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New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer

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Vaidya, JS, Bulsara, M, Baum, M, Wenz, F, Massarut, S, Pigorsch, S, Alvarado, M, Douek, M, Saunders, C, Flyger, H, Eiermann, W, Brew-Graves, C, Williams, NR, Potyka, I, Roberts, N, Bernstein, M, Brown, D, Sperk, E, Laws, S, Sütterlin, M, Corica, T, Lundgren, S, Holmes, D, Vinante, L, Bozza, F, Pazos, M, Blanc-Onfroy, ML, Gruber, G, Polkowski, W, Dedes, KJ, Niewald, M, Blohmer, J, McReady, D, Hoefer, R, Kelemen, P, Petralia, G, Falzon, M, Joseph, D & Tobias, JS 2021, 'New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer', British Journal of Cancer, bind 125, nr. 3, s. 380-389. https://doi.org/10.1038/s41416-021-01440-8

APA

Vaidya, J. S., Bulsara, M., Baum, M., Wenz, F., Massarut, S., Pigorsch, S., Alvarado, M., Douek, M., Saunders, C., Flyger, H., Eiermann, W., Brew-Graves, C., Williams, N. R., Potyka, I., Roberts, N., Bernstein, M., Brown, D., Sperk, E., Laws, S., ... Tobias, J. S. (2021). New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer. British Journal of Cancer, 125(3), 380-389. https://doi.org/10.1038/s41416-021-01440-8

CBE

Vaidya JS, Bulsara M, Baum M, Wenz F, Massarut S, Pigorsch S, Alvarado M, Douek M, Saunders C, Flyger H, Eiermann W, Brew-Graves C, Williams NR, Potyka I, Roberts N, Bernstein M, Brown D, Sperk E, Laws S, Sütterlin M, Corica T, Lundgren S, Holmes D, Vinante L, Bozza F, Pazos M, Blanc-Onfroy ML, Gruber G, Polkowski W, Dedes KJ, Niewald M, Blohmer J, McReady D, Hoefer R, Kelemen P, Petralia G, Falzon M, Joseph D, Tobias JS. 2021. New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer. British Journal of Cancer. 125(3):380-389. https://doi.org/10.1038/s41416-021-01440-8

MLA

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Author

Vaidya, Jayant S. ; Bulsara, Max ; Baum, Michael ; Wenz, Frederik ; Massarut, Samuele ; Pigorsch, Steffi ; Alvarado, Michael ; Douek, Michael ; Saunders, Christobel ; Flyger, Henrik ; Eiermann, Wolfgang ; Brew-Graves, Chris ; Williams, Norman R. ; Potyka, Ingrid ; Roberts, Nicholas ; Bernstein, Marcelle ; Brown, Douglas ; Sperk, Elena ; Laws, Siobhan ; Sütterlin, Marc ; Corica, Tammy ; Lundgren, Steinar ; Holmes, Dennis ; Vinante, Lorenzo ; Bozza, Fernando ; Pazos, Montserrat ; Blanc-Onfroy, Magali Le ; Gruber, Günther ; Polkowski, Wojciech ; Dedes, Konstantin J. ; Niewald, Marcus ; Blohmer, Jens ; McReady, David ; Hoefer, Richard ; Kelemen, Pond ; Petralia, Gloria ; Falzon, Mary ; Joseph, David ; Tobias, Jeffrey S. / New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer. I: British Journal of Cancer. 2021 ; Bind 125, Nr. 3. s. 380-389.

