Partial Breast Versus no Irradiation for Women With Early Breast Cancer

NCT ID: NCT03646955

Last Updated: 2020-10-06

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

NA

Total Enrollment

926 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-05

Study Completion Date

2035-09-01

Brief Summary

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All early breast cancer patients are offered adjuvant breast radiation therapy (RT) after breast conserving surgery for an early breast cancer. Breast cancer is heterogeneous, and selected patients have a very low gain from RT, whilst they still have risk of acute and late side effects from RT. This trial will try identify selection criteria for low risk breast cancer patients who can safely omit adjuvant RT without unacceptable high risk of local failure.

Detailed Description

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International standard of therapy is to provide adjuvant breast radiation therapy (RT) after breast conserving surgery for an early breast cancer to lower the risk of local and distant failures. However, breast cancer is a heterogeneous disease, and the gain from RT in selected low risk patients is low. RT may cause acute and late side effects, and some of these may be serious to the patient. Therefore, there is a need to tailor RT utilization to the individual recurrence risk and try identify patients who are unlikely to gain much risk reduction from RT, because those patients can then omit RT and thereby avoid late effects and over-treatment. At the present time there is no consensus as to define the selection criteria for patients who may omit RT.

Based on early results from the randomized DBCG RT PBI trial, external beam 40 Gy/15 fr partial breast irradiation (PBI) has been standard in Denmark since April 2016 for selected low risk breast cancer patients. Based on results from the UK IMPORT LOW trial, the 5 yr local recurrence risk using this technique for PBI is 0.5%, whilst 2% for developing a new contralateral breast cancer.

This trial will investigate if PBI can safely be omitted in selected low risk breast cancer patients without causing unacceptable high risk of local failure.

Conditions

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Local Neoplasm Recurrence Distantly Metastatic Malignant Neoplasm Death Fibrosis Breast Depigmentation/Hyperpigmentation of Skin Telangiectasia Scar Pain PROMs

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Clinically controlled randomized trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Partial breast irradiation

External beam irradiation 40 Gy / 15 fractions, 5 fractions per week, 3 weeks

Group Type ACTIVE_COMPARATOR

No partial breast irradiation

Intervention Type RADIATION

Omission of radiation therapy

No partial breast irradiation

No radiation therapy

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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No partial breast irradiation

Omission of radiation therapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

Female patient \>=60 years

Primary tumour characteristics by conventional histopathology

* unilateral and unifocal non-lobular histology grade 1-2
* maximum microscopic size \<=20mm
* node negative determined by sentinel node or axillary lymph node dissection
* estrogen receptor \>=10% positive
* HER2 negative (by IHC and/or in situ hybridization)
* resection margin \>=2 mm for invasive carcinoma and any ductal carcinoma in situ associated with the cancer

Surgical type is breast conservation

Performance status ECOG 0-2

No evidence of distant metastasis

Exclusion Criteria

* multifocal or multicentric invasive carcinoma or ductal carcinoma in situ
* evidence of clinical or pathological T4 breast cancer
* grade 3 malignancy
* previous breast cancer or DCIS irrespective of disease-free interval
* previous radiation therapy to the breast or thorax,
* previous neoplasm within 5 years except carcinoma in situ of the cervix, endometrium or coli, melanoma in situ.
* comorbidity precluding the patient from radiation therapy (e.g. cardiovascular or pulmonary disease, scleroderma, systemic lupus erythematosus).
* mental/psychiatric disorder which precludes the patient from understanding the randomization and the follow up.
* documented hereditary breast cancer or with high genetic risk of breast cancer
* life expectancy \<10 years
Minimum Eligible Age

60 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Danish Cancer Society

OTHER

Sponsor Role collaborator

Danish Center for Interventional Research in Radiation Oncology (CIRRO)

OTHER

Sponsor Role collaborator

Danish Breast Cancer Cooperative Group

OTHER

Sponsor Role lead

Responsible Party

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Birgitte Offersen

Professor, PhD, MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Birgitte V Offersen, PhD

Role: PRINCIPAL_INVESTIGATOR

Danish Breast Cancer Group

Locations

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Ponticia Universidad Catolica de Chile

Santiago, , Chile

Site Status RECRUITING

Aalborg University Hospital

Aalborg, , Denmark

Site Status RECRUITING

Aarhus University Hospital

Aarhus, , Denmark

Site Status RECRUITING

Rigshospitalet

Copenhagen, , Denmark

Site Status RECRUITING

Herlev Hospital

Herlev, , Denmark

Site Status RECRUITING

Naestved Hospital

Næstved, , Denmark

Site Status RECRUITING

Odense University Hospital

Odense, , Denmark

Site Status RECRUITING

Vejle Hospital

Vejle, , Denmark

Site Status RECRUITING

Haukeland HUS

Bergen, , Norway

Site Status RECRUITING

Nordlandssykehuset

Bodø, , Norway

Site Status RECRUITING

Kristiansand Hospital

Kristiansand, , Norway

Site Status RECRUITING

Oslo University Hospital, Radiumhospitalet

Oslo, , Norway

Site Status RECRUITING

Stavanger Hospital

Stavanger, , Norway

Site Status RECRUITING

Tromsø University Hospital

Tromsø, , Norway

Site Status RECRUITING

Sahlgrenska University hospital

Gothenburg, , Sweden

Site Status RECRUITING

Skånes University Hospital

Lund, , Sweden

Site Status RECRUITING

Uppsala Akademiska Sjukhuset

Uppsala, , Sweden

Site Status RECRUITING

Countries

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Chile Denmark Norway Sweden

Central Contacts

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Birgitte V Offersen, PhD

Role: CONTACT

+45 28838012

Facility Contacts

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Tomas Merino Lara

Role: primary

Tamas Lörinz, MD

Role: primary

Hanne M Nielsen, PhD

Role: primary

Claus Kamby, DMSc

Role: primary

Louise W Matthiessen

Role: primary

Sami Al-Rawi, MD

Role: primary

Mette H Nielsen, PhD

Role: primary

Troels Bechmann, PhD

Role: primary

Hans Petter Eikesdal

Role: primary

Bård Mannsåker

Role: primary

Unn-Miriam Kasti

Role: primary

Kristin Reinertsen

Role: primary

Ingvil Mjaaland

Role: primary

Egil Blix Støre

Role: primary

Dan Lundstedt

Role: primary

Sara Alkner

Role: primary

Henrik Lindman

Role: primary

Other Identifiers

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DBCG RT Natural Trial

Identifier Type: -

Identifier Source: org_study_id

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