Trial Outcomes & Findings for Monitoring and Predicting Chemotherapy Response Using DOSI (NCT NCT01217385)

NCT ID: NCT01217385

Last Updated: 2023-01-17

Results Overview

This measure will look at the Accuracy of % change in DOSI measured Tumor Optical Index (TOI) from baseline to mid therapy to predict pathologic response (pCR+ v pCR-) Pathologic response (dichotomized into responders (pCR+) and non-responders (pCR-) based pathologic assessment) will be used as the reference standard and Accuracy will be determined using receiver operating characteristic (ROC) analysis to determine the ROC Area Under the Curve (AUC).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

60 participants

Primary outcome timeframe

From baseline to mid-therapy

Results posted on

2023-01-17

Participant Flow

Seven institutions were approved to enroll a total of 60 female breast cancer patients: Enrollment began in June 2011 and completed in June 2013. All institutions activated concurrently, except MD Anderson Cancer Center and Boston University, which joined the study in January and May 2013, respectively.

Participant milestones

Participant milestones
Measure
Diffuse Optical Spectroscopy Imaging (DOSI)
Participants undergo approximately four assessments of breast health using the Diffuse optical spectroscopy imaging (DOSI)technology during treatment and prior to surgery for breast cancer. DOSI: Bedside DOSI images of the tissue concentrations of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctHbO2), water (ctH2O), lipid, and TOI (ctHHb x tH2O/lipid) were acquired on both breasts up to four times during neoadjuvant chemotherapy (NAC) treatment.
Overall Study
STARTED
60
Overall Study
COMPLETED
34
Overall Study
NOT COMPLETED
26

Reasons for withdrawal

Reasons for withdrawal
Measure
Diffuse Optical Spectroscopy Imaging (DOSI)
Participants undergo approximately four assessments of breast health using the Diffuse optical spectroscopy imaging (DOSI)technology during treatment and prior to surgery for breast cancer. DOSI: Bedside DOSI images of the tissue concentrations of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctHbO2), water (ctH2O), lipid, and TOI (ctHHb x tH2O/lipid) were acquired on both breasts up to four times during neoadjuvant chemotherapy (NAC) treatment.
Overall Study
Withdrawal by Subject
3
Overall Study
DOSI not performed/not eval
12
Overall Study
Central Path not Available
1
Overall Study
Normal Breast TOI not available
10

Baseline Characteristics

Monitoring and Predicting Chemotherapy Response Using DOSI

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Diffuse Optical Spectroscopy Imaging (DOSI)
n=34 Participants
Participants undergo approximately four assessments of breast health using the DOSI technology during treatment and prior to surgery for breast cancer. DOSI: Bedside DOSI images of the tissue concentrations of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctHbO2), water (ctH2O), lipid, and TOI (ctHHb x tH2O/lipid) were acquired on both breasts up to four times during neoadjuvant Chemotherapy (NAC) treatment.
Age, Continuous
48.4 years
STANDARD_DEVIATION 10.7 • n=5 Participants
Sex: Female, Male
Female
34 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
29 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
4 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
8 Participants
n=5 Participants
Race (NIH/OMB)
White
19 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
n=5 Participants
Histologic findings
Invasive (infiltrating) ductal carcinoma (IDC)
16 Participants
n=5 Participants
Histologic findings
Invasive lobular carcinoma (ILC)
3 Participants
n=5 Participants
Histologic findings
Ductal Carcinoma In Situ (DCIS)/ILC
11 Participants
n=5 Participants
Histologic findings
IDC/ILC
2 Participants
n=5 Participants
Histologic findings
Other/not available
2 Participants
n=5 Participants
estrogen receptor (ER) status
Positive
24 Participants
n=5 Participants
estrogen receptor (ER) status
Negative
7 Participants
n=5 Participants
estrogen receptor (ER) status
Unknown
3 Participants
n=5 Participants
progesterone receptor (PR) status
Positive
19 Participants
n=5 Participants
progesterone receptor (PR) status
Negative
12 Participants
n=5 Participants
progesterone receptor (PR) status
Unknown
3 Participants
n=5 Participants
cell division marker (Ki67) status
Positive
17 Participants
n=5 Participants
cell division marker (Ki67) status
Negative
2 Participants
n=5 Participants
cell division marker (Ki67) status
Unknown
15 Participants
n=5 Participants
hormone receptor 2 (Her2/neu) status from Immunohistochemistry (IHC):
0 - HER2-negative
4 Participants
n=5 Participants
hormone receptor 2 (Her2/neu) status from Immunohistochemistry (IHC):
1 - HER2-negative
8 Participants
n=5 Participants
hormone receptor 2 (Her2/neu) status from Immunohistochemistry (IHC):
2 - equivocal
8 Participants
n=5 Participants
hormone receptor 2 (Her2/neu) status from Immunohistochemistry (IHC):
3 - HER2-positive
4 Participants
n=5 Participants
hormone receptor 2 (Her2/neu) status from Immunohistochemistry (IHC):
unknown/not available
10 Participants
n=5 Participants
fluorescence in situ hybridization (FISH) status
Amplified
7 Participants
n=5 Participants
fluorescence in situ hybridization (FISH) status
Non amplified
14 Participants
n=5 Participants
fluorescence in situ hybridization (FISH) status
Unknown/not available
13 Participants
n=5 Participants
Areolar tumor
Areolar tumor
17 Participants
n=5 Participants
Areolar tumor
Nonareolar tumor
17 Participants
n=5 Participants

PRIMARY outcome

Timeframe: From baseline to mid-therapy

Population: Bedside DOSI images of the tissue concentrations of TOI (ctHHb x tH2O/lipid) acquired on both breasts at baseline and mid-therapy during neoadjuvant chemotherapy (NAC) treatment.

