novo Stage IV breast cancer with metastases confirmed to be limited to bone;
Patients may be enrolled either at initial diagnosis or after receiving first-line systemic therapy;
Disqualifiers
Disease progression (per RECIST 1.1 criteria) in the primary tumor, regional lymph nodes, or bone metastases after first-line systemic therapy;
Presence of other primary malignancies;
Severe comorbidities that would preclude surgery or safe administration of systemic therapy (e.g., severe cardiopulmonary disease, uncontrolled diabetes, long-term smoking history with poor pulmonary function, immunodeficiency);
Current participation in another clinical trial that would interfere with the outcomes of this study;
Trial design
Treatments tested in this trial
- Primary Tumor Resection
- Standard systemic therapy
Treatment groups
Locations
Sponsors and collaborators
West China Hospital
Lead sponsor
The Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine
Collaborator
The First Affiliated Hospital of Zhengzhou University
Collaborator
The Nineth Hospital of Shenzhen, Longgang Center Hospital
Collaborator
Baotou Cancer Hospital
Collaborator
Hebei General Hospital
Collaborator
General Hospital of Ningxia Medical University
Collaborator
The First Hospital of Jilin University
Collaborator
Tangshan People's Hospital
Collaborator
Guangdong Women and Children Hospital
Collaborator
Nanchang People's Hospital
Collaborator
Cancer Hospital of Guangxi Medical University
Collaborator
Xinjiang Medical University Cancer Hospital
Collaborator
Anyang Tumor Hospital
Collaborator
The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine
Collaborator
Shanxi Bethune Hospital
Collaborator
Hebei Medical University Fourth Hospital
Collaborator
The Affiliated Hospital of Qingdao University
Collaborator
Suzhou Municipal Hospital
Collaborator
Zhejiang Provincial People's Hospital
Collaborator
Hunan Cancer Hospital
Collaborator
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Collaborator
Shanxi Province Cancer Hospital
Collaborator
The First Hospital of Lanzhou University, Gansu, China
Collaborator
Lanzhou University Second Hospital
Collaborator