Phase II Protocol of Proton Therapy for Partial Breast Irradiation in Early Stage Breast Cancer

NCT ID: NCT01766297

Last Updated: 2025-09-09

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

132 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-02-28

Study Completion Date

2035-01-31

Brief Summary

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The purpose of this research study is to compare the effects (good and bad) on women and their cancer using proton radiation therapy.

This study is being done to see if proton radiation therapy will prove to be beneficial for women with early stage breast cancer. A clinical study is necessary to compare the results (good or bad) of proton radiation therapy.

Detailed Description

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Current standard of care for early stage breast cancer is mastectomy or breast conserving therapy with whole breast irradiation following lumpectomy. However, studies of breast cancer recurrence have demonstrated the majority of tumors to recur in or adjacent to the original tumor site. The question has thus been raised as to whether radiation to the whole breast is necessary or justified. Limiting radiation to the area of the original tumor may reduce acute and long-term skin and organ toxicities while making radiation therapy more convenient and less expensive. Several clinical trials are underway comparing partial breast irradiation (PBI) to whole breast irradiation. Numerous centers are offering partial breast irradiation outside of clinical trials as well, despite the lack of long-term safety and efficacy data on PBI.

Available PBI methods include brachytherapy, in which catheters or balloons are surgically inserted to deliver radiation therapy to the lumpectomy cavity, and conventional external beam radiation therapy, or EBRT. External beam photon therapy is attractive for its non-invasive nature and ability to deliver a more homogenous dose distribution compared to brachytherapy, however it also delivers a greater radiation dose to surrounding normal breast tissue.Proton therapy has the capacity to provide the same advantages as photon EBRT while minimizing dose to normal surrounding tissue. Clinical data on PBI with protons is minimal, however, leaving many questions unanswered. The impetus behind this protocol is to address these gaps by further investigating the feasibility, safety, and efficacy of proton therapy for partial breast irradiation.

Conditions

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Breast Cancer Breast Neoplasm Breast Tumor Cancer of the Breast

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Proton Radiotherapy

Proton Radiotherapy 4.0 Gy (RBE) x10 fractions to 40 Gy (RBE) Total Dose

Group Type EXPERIMENTAL

Proton Radiotherapy

Intervention Type RADIATION

Interventions

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Proton Radiotherapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Must sign study-specific, IRB approved informed consent form prior to study entry. Note consent by legally authorized representative is not allowed for this trial.
* Must be female.
* Must be \> = 50 years of age.
* Must have a life expectancy of at least 5 years based on age and co-morbidities.
* Must have pathology proven invasive ductal carcinoma (lobular is not allowed) and/or ductal carcinoma in situ (DCIS).
* One of the following criteria must be met: (a) Tumors that are microscopically multifocal must be 3.0 cm or less in total aggregate size and encompassed within a single scar (b) Patient does not have microscopically multifocal tumor.
* For tumors that are invasive, if in the presence of extensive intraductal component (EIC), the entire pathologic tumor size (including both the intraductal and invasive component) must be 3.0 cm or less.
* Must be Stage 0, I, II (Tis, T1, or T2, N0, M0 per AJCC criteria 7th and/or 8th Ed.). If stage II, the tumor size must be \< = 3.0 cm. A patient with invasive histology must have nodal stage pN0 by H\&E stains on sentinel node biopsy or axillary lymph node dissection.
* Must have ER positive disease with ER/PR report available.
* For tumors that are invasive, HER2 must be performed (positive or negative is acceptable).
* Must have a lumpectomy performed, with documented negative surgical margins by 0.2 cm or more. If re-excision results in negative surgical margins 0.2 cm or more, patient is eligible.
* If image guidance with daily cone beam CT with direct physician visual assessment is used for treatment positioning, the presence of markers or clips in the surgical bed is recommended but not required. If cone beam CT imaging will NOT be used for image guidance, then the patient must be prepared to have 2 fiducial markers minimum, 3 preferred, placed prior to treatment (if not previously done).

* If markers or clips were placed at the time of surgery, patient must be able to start treatment within 12 weeks after lumpectomy or re-excision for adequate margins.
* If markers were not placed at the time of surgery and are needed, patient must have markers placed within 6 weeks after surgery.
* If systemic chemotherapy was given, patient must have had clips or markers placed at the time of surgery (if they are needed) and patient must have simulation scans within 6 weeks of the completion of the chemotherapy.
* Must be able to start treatment within 12 weeks of surgery or 8 weeks of finalization of chemotherapy.

Exclusion Criteria

* Previous history of ipsilateral invasive breast cancer or DCIS.
* Any clinical or radiographically suspicious nodes, unless biopsy proven benign.
* Non-epithelial malignancies such as sarcoma or lymphoma.
* Suspicious residual microcalcifications on mammography of either breast, unless negative for malignancy on pathology.
* Multicentric or bilateral disease unless biopsy of the clinical abnormalities are performed and result is negative.
* Lymphovascular space invasion (LVSI) on pathology specimen.
* Any previously treated breast carcinoma or synchronous breast carcinoma in ipsilateral breast.
* Prior radiation therapy to the ipsilateral breast or thorax.
* Paget's disease of the nipple.
* Histologic examination showing invasive lobular histology.
* Skin involvement.
* Breasts technically unsatisfactory for radiation treatment upon the discretion of the treating physician.
* Significant infection or other co-existing medical condition that would preclude protocol therapy such as pregnancy, HIV/AIDS or collagen vascular diseases specifically systemic lupus erythematosus, scleroderma, or dermatomyositis.
* Known BRCA 1 or BRCA 2 mutation.
* Pregnant or lactating.
Minimum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Proton Collaborative Group

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Andrew Chang, MD

Role: STUDY_CHAIR

Proton Collaborative Group

Locations

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Mayo Clinic

Scottsdale, Arizona, United States

Site Status RECRUITING

California Protons Cancer Therapy Center

San Diego, California, United States

Site Status RECRUITING

Northwestern Medicine Chicago Proton Center

Warrenville, Illinois, United States

Site Status RECRUITING

Maryland Proton Treatment Center

Baltimore, Maryland, United States

Site Status RECRUITING

McLaren Proton Therapy Center

Flint, Michigan, United States

Site Status RECRUITING

New York Proton Center

New York, New York, United States

Site Status RECRUITING

Oklahoma Proton Center

Oklahoma City, Oklahoma, United States

Site Status RECRUITING

Inova Schar Cancer Institute

Fairfax, Virginia, United States

Site Status RECRUITING

Hampton University Proton Therapy Institute

Hampton, Virginia, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Karla Shields Morales

Role: primary

855-776-0015 (toll free)

Alexandra Crawford, MPH

Role: primary

858-549-7431

Don Smith, MS, CCRC

Role: primary

630-933-7820

Caitlin Eggleston

Role: primary

410-328-7586

Bradley Olsen

Role: primary

313-576-9730

Ryan Holder

Role: primary

646-968-9055 ext. 387

Angela Beebe

Role: primary

405-773-6708

Sangeetha Moturi

Role: primary

571-472-0343

Donna Sternberg, RN, BSN, OCN

Role: primary

757-251-6839

Other Identifiers

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BRE007-12

Identifier Type: -

Identifier Source: org_study_id

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