Bibtex

@article{8cf9806261524a61a67a6ff8a89e93b2,
title = "New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer",
abstract = "Background: The TARGIT-A trial reported risk-adapted targeted intraoperative radiotherapy (TARGIT-IORT) during lumpectomy for breast cancer to be as effective as whole-breast external beam radiotherapy (EBRT). Here, we present further detailed analyses. Methods: In total, 2298 women (≥45 years, invasive ductal carcinoma ≤3.5 cm, cN0–N1) were randomised. We investigated the impact of tumour size, grade, ER, PgR, HER2 and lymph node status on local recurrence-free survival, and of local recurrence on distant relapse and mortality. We analysed the predictive factors for recommending supplemental EBRT after TARGIT-IORT as part of the risk-adapted approach, using regression modelling. Non-breast cancer mortality was compared between TARGIT-IORT plus EBRT vs. EBRT. Results: Local recurrence-free survival was no different between TARGIT-IORT and EBRT, in every tumour subgroup. Unlike in the EBRT arm, local recurrence in the TARGIT-IORT arm was not a predictor of a higher risk of distant relapse or death. Our new predictive tool for recommending supplemental EBRT after TARGIT-IORT is at https://targit.org.uk/addrt. Non-breast cancer mortality was significantly lower in the TARGIT-IORT arm, even when patients received supplemental EBRT, HR 0.38 (95% CI 0.17–0.88) P = 0.0091. Conclusion: TARGIT-IORT is as effective as EBRT in all subgroups. Local recurrence after TARGIT-IORT, unlike after EBRT, has a good prognosis. TARGIT-IORT might have a beneficial abscopal effect. Trial registration: ISRCTN34086741 (21/7/2004), NCT00983684 (24/9/2009).",
author = "Vaidya, {Jayant S.} and Max Bulsara and Michael Baum and Frederik Wenz and Samuele Massarut and Steffi Pigorsch and Michael Alvarado and Michael Douek and Christobel Saunders and Henrik Flyger and Wolfgang Eiermann and Chris Brew-Graves and Williams, {Norman R.} and Ingrid Potyka and Nicholas Roberts and Marcelle Bernstein and Douglas Brown and Elena Sperk and Siobhan Laws and Marc S{\"u}tterlin and Tammy Corica and Steinar Lundgren and Dennis Holmes and Lorenzo Vinante and Fernando Bozza and Montserrat Pazos and Blanc-Onfroy, {Magali Le} and G{\"u}nther Gruber and Wojciech Polkowski and Dedes, {Konstantin J.} and Marcus Niewald and Jens Blohmer and David McReady and Richard Hoefer and Pond Kelemen and Gloria Petralia and Mary Falzon and David Joseph and Tobias, {Jeffrey S.}",
note = "Funding Information: Competing interests J.S.V. has received a research grant from Photoelectron Corp (1996–99) and from Carl Zeiss for supporting data management at the University of Dundee (Dundee, UK, 2004-2008) and has received honoraria. J.S.V., J.S.T., N.W., I.P., C. B.-G. and N.R. receive funding from HTA, NIHR, Department of Health for some activities related to the TARGIT trials. M.Ba. was briefly on the scientific advisory board of Carl Zeiss and was paid consultancy fees before 2010. F.W. has received a research grant from Carl Zeiss for supporting radiobiological research. Carl Zeiss sponsors some of the travel and accommodation for meetings of the international steering committee and data monitoring committee and when necessary for conferences where a presentation about targeted intraoperative radiotherapy is being made for all authors apart from WE who declares that he has no conflicts of interest. The remaining authors declare no competing interests. Funding Information: Funding information The study was sponsored by University College London Hospitals (UCLH)/UCL Comprehensive Biomedical Research Centre. Funding was provided by UCLH Charities, National Institute for Health Research (NIHR) Health Technology Assessment programme, Ninewells Cancer Campaign, National Health and Medical Research Council, and German Federal Ministry of Education and Research (BMBF) FKZ 01ZP0508. The infrastructure of the trial operations office in London, UK, was supported by core funding from Cancer Research Campaign (now Cancer Research UK) when the trial was initiated. The funding organisations had no role in the concept, design, analysis or writing of the manuscript. Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = aug,
day = "3",
doi = "10.1038/s41416-021-01440-8",
language = "English",
volume = "125",
pages = "380--389",
journal = "British Journal of Cancer",
issn = "0007-0920",
publisher = "Nature Publishing Group",
number = "3",

}

RIS

TY - JOUR

T1 - New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer

AU - Vaidya, Jayant S.

AU - Bulsara, Max

AU - Baum, Michael

AU - Wenz, Frederik

AU - Massarut, Samuele

AU - Pigorsch, Steffi

AU - Alvarado, Michael

AU - Douek, Michael

AU - Saunders, Christobel

AU - Flyger, Henrik

AU - Eiermann, Wolfgang

AU - Brew-Graves, Chris

AU - Williams, Norman R.

AU - Potyka, Ingrid

AU - Roberts, Nicholas

AU - Bernstein, Marcelle

AU - Brown, Douglas

AU - Sperk, Elena

AU - Laws, Siobhan

AU - Sütterlin, Marc

AU - Corica, Tammy

AU - Lundgren, Steinar

AU - Holmes, Dennis

AU - Vinante, Lorenzo

AU - Bozza, Fernando

AU - Pazos, Montserrat

AU - Blanc-Onfroy, Magali Le

AU - Gruber, Günther

AU - Polkowski, Wojciech

AU - Dedes, Konstantin J.

AU - Niewald, Marcus

AU - Blohmer, Jens

AU - McReady, David

AU - Hoefer, Richard

AU - Kelemen, Pond

AU - Petralia, Gloria

AU - Falzon, Mary

AU - Joseph, David

AU - Tobias, Jeffrey S.

