CClinicalTrials.gg
Active, not recruitingNCT03488693TAILOR RTUpdated Jul 1, 2026

Regional Radiotherapy in Biomarker Low-Risk Node Positive and T3N0 Breast Cancer

A Phase 3 interventional study of Radiation and No Radiation in Breast Cancer, sponsored by Canadian Cancer Trials Group. Active, not recruiting at 485 sites in 2 countries. Open to female participants aged 35 Years and older. Per ClinicalTrials.gov, last updated 2026-07-01.

Sponsored by Canadian Cancer Trials Group · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
2,138
Allocation
Randomized
Ages
35 Years and older
Sex
Female
01

Study summary

The purpose of this study is to compare the effects on low risk breast cancer receiving usual care that includes regional radiation therapy, with receiving no regional radiation therapy. Researchers want to see if not giving this type of radiation treatment works as well at preventing breast cancer from coming back.

Read the detailed description

Women with node positive breast cancer normally will receive endocrine therapy and some may receive chemotherapy to help prevent the cancer from coming back. Many women will also receive radiotherapy to the whole breast/chest area and the surrounding lymph glands (called regional radiotherapy). No one really knows whether patients with low risk breast cancer need to receive regional radiotherapy. Some women may be getting regional radiotherapy who do not need it. These women may be exposed to the side effects of their treatment without benefit.

02

Conditions studied

  • Breast Cancer

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03

Who can participate

Ages eligible
35 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Patients must be women with newly diagnosed histologically proven invasive carcinoma of the breast with no evidence of metastases, staged as per site standard of care.
  • Patients must have been treated by BCS or mastectomy with clear margins of excision. Post-mastectomy positive margins for invasive disease and/or DCIS is not allowed. Multifocal disease (i.e. the presence of two or more foci or breast cancer within the same breast quadrant) and multicentric disease (i.e. the presence of two or more foci of breast cancer in different quadrants of the same breast) are allowed.
  • Patients with T3N0 disease are eligible.
  • Patients with disease limited to nodal micrometastases are eligible
  • Patients with nodal macrometastases (>2mm) treated by axillary dissection must have 1-3 positive axillary nodes (macrometastases, > 2 mm).
  • Patients treated by mastectomy and SLNB alone must have only 1-2 positive axillary nodes (macrometastases, > 2 mm).
  • Patients must be ER ≥ 1% and HER2 negative on local testing
  • Patients must have an Oncotype DX recurrence score ≤25 obtained from testing of breast tumour tissue from a core biopsy or from the surgical specimen.
  • Patient must consent to provision of, and investigator(s) must agree to submit to the CCTG Central Tumour Bank, a representative formalin fixed paraffin block of tumour tissue in order that the specific correlative marker assays described in the protocol may be conducted
  • Patient must consent to provision of samples of blood in order that the specific correlative marker assays described in the protocol may be conducted.
  • Patients must have had endocrine therapy initiated or planned for ≥ 5 years. Premenopausal women will receive ovarian ablation plus aromatase inhibitor therapy or tamoxifen if adjuvant chemotherapy was not administered. For all patients, endocrine therapy can be given concurrently or following RT.
  • Patients may or may not have had adjuvant chemotherapy.
  • RT must commence within 16 weeks of definitive surgery if the patient is not treated with chemotherapy. If adjuvant chemotherapy is given, RT must begin within 12 weeks after the last dose. (Note: adjuvant chemotherapy may be ongoing at the time of randomization). Definitive surgery is defined as the last breast cancer-related surgery.
  • Patient's ECOG performance status must be 0, 1 or 2.
  • Patient's age must be ≥ 35 years.
  • For the first 736 eligible English or French-speaking subjects who have agreed to optional questionnaire completion: Patient is able (i.e. sufficiently fluent) and willing to complete the quality of life, health utilities and lost productivity questionnaires in either English or French (note: enrollment completed 2022Aug02)
  • Patient consent must be appropriately obtained in accordance with applicable local and regulatory requirements
  • Patients must be accessible for treatment and follow-up. Investigators must assure themselves the patients randomized on this trial will be available for complete documentation of the treatment, adverse events, and follow-up.
  • In accordance with CCTG policy, protocol treatment is to begin within 6 weeks of patient randomization.
  • Women of childbearing potential must have agreed to use an effective contraceptive method. A woman is considered to be of "childbearing potential" if she has had menses at any time in the preceding 12 consecutive months.

