Systemic Therapy With or Without Upfront Surgery in Metastatic Breast Cancer

NCT ID: NCT01392586

Last Updated: 2014-02-04

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

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-02-29

Study Completion Date

2014-01-31

Brief Summary

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SUBMIT is a clinical trial that intends to answer the question whether up front breast surgery in patients with primary distant metastatic breast cancer will result in an improvement of the 2-year survival compared to the survival achieved with systemic therapy and delayed local treatment or systemic therapy alone.

Randomization will take place immediately after the diagnosis of primary distant metastatic breast cancer. Patients either randomize for up front surgery of the breast tumor (UFS) followed by systemic therapy or for systemic therapy (ST) potentially followed by delayed local treatment of the breast tumor.

The primary endpoint of this trial is the 2-years survival. Quality of life is one of the most important secondary endpoints.

Detailed Description

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In the Netherlands approximately one out of eight women will be diagnosed with breast cancer; 5% have metastatic disease at presentation. Because metastatic breast cancer is considered to be an incurable disease, it is only treated with a palliative intent. Recent retrospective studies have demonstrated that (complete) resection of the primary tumor significantly improves the outcome of patients with primary metastatic breast cancer. However, other studies showed that the survival benefit in patients who underwent surgery is caused by selection bias.

SUBMIT is a clinical trial that intends to answer the question whether up front breast surgery in patients with primary distant metastatic breast cancer will result in an improvement of the 2-year survival compared to the survival achieved with systemic therapy and delayed local treatment or systemic therapy alone.

Patients to submit in this study are patients with primary distant metastatic breast cancer, with no prior treatment of the breast cancer, who are 18 years or older and fit enough to undergo surgery and systemic therapy. Exclusion criteria are: history of breast cancer, other malignancy within the last 10 years, surgical treatment or radiotherapy of this breast tumor before randomization, irresectable T4 tumor or synchronous bilateral breastcancer.

Randomization will take place immediately after the diagnosis of primary distant metastatic breast cancer. Patients either randomize for up front surgery of the breast tumor (UFS) followed by systemic therapy or for systemic therapy (ST) potentially followed by delayed local treatment of the breast tumor.

The primary endpoint of this trial is the 2-years survival. Quality of life is one of the most important secondary endpoints.

Conditions

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Metastatic Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Upfront surgery

Upfront surgery followed by systemic treatment

Group Type EXPERIMENTAL

upfront breast surgery

Intervention Type PROCEDURE

surgery of primary tumor, lumpectomy or mastectomy

Systemic therapy

Systemic therapy possibly followed by local treatment of the breast tumor

Group Type OTHER

systemic therapy

Intervention Type OTHER

chemotherapy, immunotherapy or endocrine therapy (possibly followed by local surgery of the breast)

Interventions

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upfront breast surgery

surgery of primary tumor, lumpectomy or mastectomy

Intervention Type PROCEDURE

systemic therapy

chemotherapy, immunotherapy or endocrine therapy (possibly followed by local surgery of the breast)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Newly diagnosed primary distant metastatic breast cancer (M1)
* Anticipated survival of at least 6 months
* Histologically proven breast cancer
* Hormonal and HER2Neu status should be known
* T1-T3, resectable T4 status, N0-N3
* Performance status of the patient should allow surgery / systemic therapy
* Co-morbidity of the patient should allow surgery / systemic therapy
* Age \> 18 years
* Written informed consent

Exclusion Criteria

* Primary invasive breast cancer in medical history
* Other malignancy within the last 10 years, besides basal cell carcinoma of the skin or early stage cervical cancer
* Surgical treatment / radiotherapy of this breast tumor before randomization
* Irresectable T4 breast tumor
* Synchronous bilateral breast cancer
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Borstkanker Onderzoek Groep

NETWORK

Sponsor Role collaborator

Comprehensive Cancer Centre The Netherlands

OTHER

Sponsor Role collaborator

Jeroen Bosch Ziekenhuis

OTHER

Sponsor Role lead

Responsible Party

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M.F. Ernst, dr

Dr.M.F.Ernst

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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M.F. Ernst, dr

Role: PRINCIPAL_INVESTIGATOR

Jeroen Bosch Ziekenhuis

A.C. Voogd, dr

Role: PRINCIPAL_INVESTIGATOR

Maastricht University Medical Centre

V.C.G. Tjan-Heijnen, Prof, dr

Role: PRINCIPAL_INVESTIGATOR

Maastricht University Medical Centre

Locations

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Jeroen Bosch Ziekenhuis

's-Hertogenbosch, , Netherlands

Site Status

Medisch Centrum Alkmaar

Alkmaar, , Netherlands

Site Status

Ziekenhuisgroep Twente

Almelo, , Netherlands

Site Status

Wilhelmina Ziekenhuis

Assen, , Netherlands

Site Status

Rode Kruis Ziekenhuis

Beverwijk, , Netherlands

Site Status

Tergooiziekenhuizen, loc Blaricum

Blaricum, , Netherlands

Site Status

Reinier de Graaf

Delft, , Netherlands

Site Status

Catharina Ziekenhuis

Eindhoven, , Netherlands

Site Status

Maxima Medisch Centrum

Eindhoven, , Netherlands

Site Status

Atrium Medisch Centrum

Heerlen, , Netherlands

Site Status

Ziekenhuis Elkerliek, loc Helmond

Helmond, , Netherlands

Site Status

Ziekenhuisgroep Twente, Loc. SMT

Hengelo, , Netherlands

Site Status

Spaarne Ziekenhuis

Hoofddorp, , Netherlands

Site Status

Medisch Centrum Leeuwarden

Leeuwarden, , Netherlands

Site Status

Diaconessenhuis

Leiden, , Netherlands

Site Status

Maastricht University Medical Center

Maastricht, , Netherlands

Site Status

St. Antonius Ziekenhuis, Loc. Nieuwegein

Nieuwegein, , Netherlands

Site Status

Canisius-Wilhelmina Ziekenhuis

Nijmegen, , Netherlands

Site Status

UMC St. Radboud

Nijmegen, , Netherlands

Site Status

Ikazia Ziekenhuis

Rotterdam, , Netherlands

Site Status

Orbis Medisch Centrum

Sittard, , Netherlands

Site Status

Haga Ziekenhuis, Loc. Leijweg

The Hague, , Netherlands

Site Status

Ziekenhuis Bronovo

The Hague, , Netherlands

Site Status

St. Elisabeth Ziekenhuis

Tilburg, , Netherlands

Site Status

Viecuri Medisch Centrum, loc. St Maartens Gasthuis

Venlo, , Netherlands

Site Status

Isala Klinieken

Zwolle, , Netherlands

Site Status

Countries

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Netherlands

References

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Ruiterkamp J, Voogd AC, Tjan-Heijnen VC, Bosscha K, van der Linden YM, Rutgers EJ, Boven E, van der Sangen MJ, Ernst MF; Dutch Breast Cancer Trialists' Group (BOOG). SUBMIT: Systemic therapy with or without up front surgery of the primary tumor in breast cancer patients with distant metastases at initial presentation. BMC Surg. 2012 Apr 2;12:5. doi: 10.1186/1471-2482-12-5.

Reference Type DERIVED
PMID: 22469291 (View on PubMed)

Other Identifiers

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BOOG 2010-05

Identifier Type: -

Identifier Source: org_study_id

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