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RecruitingNCT03646955Updated Oct 6, 2020

Partial Breast Versus no Irradiation for Women With Early Breast Cancer

An interventional study of No partial breast irradiation in Local Neoplasm Recurrence, Distantly Metastatic Malignant Neoplasm and Death, sponsored by Danish Breast Cancer Cooperative Group. Recruiting at 17 sites in 4 countries. Open to female participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2020-10-06.

Sponsored by Danish Breast Cancer Cooperative Group · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
926
Allocation
Randomized
Ages
60 Years and older
Sex
Female
01

Study summary

All early breast cancer patients are offered adjuvant breast radiation therapy (RT) after breast conserving surgery for an early breast cancer. Breast cancer is heterogeneous, and selected patients have a very low gain from RT, whilst they still have risk of acute and late side effects from RT. This trial will try identify selection criteria for low risk breast cancer patients who can safely omit adjuvant RT without unacceptable high risk of local failure.

Read the detailed description

International standard of therapy is to provide adjuvant breast radiation therapy (RT) after breast conserving surgery for an early breast cancer to lower the risk of local and distant failures. However, breast cancer is a heterogeneous disease, and the gain from RT in selected low risk patients is low. RT may cause acute and late side effects, and some of these may be serious to the patient. Therefore, there is a need to tailor RT utilization to the individual recurrence risk and try identify patients who are unlikely to gain much risk reduction from RT, because those patients can then omit RT and thereby avoid late effects and over-treatment. At the present time there is no consensus as to define the selection criteria for patients who may omit RT.

Based on early results from the randomized DBCG RT PBI trial, external beam 40 Gy/15 fr partial breast irradiation (PBI) has been standard in Denmark since April 2016 for selected low risk breast cancer patients. Based on results from the UK IMPORT LOW trial, the 5 yr local recurrence risk using this technique for PBI is 0.5%, whilst 2% for developing a new contralateral breast cancer.

This trial will investigate if PBI can safely be omitted in selected low risk breast cancer patients without causing unacceptable high risk of local failure.

02

Conditions studied

  • Local Neoplasm Recurrence
  • Distantly Metastatic Malignant Neoplasm
  • Death
  • Fibrosis Breast
  • Depigmentation/Hyperpigmentation of Skin
  • Telangiectasia
  • Scar
  • Pain
  • PROMs
03

Who can participate

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

Inclusion criteria

Female patient >=60 years

Primary tumour characteristics by conventional histopathology

  • unilateral and unifocal non-lobular histology grade 1-2
  • maximum microscopic size \<=20mm
  • node negative determined by sentinel node or axillary lymph node dissection
  • estrogen receptor >=10% positive
  • HER2 negative (by IHC and/or in situ hybridization)
  • resection margin >=2 mm for invasive carcinoma and any ductal carcinoma in situ associated with the cancer

Surgical type is breast conservation

Performance status ECOG 0-2

No evidence of distant metastasis

Exclusion criteria

Exclusion Criteria:

  • multifocal or multicentric invasive carcinoma or ductal carcinoma in situ
  • evidence of clinical or pathological T4 breast cancer
  • grade 3 malignancy
  • previous breast cancer or DCIS irrespective of disease-free interval
  • previous radiation therapy to the breast or thorax,
  • previous neoplasm within 5 years except carcinoma in situ of the cervix, endometrium or coli, melanoma in situ.
  • comorbidity precluding the patient from radiation therapy (e.g. cardiovascular or pulmonary disease, scleroderma, systemic lupus erythematosus).
  • mental/psychiatric disorder which precludes the patient from understanding the randomization and the follow up.
  • documented hereditary breast cancer or with high genetic risk of breast cancer
  • life expectancy \<10 years
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
926 participants (estimated)

Study arms

  • Active comparator
    Partial breast irradiation

    External beam irradiation 40 Gy / 15 fractions, 5 fractions per week, 3 weeks

    Radiation: No partial breast irradiation

  • No intervention
    No partial breast irradiation

    No radiation therapy

Interventions

  • RadiationNo partial breast irradiation

    Omission of radiation therapy

05

What researchers measure

Primary outcomes

  1. Invasive local recurrence

    Invasive local recurrence

    Time frame: 10 years

Secondary outcomes

  1. Regional nodes recurrence

    Invasive recurrence in regional nodes of the treated breast

    Time frame: 10 years

  2. Distant failure

    Invasive recurrence from the breast cancer outside the loco-regional area

    Time frame: 10 years

  3. Death

    Death and cause of death

    Time frame: 10 years

06

Study locations

17 of 17 sites recruiting
  • Ponticia Universidad Catolica de Chile
    Santiago de Chile, Chile
    • Tomas Merino Lara · Contact
    Recruiting
  • Aalborg University Hospital
    Aalborg, Denmark
    • Tamas Lörinz, MD · Contact
    Recruiting
  • Aarhus University Hospital
    Aarhus, Denmark
    • Hanne M Nielsen, PhD · Contact
    Recruiting
  • Rigshospitalet
    Copenhagen, Denmark
    • Claus Kamby, DMSc · Contact
    Recruiting
  • Herlev Hospital
    Herlev, Denmark
    • Louise W Matthiessen · Contact
    Recruiting
  • Naestved Hospital
    Naestved, Denmark
    • Sami Al-Rawi, MD · Contact
    Recruiting
  • Odense University Hospital
    Odense, Denmark
    • Mette H Nielsen, PhD · Contact
    Recruiting
  • Vejle Hospital
    Vejle, Denmark
    • Troels Bechmann, PhD · Contact
    Recruiting
  • Haukeland HUS
    Bergen, Norway
    • Hans Petter Eikesdal · Contact
    Recruiting
  • Nordlandssykehuset
    Bodø, Norway
    • Bård Mannsåker · Contact
    Recruiting
  • Kristiansand Hospital
    Kristiansand, Norway
    • Unn-Miriam Kasti · Contact
    Recruiting
  • Oslo University Hospital, Radiumhospitalet
    Oslo, Norway
    • Kristin Reinertsen · Contact
    Recruiting
  • Stavanger Hospital
    Stavanger, Norway
    • Ingvil Mjaaland · Contact
    Recruiting
  • Tromsø University Hospital
    Tromsø, Norway
    • Egil Blix Støre · Contact
    Recruiting
  • Sahlgrenska University hospital
    Göteborg, Sweden
    • Dan Lundstedt · Contact
    Recruiting
  • Skånes University Hospital
    Lund, Sweden
    • Sara Alkner · Contact
    Recruiting
  • Uppsala Akademiska Sjukhuset
    Uppsala, Sweden
    • Henrik Lindman · Contact
    Recruiting
07

References and documents

Individual participant data

Plan to share: Yes — When the results from the trial are published, the DBCG RT Committee can decide that the results may be part of a meta-analysis.

Supporting information: Study protocol

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03646955
Lead sponsor
Danish Breast Cancer Cooperative Group
Collaborators
Danish Cancer Society, Danish Center for Interventional Research in Radiation Oncology (CIRRO)
Responsible party
Birgitte Offersen (Professor, PhD, MD, Danish Breast Cancer Cooperative Group) — Principal investigator
First posted
Aug 24, 2018
Start date
Sep 5, 2018
Primary completion
Sep 1, 2033 (estimated)
Completion
Sep 1, 2035 (estimated)
Last update
Oct 6, 2020

Study contacts

Birgitte V Offersen, PhD
Contact
bvo@oncology.au.dk
+45 28838012
Birgitte V Offersen, PhD
principal investigator · Danish Breast Cancer Group

Oversight

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

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