NOSTRA-Feasibility Study: A Study Looking at Ultrasound Guided Biopsies for Breast Cancer

NCT ID: NCT04118192

Last Updated: 2025-01-24

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

ACTIVE_NOT_RECRUITING

Total Enrollment

72 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-05-22

Study Completion Date

2025-12-31

Brief Summary

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A prospective non-randomised multi-centre feasibility study to assess if patients with residual cancer following dual-targeted neoadjuvant chemotherapy treatment for HER2-positive, ER-negative early breast cancer can be identified by multiple ultrasound (US)-guided tumour bed core biopsies

Detailed Description

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The NOSTRA-Feasibility study is designed to determine if it is safe to omit surgery after the planned neoadjuvant chemotherapy plus dual-targeted anti-HER2 treatment. The study is needed to determine whether patients with residual cancer can be identified by histological examination of multiple ultrasound-guided tumour bed core biopsies following dual-targeted neoadjuvant treatment for HER2-positive, ER-negative early primary breast cancer and whether there is concordance between local pathology reporting and central pathology reporting by the trials expert pathologists.

Conditions

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Breast Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Tumour bed core biopsy

Collection of up to 8 core biopsies across 4 zones of the whole tumour bed to detect residual cancer post neo-adjuvant treatment

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patient with histological diagnosis of operable HER2-positive, ER-negative, early stage invasive breast cancer
* Tumour size ≥ 1cm and visible on US (T1c to T4d)
* Patient fit and willing to receive, or is already receiving and has received no more than five cycles of a NOSTRA-Feasibility Study approved treatment regimen, in the opinion of the responsible clinician
* Eastern Co-operative Group (ECOG) performance status of 0 or 1
* Women of child-bearing potential, prepared to adopt highly effective contraceptive measures if sexually active for at least 6 months after completion of study medication
* Female, 18 years or older
* Able to provide informed consent for the study
* Availability of embedded paraffin tumour blocks from pre-chemotherapy biopsy
* The radiology team are able and willing to perform the tumour bed core biopsies


* Patient has not yet started neoadjuvant treatment
* Patient is willing and able to give blood samples as per ctDNA Sub-Study Guidelines

Exclusion Criteria

* Previous ipsilateral invasive breast cancer or Ductal Carcinoma in Situ (DCIS)
* Unequivocal evidence of distant metastatic disease at registration
* Multi-focal disease at diagnosis
* Active malignancy
* Previous chemotherapy
* Prior extensive radiotherapy (as judged by the Investigator) to bone marrow
* Risk factors precluding the safe administration of the intended cytotoxic chemotherapy regimen
* Patient unsuitable for the planned dual-targeted anti-HER2 treatment in opinion of the Investigator
* Prior diagnosis of cardiac failure
* Uncontrolled hypertension, coronary heart disease or other significant cardiac abnormality
* Bleeding diathesis
* Any evidence of other disease which in the opinion of the Investigator places the patient at high risk of treatment related complications
* Pregnant (female patients of child bearing potential must have a urine or blood Human Chorionic Gonadotropin test performed to rule out pregnancy prior to study entry)
* Patient lactating
* Patients who have received live vaccine within 4 weeks of the date of study entry
* Any concomitant medical or psychiatric problems which in the opinion of the Investigator would prevent completion of treatment or follow-up
* Patient unfit and/or unwilling to undergo surgery
* Patient unwilling or unable to comply with scheduled visits, treatment plan and study procedures
* Patient has started protocol non-compliant neo-adjuvant chemotherapy
* Patient has started approved neoadjuvant chemotherapy but insufficient data is available to complete relevant CRFs
* Patient has already received more than five cycles of approved neoadjuvant chemotherapy
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Roche Pharma AG

INDUSTRY

Sponsor Role collaborator

Cancer Research UK

OTHER

Sponsor Role collaborator

University of Birmingham

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Daniel Rea

Role: PRINCIPAL_INVESTIGATOR

University of Birmingham

Locations

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Basildon Hospital

Basildon, Essex, United Kingdom

Site Status

Belfast City Hospital

Belfast, , United Kingdom

Site Status

City Hospital

Birmingham, , United Kingdom

Site Status

Queen Elizabeth Hospital

Birmingham, , United Kingdom

Site Status

Blackpool Teaching Hospitals NHS Trust

Blackpool, , United Kingdom

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Southmead Hospital

Bristol, , United Kingdom

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University Hospital of Llandough

Cardiff, , United Kingdom

Site Status

Cheltenham General Hospital

Cheltenham, , United Kingdom

Site Status

Dumfries and Galloway Royal Infirmary

Dumfries, , United Kingdom

Site Status

Western General

Edinburgh, , United Kingdom

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Northwick Park Hospital

Harrow, , United Kingdom

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St James's University Hospital

Leeds, , United Kingdom

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Royal Liverpool Hospital

Liverpool, , United Kingdom

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Royal Marsden Hospital

London, , United Kingdom

Site Status

Borders General Hospital

Melrose, , United Kingdom

Site Status

Royal Victoria Infirmary

Newcastle upon Tyne, , United Kingdom

Site Status

Nottingham City Hospital

Nottingham, , United Kingdom

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Peterborough City Hospital

Peterborough, , United Kingdom

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Poole Hospital

Poole, , United Kingdom

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Weston Park Hospital

Sheffield, , United Kingdom

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Southampton General Hospital

Southampton, , United Kingdom

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Singleton Hospital

Swansea, , United Kingdom

Site Status

Arrowe Park Hospital

Upton, , United Kingdom

Site Status

Thomas Linacre Centre

Wigan, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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RG_16-108

Identifier Type: -

Identifier Source: org_study_id

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