Exclusion criteria

Exclusion Criteria:

  • Patients with nodal disease limited to isolated tumour cells (pN0i+ \< 0.2 mm).
  • Patients with pT3N1 and pT4 disease (Note: patients with T3N0 are eligible).
  • Any prior history, not including the index cancer, of ipsilateral invasive breast cancer or ipsilateral DCIS treated with radiation therapy. (Patients with synchronous or previous ipsilateral LCIS are eligible.)
  • Synchronous or previous contralateral invasive breast cancer. (Patients with contralateral DCIS are eligible unless previously treated with radiation.)
  • History of non-breast malignancies except adequately treated non-melanoma skin cancers, in situ cancers treated by local excision or other cancers curatively treated with no evidence of disease for ≥ 5 years.
  • Patients who are pregnant.
  • Patients that have had prior ipsilateral chestwall/thoracic radiation.
  • Patients treated with chemo or endocrine therapy administered in the neoadjuvant setting for breast cancer. Endocrine therapy exposure 12 weeks or less prior to surgery is permitted.
  • Patients with serious non-malignant disease (e.g. cardiovascular, scleroderma etc.) which would preclude RT.
  • Patients with any serious active or co-morbid medical conditions, laboratory abnormality, psychiatric illness, active or uncontrolled infections, or serious illnesses or medical conditions that would prevent the patient from participating or to be managed according to the protocol (according to investigator's decision).
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
2,138 participants (actual)

Study arms

  • Active comparator
    No Regional Radiotherapy

    A. Whole Breast Irradiation (WBI) following BCS or; B. No Radiotherapy (RT) following mastectomy

    Radiation: Radiation · Other: No Radiation

  • Active comparator
    Regional Radiotherapy

    A. WBI plus RT to the regional nodes (supraclavicular, non-dissected axillary, and internal mammary) following BCS or; B. RT to the chestwall and regional nodes (supraclavicular, non-dissected axillary, and internal mammary) following mastectomy

    Radiation: Radiation

Interventions

  • RadiationRadiation

    Radiotherapy given

  • OtherNo Radiation

    No radiotherapy given

05

What researchers measure

Primary outcomes

  1. compare the breast cancer recurrence-free interval (BCRFI) between patients that received regional RT or not

    Defined as time from randomization to time of invasive recurrent disease in the ipsilateral chestwall, breast, regional nodes, distant sites or death due to BC.

    Time frame: 9.5 years

Secondary outcomes

  1. Compare the invasive disease-free survival between patients that received regional RT or not.

    Defined as time from randomization to time of invasive recurrent disease in the ipsilateral chestwall, breast, regional nodes, distant sites or death due to BC

    Time frame: 9.5 years

  2. Compare the breast cancer mortality between patients that received regional RT or not.

    Defined as death due to BC

    Time frame: 9.5 years

  3. Compare the overall survival (OS) between patients that received regional RT or not

    Defined as the time from randomization to the time of death from any cause

    Time frame: 9.5 years

  4. Compare the locoregional recurrence-free interval (LRRFI) between patients that received regional RT or not.

    Defined as time from randomization to time of invasive recurrent disease in the ipsilateral chestwall, breast or regional nodes, or death to due to BC

    Time frame: 9.5 years

  5. Compare the distant recurrence-free interval (DRFI) between patients that received regional RT or not.

    Defined as time from randomization to time of invasive recurrent disease in distant sites or death due to BC

    Time frame: 9.5 years

  6. Number and severity of adverse events using the current CTCAE version 4

    Time frame: 9.5 years

  7. Compare arm volume and mobility measurements between patients that received regional RT or not

    A Fisher's Exact Test will be used to compare lymphedema and arm abduction deficit between two arms. Defined as a difference in arm abduction of 10% or greater in the comparison of the ipsilateral to the contralateral arm.

    Time frame: 9.5 years

  8. Compare patient-reported outcomes (PROs) and the quality of life (QOL) between patients that received regional RT or not

    using the NSABP Questionnaire for patients treated by BCS or mastectomy.

    Time frame: 9.5 years

  9. Compare the quality of life (QOL) between patients that received regional RT or not

    Overall QOL (EORTC QLQ-C30) will be compared between the two treatment groups using a similar approach.

    Time frame: 9.5 years

  10. Compare the cost-effectiveness between patients that received regional RT or not

    Costs will be expressed in $US and $CAN base currencies based on the final year of the study. An average cost per study subject by treatment arm for an overall mean cost per study arm will be generated

    Time frame: 9.5 years

  11. Compare the quality of life (QOL) between patients that received regional RT or not

    breast symptoms (NSABP B32 Questionnaire) will be compared between the two treatment groups using a similar approach.

    Time frame: 9.5 years

  12. Compare the quality of life (QOL) between patients that received regional RT or not

    skin symptoms and fatigue (EORTC QLQ-BR23) will be compared between the two treatment groups using a similar approach.

