Radiation Therapy to the Head in Preventing Brain Metastases in Women Receiving Trastuzumab and Chemotherapy for Metastatic or Locally Advanced Breast Cancer

NCT ID: NCT00639366

Last Updated: 2013-08-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

390 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-02-28

Study Completion Date

2010-10-31

Brief Summary

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RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. It is not yet known whether radiation therapy directed at the head is effective in preventing brain metastases in patients with advanced cancer.

PURPOSE: This randomized phase III trial is studying radiation therapy to the head to see how well it works in preventing brain metastases in women receiving trastuzumab and chemotherapy for metastatic or locally advanced breast cancer.

Detailed Description

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OBJECTIVES:

* To test if prophylactic cranial radiotherapy delivering 30 Gy in 10 fractions will significantly reduce (from 35% to 21% at 2 years) the incidence of symptomatic brain metastases in patients treated with trastuzumab (Herceptin®) for metastatic breast cancer.

OUTLINE: This is a multicenter study. Patients are stratified by center, type of systemic therapy (trastuzumab \[Herceptin®\] monotherapy vs combination with chemotherapy), hormone receptor status, and presence of lung metastases (yes vs no). Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive taxane/trastuzumab therapy for 6 weeks. While continuing taxane/trastuzumab therapy, patients then undergo 10 fractions of concurrent prophylactic cranial radiotherapy in the absence of disease progression or unacceptable toxicity.
* Arm II: Patients receive taxane/trastuzumab therapy without concurrent prophylactic cranial radiotherapy.

All patients undergo quality of life assessments every 8 weeks for 9 months.

After completion of study treatment, patients are followed periodically for at least 1 year.

Conditions

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Breast Cancer

Keywords

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recurrent breast cancer stage IIIA breast cancer stage IIIB breast cancer stage IIIC breast cancer stage IV breast cancer

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

PREVENTION

Interventions

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trastuzumab

Intervention Type BIOLOGICAL

chemotherapy

Intervention Type DRUG

radiation therapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically proven breast carcinoma

* Metastatic or locally advanced disease
* Must demonstrate HER2 3+ positivity on IHC or 2+ over-expression and FISH test demonstrating C-erB2 gene amplification
* No known or suspected brain metastases or CNS disease, as defined by the presence of any of the following key symptoms:

* Headache
* Nausea and/or vomiting
* Clinical signs of raised intracranial pressure
* Seizures
* Focal symptoms
* Cognitive dysfunction
* Affective disorder
* Hormone receptor status not specified

PATIENT CHARACTERISTICS:

* Female
* Postmenopausal status not specified
* ECOG performance status 0 or 1
* Patients must a-priori be suitable for trastuzumab (Herceptin®) +/- chemotherapy in terms of bone marrow, hepatic, and renal function
* No prior history of cerebrovascular disease or neurological disorder including seizures

PRIOR CONCURRENT THERAPY:

* No prior cranial radiotherapy
* No prior neurosurgery
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Anglo Celtic Cooperative Oncology Group

OTHER

Sponsor Role lead

Principal Investigators

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Peter A. Canney, MD

Role: PRINCIPAL_INVESTIGATOR

University of Glasgow

Locations

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Basildon University Hospital

Basildon, England, United Kingdom

Site Status

Ipswich Hospital

Ipswich, England, United Kingdom

Site Status

Leeds Cancer Centre at St. James's University Hospital

Leeds, England, United Kingdom

Site Status

Royal Liverpool University Hospital

Liverpool, England, United Kingdom

Site Status

Aintree University Hospital

Liverpool, England, United Kingdom

Site Status

Barts and the London School of Medicine

London, England, United Kingdom

Site Status

Christie Hospital

Manchester, England, United Kingdom

Site Status

Clatterbridge Centre for Oncology

Merseyside, England, United Kingdom

Site Status

Cancer Research Centre at Weston Park Hospital

Sheffield, England, United Kingdom

Site Status

Great Western Hospital

Swindon, England, United Kingdom

Site Status

Southend University Hospital NHS Foundation Trust

Westcliff-on-Sea, England, United Kingdom

Site Status

Cancer Care Centre at York Hospital

York, England, United Kingdom

Site Status

Dumfries & Galloway Royal Infirmary

Dumfries, Scotland, United Kingdom

Site Status

Ninewells Hospital

Dundee, Scotland, United Kingdom

Site Status

Edinburgh Cancer Centre at Western General Hospital

Edinburgh, Scotland, United Kingdom

Site Status

Falkirk and District Royal Infirmary

Falkirk, Scotland, United Kingdom

Site Status

Beatson West of Scotland Cancer Centre

Glasgow, Scotland, United Kingdom

Site Status

Crosshouse Hospital

Kilmarnock, Scotland, United Kingdom

Site Status

Wishaw General Hospital

Wishaw, Scotland, United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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CDR0000588868

Identifier Type: REGISTRY

Identifier Source: secondary_id

ISRCTN64624715

Identifier Type: -

Identifier Source: secondary_id

EU-20822

Identifier Type: -

Identifier Source: secondary_id

ACCOG-HER-PCI

Identifier Type: -

Identifier Source: org_study_id