N1 - Funding Information: Competing interests J.S.V. has received a research grant from Photoelectron Corp (1996–99) and from Carl Zeiss for supporting data management at the University of Dundee (Dundee, UK, 2004-2008) and has received honoraria. J.S.V., J.S.T., N.W., I.P., C. B.-G. and N.R. receive funding from HTA, NIHR, Department of Health for some activities related to the TARGIT trials. M.Ba. was briefly on the scientific advisory board of Carl Zeiss and was paid consultancy fees before 2010. F.W. has received a research grant from Carl Zeiss for supporting radiobiological research. Carl Zeiss sponsors some of the travel and accommodation for meetings of the international steering committee and data monitoring committee and when necessary for conferences where a presentation about targeted intraoperative radiotherapy is being made for all authors apart from WE who declares that he has no conflicts of interest. The remaining authors declare no competing interests. Funding Information: Funding information The study was sponsored by University College London Hospitals (UCLH)/UCL Comprehensive Biomedical Research Centre. Funding was provided by UCLH Charities, National Institute for Health Research (NIHR) Health Technology Assessment programme, Ninewells Cancer Campaign, National Health and Medical Research Council, and German Federal Ministry of Education and Research (BMBF) FKZ 01ZP0508. The infrastructure of the trial operations office in London, UK, was supported by core funding from Cancer Research Campaign (now Cancer Research UK) when the trial was initiated. The funding organisations had no role in the concept, design, analysis or writing of the manuscript. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/8/3

Y1 - 2021/8/3

N2 - Background: The TARGIT-A trial reported risk-adapted targeted intraoperative radiotherapy (TARGIT-IORT) during lumpectomy for breast cancer to be as effective as whole-breast external beam radiotherapy (EBRT). Here, we present further detailed analyses. Methods: In total, 2298 women (≥45 years, invasive ductal carcinoma ≤3.5 cm, cN0–N1) were randomised. We investigated the impact of tumour size, grade, ER, PgR, HER2 and lymph node status on local recurrence-free survival, and of local recurrence on distant relapse and mortality. We analysed the predictive factors for recommending supplemental EBRT after TARGIT-IORT as part of the risk-adapted approach, using regression modelling. Non-breast cancer mortality was compared between TARGIT-IORT plus EBRT vs. EBRT. Results: Local recurrence-free survival was no different between TARGIT-IORT and EBRT, in every tumour subgroup. Unlike in the EBRT arm, local recurrence in the TARGIT-IORT arm was not a predictor of a higher risk of distant relapse or death. Our new predictive tool for recommending supplemental EBRT after TARGIT-IORT is at https://targit.org.uk/addrt. Non-breast cancer mortality was significantly lower in the TARGIT-IORT arm, even when patients received supplemental EBRT, HR 0.38 (95% CI 0.17–0.88) P = 0.0091. Conclusion: TARGIT-IORT is as effective as EBRT in all subgroups. Local recurrence after TARGIT-IORT, unlike after EBRT, has a good prognosis. TARGIT-IORT might have a beneficial abscopal effect. Trial registration: ISRCTN34086741 (21/7/2004), NCT00983684 (24/9/2009).

AB - Background: The TARGIT-A trial reported risk-adapted targeted intraoperative radiotherapy (TARGIT-IORT) during lumpectomy for breast cancer to be as effective as whole-breast external beam radiotherapy (EBRT). Here, we present further detailed analyses. Methods: In total, 2298 women (≥45 years, invasive ductal carcinoma ≤3.5 cm, cN0–N1) were randomised. We investigated the impact of tumour size, grade, ER, PgR, HER2 and lymph node status on local recurrence-free survival, and of local recurrence on distant relapse and mortality. We analysed the predictive factors for recommending supplemental EBRT after TARGIT-IORT as part of the risk-adapted approach, using regression modelling. Non-breast cancer mortality was compared between TARGIT-IORT plus EBRT vs. EBRT. Results: Local recurrence-free survival was no different between TARGIT-IORT and EBRT, in every tumour subgroup. Unlike in the EBRT arm, local recurrence in the TARGIT-IORT arm was not a predictor of a higher risk of distant relapse or death. Our new predictive tool for recommending supplemental EBRT after TARGIT-IORT is at https://targit.org.uk/addrt. Non-breast cancer mortality was significantly lower in the TARGIT-IORT arm, even when patients received supplemental EBRT, HR 0.38 (95% CI 0.17–0.88) P = 0.0091. Conclusion: TARGIT-IORT is as effective as EBRT in all subgroups. Local recurrence after TARGIT-IORT, unlike after EBRT, has a good prognosis. TARGIT-IORT might have a beneficial abscopal effect. Trial registration: ISRCTN34086741 (21/7/2004), NCT00983684 (24/9/2009).

UR - http://www.scopus.com/inward/record.url?scp=85106457037&partnerID=8YFLogxK

U2 - 10.1038/s41416-021-01440-8

DO - 10.1038/s41416-021-01440-8

M3 - Journal article

C2 - 34035435

AN - SCOPUS:85106457037

VL - 125

SP - 380

EP - 389

JO - British Journal of Cancer

JF - British Journal of Cancer

SN - 0007-0920

IS - 3

ER -

ID: 66209005