Radiation Therapy Boost Before Surgery for the Treatment of Non-metastatic Breast Cancer

NCT ID: NCT04871516

Last Updated: 2026-01-22

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

Clinical Phase

NA

Total Enrollment

103 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-05-18

Study Completion Date

2028-01-31

Brief Summary

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This phase II trial investigates the safety of delivering a part (boost) of radiation treatment before breast surgery in treating patients with breast cancer that has not spread to other places in the body (non-metastatic). Radiation therapy uses high energy photons/electrons to kill tumor cells and shrink tumors. Delivering a boost radiation treatment before surgery when doctors can still visualize the tumor on imaging may help to better target the tumor and decrease the volume of normal irradiated tissue. By so doing, doctors may achieve better cosmetic outcomes and possibly better tumor control.

Detailed Description

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PRIMARY OBJECTIVE:

I. To demonstrate that the incidence of grade 3 or more wound complications in patients with non-metastatic node negative breast cancer who are eligible for breast conserving surgery (BCS) and treated with pre-operative radiation boost at 1 month after end of whole breast radiation is no worse than the rates in the current standard of care (6-20%).

SECONDARY OBJECTIVE:

I. To demonstrate that the physician reported cosmetic outcome at 1 and 3 years after the end of treatment is better than what has been reported for the current standard of practice for patients undergoing BCS and hypofractionated whole breast irradiation (WBI).

TERTIARY/EXPLORATORY OBJECTIVES:

I. To measure the acute and late radiation related toxicities such as radiation dermatitis, telangiectasia and fibrosis in this cohort of patients.

II. To measure the pre-operative boost clinical target volume (CTV) and compare to the post-op CTV volume that would have been contoured as CTV if the boost was to be delivered post-operatively.

III. To measure the incidence of fair/poor patient reported cosmetic outcome using the Breast Cancer Treatment Outcomes Scale (BCTOS) cosmetic scale.

IV. To study the cancer biology before and after radiation treatment.

OUTLINE:

Prior to surgery, patients undergo radiation therapy boost over 4 fractions. Patients then undergo standard of care surgery 1-3 weeks from the last day of boost. 3 to 5 weeks after surgery, patients continue standard of care WBI in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 1, 3, 6, 9, 12, 18, and 24 months

Conditions

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Anatomic Stage 0 Breast Cancer AJCC v8 Anatomic Stage I Breast Cancer AJCC v8 Anatomic Stage IA Breast Cancer AJCC v8 Anatomic Stage IB Breast Cancer AJCC v8 Anatomic Stage II Breast Cancer AJCC v8 Anatomic Stage IIA Breast Cancer AJCC v8 Anatomic Stage IIB Breast Cancer AJCC v8 Invasive Breast Carcinoma Non-Metastatic Breast Carcinoma Prognostic Stage 0 Breast Cancer AJCC v8 Prognostic Stage I Breast Cancer AJCC v8 Prognostic Stage IA Breast Cancer AJCC v8 Prognostic Stage IB Breast Cancer AJCC v8 Prognostic Stage II Breast Cancer AJCC v8 Prognostic Stage IIA Breast Cancer AJCC v8 Prognostic Stage IIB Breast Cancer AJCC v8 Prognostic Stage III Breast Cancer AJCC v8 Prognostic Stage IIIA Breast Cancer AJCC v8 Prognostic Stage IIIB Breast Cancer AJCC v8 Prognostic Stage IIIC Breast Cancer AJCC v8

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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Treatment (radiation therapy boost, WBI)

Prior to surgery, patients undergo radiation therapy boost over 4 fractions. Patients then undergo standard of care surgery 1-3 weeks from the last day of boost. 3 to 5 weeks after surgery, patients continue standard of care WBI in the absence of disease progression or unacceptable toxicity.

Group Type EXPERIMENTAL

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Radiation Boost

Intervention Type RADIATION

Undergo radiation therapy boost

Therapeutic Surgical Procedure

Intervention Type PROCEDURE

Undergo standard surgery

Whole Breast Irradiation

Intervention Type RADIATION

Undergo standard WBI

Breast MRI

Intervention Type OTHER

A baseline breast MRI

Interventions

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Quality-of-Life Assessment

Ancillary studies

Intervention Type OTHER

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Radiation Boost

Undergo radiation therapy boost

Intervention Type RADIATION

Therapeutic Surgical Procedure

Undergo standard surgery

Intervention Type PROCEDURE

Whole Breast Irradiation

Undergo standard WBI

Intervention Type RADIATION

Breast MRI

A baseline breast MRI

Intervention Type OTHER

Other Intervention Names

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Quality of Life Assessment Boost Radiation Boost Radiation Therapy Boost Radiotherapy Radiation Therapy Boost Radiotherapy Boost

Eligibility Criteria

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Inclusion Criteria

* Breast cancer patients with biopsy proven invasive cancer
* Clinically and radiographically node negative
* No indication of metastatic disease
* Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
* Synchronous bilateral invasive cancer allowed
* Negative serum pregnancy test within one month from the radiation therapy (RT) boost delivery
* Willingness to participate in the clinical trial and adhere to the study protocol
* Individuals of all races, genders and ethnic groups are eligible for this trial

Exclusion Criteria

* Need for neoadjuvant chemotherapy
* Inflammatory breast cancer (cT4)
* Multicentric tumor
* Prior ipsilateral breast or thoracic RT
* Contraindication for baseline magnetic resonance imaging (MRI)
* Contraindication for surgery
* Distant metastatic disease
* Other synchronous cancer (besides bilateral breast)
* Contraindication to radiation therapy (presence of scleroderma or other collagen vascular disease)
* Any serious or uncontrolled medical disorder that, in the opinion of the investigator, may increase the risk associated with study participation or study drug administration, impair the ability of the subject to receive protocol therapy, or interfere with the interpretation of study results
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Rutgers, The State University of New Jersey

OTHER

Sponsor Role lead

Responsible Party

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Bruce G Haffty

Professor and Chairman, Department of Radiation Oncology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bruce G Haffty

Role: PRINCIPAL_INVESTIGATOR

Rutgers Cancer Institute of New Jersey

Locations

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Clara Maass Medical Center

Belleville, New Jersey, United States

Site Status

RWJBarnabas Health-Trinitas Hospital and Comprehensive Care

Elizabeth, New Jersey, United States

Site Status

The Cancer Institute of New Jersey Hamilton

Hamilton, New Jersey, United States

Site Status

RWJBarnabas Health Jersey City Medical Center

Jersey City, New Jersey, United States

Site Status

RWJBarnabas Health - Monmouth Medical Center Southern Campus

Lakewood, New Jersey, United States

Site Status

Cooperman Barnabas Medical Center (Saint Barnabas Medical Center)

Livingston, New Jersey, United States

Site Status

Rutgers Cancer Institute of New Jersey

New Brunswick, New Jersey, United States

Site Status

Rutgers New Jersey Medical School

Newark, New Jersey, United States

Site Status

RWJBarnabas Health - Newark Beth Israel Medical Center

Newark, New Jersey, United States

Site Status

Robert Wood Johnson University Hospital Somerset

Somerville, New Jersey, United States

Site Status

RWJBarnabas Health - Community Medical Center

Toms River, New Jersey, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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NCI-2020-05711

Identifier Type: REGISTRY

Identifier Source: secondary_id

Pro2020001306

Identifier Type: -

Identifier Source: secondary_id

042005

Identifier Type: OTHER

Identifier Source: secondary_id

P30CA072720

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Pro2020001306

Identifier Type: -

Identifier Source: org_study_id

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