Emotional Distress in Patients With Metastatic Breast Cancer in First Line of Therapy

NCT ID: NCT06994377

Last Updated: 2025-12-04

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

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-06-25

Study Completion Date

2029-06-30

Brief Summary

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Few data about the impact of emotional distress (ED) on treatment efficacy in patients with metastatic breast cancer (mBC) are available.

Aim of this study is to assess the outcomes of patients with mBC receiving first-line treatment according to the presence of baseline ED.

Detailed Description

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Metastatic breast cancer (mBC) is the most incident and prevalent cancer in the world and, according to a recent meta-analysis, 50% of patients with BC report emotional distress (ED).

In patients with cancer, ED negatively impacts treatment adherence, ability to self-manage the physical and emotional consequences of cancer symptoms and treatment-related adverse events, and overall quality of life. ED has been shown to directly affect treatment outcomes in patients with breast cancer, with studies demonstrating that psychological well-being plays a critical role in therapeutic success.

Furthermore, recent studies showed that baseline ED is associated with a lower efficacy of immunotherapy in patients with non-small cell lung cancer (NSCLC) or melanoma.

Few data about the impact of ED on treatment efficacy in patients with mBC are available. In the first line setting patients receive endocrine therapy, chemotherapy, immunotherapy and/or targeted therapy according to the disease subtype. These agents display different mechanisms of action, which involve the immune system at different levels. However, the role of ED on the efficacy of these treatments according to the BC subtype is unknown.

Aim of this study is to assess the outcomes of patients with mBC receiving first-line treatment according to the presence of baseline ED.

Conditions

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Metastatic Breast Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Cohort A (HR-/HER2-, PD-L1+)

Triple-negative Programmed Cell Death Ligand 1 (PD-L1)+ mBC patients receiving chemotherapy with immune checkpoint inhibitors (ICIs)

ED and quality of life assessment

Intervention Type BEHAVIORAL

Patients will undergo ED and quality of life assessments through specific questionnaires completion

Cohort B (HR-/HER2-, PD-L1-)

Triple-negative PD-L1- mBC patients receiving chemotherapy

ED and quality of life assessment

Intervention Type BEHAVIORAL

Patients will undergo ED and quality of life assessments through specific questionnaires completion

Cohort C (HR+/HER2-)

HR+/HER2- mBC patients receiving Cyclin-Dependent Kinase 4/6 (CDK4/6) inhibitor + endocrine therapy

ED and quality of life assessment

Intervention Type BEHAVIORAL

Patients will undergo ED and quality of life assessments through specific questionnaires completion

Cohort D (HER2+)

HER2+ mBC patients receiving chemotherapy + trastuzumab and pertuzumab

ED and quality of life assessment

Intervention Type BEHAVIORAL

Patients will undergo ED and quality of life assessments through specific questionnaires completion

Interventions

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ED and quality of life assessment

Patients will undergo ED and quality of life assessments through specific questionnaires completion

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Age over 18 years
* Confirmed histological diagnosis of breast cancer
* No prior treatment for advanced/metastatic cancer
* Indication to receive first-line therapy as per standard clinical practice based on the disease subtype:

1. cohort A (HR-/HER2-, PD-L1+): pembrolizumab or atezolizumab + chemotherapy
2. cohort B (HR-/HER2-, PD-L1-): chemotherapy
3. cohort C (HR+/HER2-): CDK4/6 inhibitor + endocrine therapy
4. cohort D (HER2+): chemotherapy + trastuzumab and pertuzumab
* Presence of measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) v.1.1 and/or Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) criteria
* Able to provide full informed consent for the study

Exclusion Criteria

* Pre-existing severe psychiatric disorders or other conditions that could impair the ability to provide informed consent
* Inability to complete questionnaires
* Presence of another malignancy in the previous 3 years
* Symptomatic brain metastases
* Ongoing treatment with antidepressant and/or anxiolytic drugs
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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European Institute of Oncology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gabriella Pravettoni, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

European Istitute of Oncology

Locations

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Ospedali Riuniti di Ancona

Ancona, , Italy

Site Status NOT_YET_RECRUITING

CRO (Centro di Riferimento Oncologico)

