SABR-COMET: stereotactic ablative radiotherapy for oligometastatic cancer
The randomised trial that made treating a handful of metastases with pinpoint radiotherapy respectable: survival was longer with SABR, and at five years more than twice as many patients were alive.
Overview
Ninety-nine patients with one to five metastases were randomised between palliative standard of care and standard of care plus stereotactic ablative radiotherapy to all sites. The 2019 Lancet report showed longer overall survival with SABR; the 2020 long-term update reported five-year overall survival of 42.3 percent with SABR against 17.7 percent with standard care. Grade 5 toxicity occurred in the SABR arm, and the phase 3 successors SABR-COMET-3 and SABR-COMET-10 are testing the approach in one to three and four to ten metastases.
- 42.3 vs 17.7 out of 100 alive at 5 years with SABR + standard care compared with Standard care; 24.6 more per 100.
- Roughly one extra person helped for every 4 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- These results apply to the people the trial enrolled: Controlled primary and one to five metastases, any solid tumour: standard palliative care alone versus standard care plus stereotactic ablative radiotherapy to every metastasis; ten centres, 99 randomised 1:2. People in a different situation may not see the same effect.
- Only 99 people took part, so the numbers are less certain than in a large trial.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
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