New QOL Outcomes Data Available on DCIS Active Monitoring Versus Surgery

At the 2024 San Antonio Breast Cancer Symposium, results of the COMET trial for patients with low-risk ductal carcinoma in situ (DCIS) were presented. The study compared physical, emotional, and psychological outcomes in patients who received upfront treatment with those of patients who had active monitoring. The results were simultaneously published in JAMA Oncology.

The study was a prespecified secondary analysis of data from 957 participants in the randomized COMET clinical trial. Intervention included random assignment to surgery or active monitoring. Overall health-related quality of life, anxiety, depression, worries, and symptom trajectories were comparable between the active-monitoring group and the surgery (guideline-concordant care) group during two years of follow-up.

Quality of life, anxiety, depression, worries about DCIS, and symptom trajectories were comparable between groups, with modest fluctuations of limited clinical significance over time. Physical functioning was the only specific Medical Outcomes Study 36-item short-form health survey domain for which changes in the score trajectory differed by group over time, with mean scores ranging from 50 (baseline) to 48 (6, 12, and 24 months) in the surgery group and 50 (baseline) to 47 (12 months) and 48 (6 and 24 months) in the active-monitoring group (pooled SD, 9.9; P=.01), although these were also of limited clinical significance.

“In this prespecified secondary analysis of the COMET prospective randomized trial, the overall lived experience of women randomized to undergo AM [active management] for low-risk DCIS was similar to that of women randomized to GCC [guideline-concordant care] during the 2 years following diagnosis,” the researchers concluded.

Source

JAMA Oncology