David Anderson, MD, and Elisa Port, MD, both of Mount Sinai Medical Center, discuss systemic therapy vs surgery for the treatment of de novo stage IV breast cancer, citing the findings from the E2108 study.

In the randomized phase III trial E2108, women presenting with metastatic breast cancer and an intact primary tumor received chemotherapy for 4-8 months. If no disease progression occurred, they were randomly assigned to surgery and radiation (locoregional therapy) or continued chemotherapy. The results show that there was no improvement in overall survival, and a lack of evidence for improved quality of life, from locoregional therapy (Khan SA, J Clin Onc. January 2022). E2108 was conducted to resolve conflicting results from recent clinical trials, and its findings led study authors to conclude that locoregional therapy should not be recommended for these patients.