    Time frame: 9.5 years

06

Study locations

485 sites
  • Fairbanks Memorial Hospital
    Fairbanks, Alaska 99701, United States
  • Banner MD Anderson Cancer Center
    Gilbert, Arizona 85234, United States
  • Banner-University Medical Center Phoenix
    Phoenix, Arizona 85006, United States
  • University of Arizona Cancer Center-Orange Grove Campus
    Tucson, Arizona 85704, United States
  • University of Arizona Cancer Center-North Campus
    Tucson, Arizona 85719, United States
  • University of Arkansas for Medical Sciences
    Little Rock, Arkansas 72205, United States
  • Kaiser Permanente-Anaheim
    Anaheim, California 92806, United States
  • Kaiser Permanente-Bellflower
    Bellflower, California 90706, United States
  • Alta Bates Summit Medical Center-Herrick Campus
    Berkeley, California 94704, United States
  • City of Hope Corona
    Corona, California 92882, United States
  • City of Hope Comprehensive Cancer Center
    Duarte, California 91010, United States
  • Kaiser Permanente Dublin
    Dublin, California 94568, United States
  • UC San Diego Health System - Encinitas
    Encinitas, California 92024, United States
  • Fresno Cancer Center
    Fresno, California 93720, United States
  • City of Hope at Irvine Lennar
    Irvine, California 92618, United States
  • UC San Diego Moores Cancer Center
    La Jolla, California 92093, United States
  • City of Hope Antelope Valley
    Lancaster, California 93534, United States
  • Kaiser Permanente Los Angeles Medical Center
    Los Angeles, California 90027, United States
  • Los Angeles General Medical Center
    Los Angeles, California 90033, United States
  • USC / Norris Comprehensive Cancer Center
    Los Angeles, California 90033, United States
  • Providence Queen of The Valley
    Napa, California 94558, United States
  • Kaiser Permanente Oakland-Broadway
    Oakland, California 94611, United States
  • Kaiser Permanente-Ontario
    Ontario, California 91761, United States
  • Saint Joseph Hospital - Orange
    Orange, California 92868, United States
  • UC Irvine Health/Chao Family Comprehensive Cancer Center
    Orange, California 92868, United States
  • Desert Regional Medical Center
    Palm Springs, California 92262, United States
  • Kaiser Permanente-Rancho Cordova Cancer Center
    Rancho Cordova, California 95670, United States
  • Rohnert Park Cancer Center
    Rohnert Park, California 94928, United States
  • The Permanente Medical Group-Roseville Radiation Oncology
    Roseville, California 95678, United States
  • Mercy Cancer Center - Sacramento
    Sacramento, California 95816, United States
  • Kaiser Permanente Medical Center - Santa Clara
    Santa Clara, California 95051, United States
  • Saint John's Cancer Institute
    Santa Monica, California 90404, United States
  • City of Hope South Pasadena
    South Pasadena, California 91030, United States
  • Kaiser Permanente Cancer Treatment Center
    South San Francisco, California 94080, United States
  • Saint Helena Hospital
    St. Helena, California 94574, United States
  • City of Hope South Bay
    Torrance, California 90503, United States
  • City of Hope Upland
    Upland, California 91786, United States
  • Sutter Solano Medical Center/Cancer Center
    Vallejo, California 94589, United States
  • BASS Medical Group - Lennon
    Walnut Creek, California 94598, United States
  • UCHealth University of Colorado Hospital
    Aurora, Colorado 80045, United States
  • Rocky Mountain Cancer Centers-Boulder
    Boulder, Colorado 80304, United States
  • Penrose-Saint Francis Healthcare
    Colorado Springs, Colorado 80907, United States
  • UCHealth Memorial Hospital Central
    Colorado Springs, Colorado 80909, United States
  • Memorial Hospital North
    Colorado Springs, Colorado 80920, United States
  • Saint Francis Cancer Center
    Colorado Springs, Colorado 80923, United States
  • UCHealth - Cherry Creek
    Denver, Colorado 80206, United States
  • AdventHealth Porter
    Denver, Colorado 80210, United States
  • Poudre Valley Hospital
    Fort Collins, Colorado 80524, United States
  • Lutheran Hospital - Cancer Centers of Colorado
    Golden, Colorado 80401, United States
  • Banner North Colorado Medical Center
    Greeley, Colorado 80631, United States
  • UCHealth Greeley Hospital
    Greeley, Colorado 80631, United States
  • UCHealth Highlands Ranch Hospital
    Highlands Ranch, Colorado 80129, United States
  • AdventHealth Littleton
    Littleton, Colorado 80122, United States
  • Banner North Colorado Medical Center - Loveland Campus
    Loveland, Colorado 80539, United States
  • Saint Anthony North Hospital
    Westminster, Colorado 80023, United States
