COMET trial shows active monitoring is noninferior to standard treatment for low-risk DCIS

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COMET trial shows active monitoring is noninferior to standard treatment for low-risk DCIS
CancerCarcinomaClinical Trial
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Among patients with hormone receptor (HR)-positive, HER2-negative, low-risk ductal carcinoma in situ (DCIS), those who underwent active monitoring had similar two-year invasive ipsilateral breast cancer recurrence rates as those who underwent guideline-concordant treatment, according to results from the COMET clinical trial presented at the San...

American Association for Cancer Research Dec 12 2024 Among patients with hormone receptor -positive, HER2-negative, low-risk ductal carcinoma in situ , those who underwent active monitoring had similar two-year invasive ipsilateral breast cancer recurrence rates as those who underwent guideline-concordant treatment, according to results from the COMET clinical trial presented at the San Antonio Breast Cancer Symposium , held December 10-13, 2024.

All current treatments for DCIS aim to reduce the risk of future invasive cancer, despite a growing body of evidence that not all DCIS is destined to progress. Thus, current practice may result in the overtreatment of women whose tumors are at low risk of progression, leading to chronic pain, altered body image, reduced quality of life, and other side effects that may be avoidable."

The COMET team sought to assess whether active monitoring is as effective as upfront treatment among patients whose DCIS has a low risk of progressing to invasive cancer. They conducted a multicenter, randomized clinical trial that enrolled 995 patients with grade 1 or 2, HR-positive, HER2-negative DCIS with no evidence of invasive cancer.

Related StoriesBecause 29% of patients overall did not adhere to their randomized treatment arm, the researchers performed a separate analysis of 673 patients who received their assigned treatment. The two-year rate of invasive ipsilateral breast cancer was 8.7% in the guideline-concordant care arm and 3.1% in the active monitoring arm.

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