This measure will look at the Accuracy of % change in DOSI measured Tumor Optical Index (TOI) from baseline to mid therapy to predict pathologic response (pCR+ v pCR-) Pathologic response (dichotomized into responders (pCR+) and non-responders (pCR-) based pathologic assessment) will be used as the reference standard and Accuracy will be determined using receiver operating characteristic (ROC) analysis to determine the ROC Area Under the Curve (AUC).

Outcome measures

Outcome measures
Measure
Diffuse Optical Spectroscopy Imaging (DOSI
n=34 Participants
Participants undergo approximately four assessments of breast health using the DOSI technology during treatment and prior to surgery for breast cancer. DOSI: Bedside DOSI images of the tissue concentrations of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctHbO2), water (ctH2O), lipid, and TOI (ctHHb x tH2O/lipid) were acquired on both breasts up to four times during NAC treatment.
PR- Participants
Participants who are Progesterone Receptor Negative (PR-)
PR? Participants
Participants whose PR status is unknown
Accuracy of %Change in TOI Between Baseline and Mid-therapy to Predict Pathologic Response (pCR +/-)
0.60 probability
Interval 0.39 to 0.81

SECONDARY outcome

Timeframe: baseline to mid-therapy

Population: Analysis population consists of the 34 participants with both baseline and mid-therapy TOI measurements.

Pathologic Complete response vs Non-Complete response, by PR status Progesterone Receptor Status (positive, negative, unknown ) is determined at pathological assessment of the tumor sample. %change in TOI is evaluated from baseline to mid-therapy.

Outcome measures

Outcome measures
Measure
Diffuse Optical Spectroscopy Imaging (DOSI
n=19 Participants
Participants undergo approximately four assessments of breast health using the DOSI technology during treatment and prior to surgery for breast cancer. DOSI: Bedside DOSI images of the tissue concentrations of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctHbO2), water (ctH2O), lipid, and TOI (ctHHb x tH2O/lipid) were acquired on both breasts up to four times during NAC treatment.
PR- Participants
n=12 Participants
Participants who are Progesterone Receptor Negative (PR-)
PR? Participants
n=3 Participants
Participants whose PR status is unknown
%Change in TOI Between Baseline and Mid-therapy to Predict pCR+; Stratified by Progesterone Receptor (PR) Status (Positive, Negative, Unknown )
-29.874 percentage change
Standard Deviation 31.349
-14.605 percentage change
Standard Deviation 107.425
-45.701 percentage change
Standard Deviation 25.237

SECONDARY outcome

Timeframe: baseline to mid-therapy

Population: evaluable subjects with baseline tumor StO2 dichotomized at 76.9%. (i.e. population median) and %change TOI dichotomized at -40%

subset analysis, subjects were stratified using the median tumor StO2 %change TOI Between Baseline and Mid-therapy dichotomized at -40% stratified by the set evaluable subjects with baseline tumor StO2 dichotomized at 76.9%. (i.e. population median). Accuracy will be determined using ROC analysis to determine the ROC Area Under the Curve (AUC).

Outcome measures

Outcome measures
Measure
Diffuse Optical Spectroscopy Imaging (DOSI
n=17 Participants
Participants undergo approximately four assessments of breast health using the DOSI technology during treatment and prior to surgery for breast cancer. DOSI: Bedside DOSI images of the tissue concentrations of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctHbO2), water (ctH2O), lipid, and TOI (ctHHb x tH2O/lipid) were acquired on both breasts up to four times during NAC treatment.
PR- Participants
n=17 Participants
Participants who are Progesterone Receptor Negative (PR-)
PR? Participants
Participants whose PR status is unknown
Accuracy of %Change in TOI Between Baseline and Mid-therapy to Predict pCR+; Stratified by Oxygen Saturation (St02)
0.38 probability
Interval 0.08 to 0.68
0.83 probability
Interval 0.63 to 1.0

SECONDARY outcome

Timeframe: baseline to mid-therapy

Population: participants having TOI ratio (T/N) using tumor breast normal at baseline and mid-therapy and have pathologic response data.

Determine the optimal cutpoint (aka Youden-index) for %Change in TOI ratio (T/N) to maximize sensitivity and specificity in the predication of pCR

Outcome measures

Outcome measures
Measure
Diffuse Optical Spectroscopy Imaging (DOSI
n=44 Participants
Participants undergo approximately four assessments of breast health using the DOSI technology during treatment and prior to surgery for breast cancer. DOSI: Bedside DOSI images of the tissue concentrations of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctHbO2), water (ctH2O), lipid, and TOI (ctHHb x tH2O/lipid) were acquired on both breasts up to four times during NAC treatment.
PR- Participants
Participants who are Progesterone Receptor Negative (PR-)
PR? Participants
Participants whose PR status is unknown
Estimate the Optimal Cutpoint for %Change in TOI From Baseline to Mid-therapy to Predict pCR
-32.527 percentage change in TOI

Adverse Events

DOSI

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Donna Hartfeil, Director Protocol Management

American College of Radiology

Phone: 215-717-2765

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place