Hypofractionated Partial Breast Irradiation in Treating Patients With Early Stage Breast Cancer

NCT ID: NCT03077841

Last Updated: 2025-09-05

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

SUSPENDED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

928 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-06

Study Completion Date

2027-11-08

Brief Summary

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This phase II trial studies how well hypofractionated partial breast irradiation works in treating patients with early stage breast cancer. Hypofractionated radiation therapy delivers higher doses of radiation therapy over a shorter period of time and may kill more tumor cells and have fewer side effects. Treating only the part of the breast where the cancer started may lead to fewer side effects than standard treatment.

Detailed Description

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PRIMARY OBJECTIVE:

I. The risk of grade 2 or higher toxicity occurring during radiation and through the 6 month post-radiation follow up visit in patients treated with Optimizing Preventative Adjuvant Linac-based Radiation (OPAL) regimen.

SECONDARY OBJECTIVES:

I. To measure patient-reported cosmetic outcome, functional status, and breast pain with the OPAL regimen at 6 months, one year, two years, three years, four years, and five years after completing the OPAL regimen.

II. To measure physician-reported and photographically-assessed cosmetic outcome at 6 months, one year, two years, three years, four years, and five years after completing the OPAL regimen and to compare this to the best performing arm of 2010-0559.

III. To determine the 5-year risk of pathologically-confirmed invasive and/or in situ ipsilateral breast tumor recurrence (IBTR) for patients with ductal breast carcinoma in situ (DCIS) and early invasive breast cancer.

IV. To determine the 5-year risk of any recurrence of breast cancer, disease-free survival, and overall survival.

V. To determine maximal late (within 5 years) toxicities using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v) 4.0 scale.

VI. To establish the feasibility of conducting multi-center radiation therapy trials within the MD Anderson Network.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients undergo hypofractionated partial breast irradiation daily for 5 days. Patients may then receive 3 additional boost fractions at the discretion of the doctor.

ARM II: Patients undergo standard breast irradiation daily for 15 days. Patients may then receive 5 additional boost fractions at the discretion of the doctor.

After completion of study treatment, patients are followed up at 6 months, and at 1.5, 3.5, and 5.5 years.

Conditions

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Ductal Breast Carcinoma In Situ Early-Stage Breast Carcinoma Invasive Breast Carcinoma Stage 0 Breast Cancer AJCC v6 and v7 Stage I Breast Cancer AJCC v7 Stage IA Breast Cancer AJCC v7 Stage IB Breast Cancer AJCC v7 Stage II Breast Cancer AJCC v6 and v7 Stage IIA Breast Cancer AJCC v6 and v7 Stage IIB Breast Cancer AJCC v6 and v7

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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Arm I (hypofractionated partial breast irradiation)

Patients undergo hypofractionated partial breast irradiation daily for 5 days. Patients may then receive 3 additional boost fractions at the discretion of the doctor.

Group Type EXPERIMENTAL

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Partial Breast Irradiation

Intervention Type RADIATION

Undergo hypofractionated partial breast irradiation

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Arm II (hypofractionated partial breast irradiation)

Patients undergo standard breast irradiation daily for 15 days. Patients may then receive 5 additional boost fractions at the discretion of the doctor.

Group Type ACTIVE_COMPARATOR

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Partial Breast Irradiation

Intervention Type RADIATION

Undergo hypofractionated partial breast irradiation

Interventions

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Laboratory Biomarker Analysis

Correlative studies

Intervention Type OTHER

Partial Breast Irradiation

Undergo hypofractionated partial breast irradiation

Intervention Type RADIATION

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of pathologically-confirmed invasive breast cancer or ductal carcinoma in situ
* Pathologic T stage of Tis, T1, or T2 with total size of tumor =\< 3 cm (this size criteria applies to both pure DCIS and invasive tumors)
* For patients with invasive breast cancer, pathologic N stage of N0, N0 (i-), or N0 (i+); pathologic staging of the axilla is not required for patients with pure DCIS
* Treatment with breast conserving surgery
* Unifocal primary tumor based on imaging and clinical assessment; microscopic multifocality is allowed
* Final surgical margins negative defined as no tumor on ink; lobular carcinoma in situ involving the final surgical margin will be disregarded
* For invasive cancers, the tumor must be estrogen receptor positive (defined as 10% or greater expression of estrogen receptor)
* If the patient has a history of a prior non-breast cancer, all treatment for this cancer must have been completed at least one month prior to study registration and the patient must have no evidence of disease for this prior non-breast cancer
* Patients must be enrolled on the trial within 12 weeks of the later of two dates: the final breast conserving surgical procedure or administration of the last cycle of cytotoxic chemotherapy
* Final criteria for eligibility established after simulation: The tumor bed can be readily visualized on simulation computed tomography (CT) and is localized to one quadrant or region of the breast that is amenable to partial breast irradiation

Exclusion Criteria

* Tumor invasion of the skin including dermis, chest wall, or pectoralis musculature
* Any evidence of nodal positivity beyond pathologic stage of pN0(i+)
* Systemic chemotherapy prior to final breast conserving surgery
* Patient is pregnant or nursing
* History of therapeutic irradiation to the breast, lower neck, mediastinum or other area in which there could potentially be overlap with the affected breast
* History of prior invasive or in situ cancer in either breast
* Current diagnosis of bilateral breast cancer
* History of lupus or scleroderma
Minimum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Benjamin D Smith

Role: PRINCIPAL_INVESTIGATOR

M.D. Anderson Cancer Center

Locations

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Baptist MD Anderson Cancer Center

Jacksonville, Florida, United States

Site Status

Piedmont Hospital

Atlanta, Georgia, United States

Site Status

Community Cancer Center East

Indianapolis, Indiana, United States

Site Status

Covenant Medical Center Harrison

Saginaw, Michigan, United States

Site Status

Summit Medical Group

Berkeley Heights, New Jersey, United States

Site Status

Cooper Hospital University Medical Center

Camden, New Jersey, United States

Site Status

MD Anderson Cancer Center at Cooper-Voorhees

Voorhees Township, New Jersey, United States

Site Status

Presbyterian Hospital

Albuquerque, New Mexico, United States

Site Status

OhioHealth Mansfield Hospital

Mansfield, Ohio, United States

Site Status

MD Anderson in The Woodlands

Conroe, Texas, United States

Site Status

M D Anderson Cancer Center

Houston, Texas, United States

Site Status

MD Anderson West Houston

Houston, Texas, United States

Site Status

MD Anderson League City

League City, Texas, United States

Site Status

Saint Luke's Baptist Health System

San Antonio, Texas, United States

Site Status

MD Anderson in Sugar Land

Sugar Land, Texas, United States

Site Status

Countries

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United States

References

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Reddy JP, Lei X, Bloom ES, Reed VK, Schlembach PJ, Arzu I, Mayo L, Chun SG, Ahmad NR, Stauder MC, Gopal R, Kaiser K, Fang P, Smith BD; OPAL Trial Investigators. Optimizing Preventive Adjuvant Linac-Based (OPAL) Radiation: A Phase 2 Trial of Daily Partial Breast Irradiation. Int J Radiat Oncol Biol Phys. 2023 Mar 1;115(3):629-644. doi: 10.1016/j.ijrobp.2022.09.083. Epub 2022 Oct 8.

Reference Type DERIVED
PMID: 36216274 (View on PubMed)

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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NCI-2017-00476

Identifier Type: REGISTRY

Identifier Source: secondary_id

2016-1035

Identifier Type: OTHER

Identifier Source: secondary_id

2016-1035

Identifier Type: -

Identifier Source: org_study_id

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