  • Intermountain Health Lutheran Hospital
    Wheat Ridge, Colorado 80401, United States
  • Danbury Hospital
    Danbury, Connecticut 06810, United States
  • Smilow Cancer Hospital Care Center - Guilford
    Guilford, Connecticut 06437, United States
  • Smilow Cancer Hospital-Hamden Care Center
    Hamden, Connecticut 06518, United States
  • Yale University
    New Haven, Connecticut 06520, United States
  • Norwalk Hospital
    Norwalk, Connecticut 06856, United States
  • Smilow Cancer Hospital Care Center-Trumbull
    Trumbull, Connecticut 06611, United States
  • Smilow Cancer Hospital Care Center - Waterford
    Waterford, Connecticut 06385, United States
  • Helen F Graham Cancer Center
    Newark, Delaware 19713, United States
  • Christiana Care Health System-Christiana Hospital
    Newark, Delaware 19718, United States
  • MedStar Georgetown University Hospital
    Washington D.C., District of Columbia 20007, United States
  • MedStar Washington Hospital Center
    Washington D.C., District of Columbia 20010, United States
  • Sibley Memorial Hospital
    Washington D.C., District of Columbia 20016, United States
  • Boca Raton Regional Hospital
    Boca Raton, Florida 33486, United States
  • Morton Plant Hospital
    Clearwater, Florida 33756, United States
  • UM Sylvester Comprehensive Cancer Center at Coral Gables
    Coral Gables, Florida 33146, United States
  • UM Sylvester Comprehensive Cancer Center at Deerfield Beach
    Deerfield Beach, Florida 33442, United States
  • Broward Health Medical Center
    Fort Lauderdale, Florida 33316, United States
  • UF Health Cancer Institute - Gainesville
    Gainesville, Florida 32610, United States
  • Memorial Regional Hospital/Joe DiMaggio Children's Hospital
    Hollywood, Florida 33021, United States
  • Mayo Clinic in Florida
    Jacksonville, Florida 32224-9980, United States
  • University of Miami Miller School of Medicine-Sylvester Cancer Center
    Miami, Florida 33136, United States
  • Miami Cancer Institute
    Miami, Florida 33176, United States
  • Orlando Health Cancer Institute
    Orlando, Florida 32806, United States
  • Memorial Hospital West
    Pembroke Pines, Florida 33028, United States
  • Miami Cancer Institute at Plantation
    Plantation, Florida 33324, United States
  • UM Sylvester Comprehensive Cancer Center at Plantation
    Plantation, Florida 33324, United States
  • Saint Anthony's Hospital Cancer Care Center
    St. Petersburg, Florida 33705, United States
  • Saint Joseph's Hospital/Children's Hospital-Tampa
    Tampa, Florida 33607, United States
  • Moffitt Cancer Center
    Tampa, Florida 33612, United States
  • Cleveland Clinic-Weston
    Weston, Florida 33331, United States
  • Grady Health System
    Atlanta, Georgia 30303, United States
  • Emory University Hospital Midtown
    Atlanta, Georgia 30308, United States
  • Emory University Hospital/Winship Cancer Institute
    Atlanta, Georgia 30322, United States
  • Emory Saint Joseph's Hospital
    Atlanta, Georgia 30342, United States
  • Emory Decatur Hospital
    Decatur, Georgia 30033, United States
  • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
    Savannah, Georgia 31405, United States
  • Saint Alphonsus Cancer Care Center-Boise
    Boise, Idaho 83706, United States
  • Kootenai Health - Coeur d'Alene
    Coeur d'Alene, Idaho 83814, United States
  • Kootenai Clinic Cancer Services - Post Falls
    Post Falls, Idaho 83854, United States
  • Northwestern University
    Chicago, Illinois 60611, United States
  • Rush MD Anderson Cancer Center
    Chicago, Illinois 60612, United States
  • University of Illinois
    Chicago, Illinois 60612, United States
  • Swedish Covenant Hospital
    Chicago, Illinois 60625, United States
  • University of Chicago Comprehensive Cancer Center
    Chicago, Illinois 60637, United States

Showing the first 100 of 485 sites across 2 countries.

07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03488693
Lead sponsor
Canadian Cancer Trials Group
Collaborators
Alliance for Clinical Trials in Oncology, Eastern Cooperative Oncology Group, NRG Oncology, SWOG Cancer Research Network
Responsible party
Sponsor
First posted
Apr 5, 2018
Start date
Oct 16, 2018
Primary completion
Sep 1, 2027 (estimated)
Completion
Dec 30, 2027 (estimated)
Last update
Jul 1, 2026

Study contacts

Timothy Whelan
study chair · Juravinski Cancer Centre at Hamilton Health Sciences, Ontario Canada

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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This study is active, not recruiting, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.

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