Aviano, , Italy

Site Status NOT_YET_RECRUITING

Azienda Usl Toscana centro - Ospedale Santa Maria Annunziata

Bagno a Ripoli, , Italy

Site Status NOT_YET_RECRUITING

IRCCS Istituto Tumori Giovanni Paolo II

Bari, , Italy

Site Status NOT_YET_RECRUITING

ASST Papa Giovanni XXIII

Bergamo, , Italy

Site Status NOT_YET_RECRUITING

ASST Spedali Civili

Brescia, , Italy

Site Status NOT_YET_RECRUITING

Ospedale A. Perrino

Brindisi, , Italy

Site Status NOT_YET_RECRUITING

ASST della Valle Olona

Busto Arsizio, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Valduce

Como, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Careggi

Florence, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Policlinico San Martino

Genova, , Italy

Site Status NOT_YET_RECRUITING

AOU Gaetano Martino di Messina

Messina, , Italy

Site Status RECRUITING

European Institute of Oncology

Milan, , Italy

Site Status RECRUITING

ASST Fatebenefratelli Sacco

Milan, , Italy

Site Status NOT_YET_RECRUITING

Fondazione IRCCS Istituto Nazionale dei Tumori

Milan, , Italy

Site Status NOT_YET_RECRUITING

IRCCS Ospedale San Raffaele

Milan, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Niguarda

Milan, , Italy

Site Status NOT_YET_RECRUITING

Ospedale San Giuseppe MultiMedica

Milan, , Italy

Site Status NOT_YET_RECRUITING

Policlinico di Milano

Milan, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliero-Universitaria di Modena

Modena, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera Universitaria Federico II

Napoli, , Italy

Site Status NOT_YET_RECRUITING

Istituto Nazionale Tumori IRCCS Fondazione G. Pascale

Napoli, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Maggiore di Novara

Novara, , Italy

Site Status NOT_YET_RECRUITING

Policlinico Universitario Paolo Giaccone

Palermo, , Italy

Site Status NOT_YET_RECRUITING

Policlinico San Matteo

Pavia, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliero Universitaria Pisana

Pisa, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliero Universitaria Pisana

Pisa, , Italy

Site Status NOT_YET_RECRUITING

Azienda Usl Toscana centro - Ospedale di Prato Santo Stefano

Prato, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Infermi

Rimini, , Italy

Site Status NOT_YET_RECRUITING

Policlinico Universitario Campus Bio-Medico

Roma, , Italy

Site Status NOT_YET_RECRUITING

Policlinico Umberto I

Rome, , Italy

Site Status NOT_YET_RECRUITING

Policlinico Universitario Agostino Gemelli IRCCS

Rome, , Italy

Site Status RECRUITING

Azienda Ospedaliero Universitaria di Sassari

Sassari, , Italy

Site Status RECRUITING

ASL CN2 - Ospedale Michele e Pietro Ferrero

Verduno, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedaliera Universitaria Integrata Verona

Verona, , Italy

Site Status NOT_YET_RECRUITING

Ospedale Sacro Cuore Don Calabria - Negrar

Verona, , Italy

Site Status NOT_YET_RECRUITING

ASST Brianza

Vimercate, , Italy

Site Status NOT_YET_RECRUITING

Countries

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Italy

Central Contacts

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Gabriella Pravettoni, MD, PhD

Role: CONTACT

+39 0257489731

Mara Negri

Role: CONTACT

+39 0257489536

Facility Contacts

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Rossana Berardi

Role: primary

Fabio Puglisi, MD

Role: primary

Carlotta Bacci, MD

Role: primary

Nicola Silvestris, MD

Role: primary

Alberto Zambelli, MD

Role: primary

Rebecca Pedersini, MD

Role: primary

Saverio Cinieri, MD

Role: primary

Maria Marconi, MD

Role: primary

Giovanni Scognamiglio, MD

Role: primary

Icro Meattini, MD

Role: primary

Lucia Del Mastro, MD

Role: primary

Massimilano Berretta, MD

Role: primary

Gabriella Pravettoni, MD

Role: primary

Nicla La Verde, MD

Role: primary

Claudio Vernieri, MD

Role: primary

Giulia Viale, MD

Role: primary

Salvatore Siena, MD

Role: primary

Pier Francesco Ferrucci, MD

Role: primary

Ornella Garrone, MD

Role: primary

Angela Toss, MD

Role: primary

Roberto Bianco, MD

Role: primary

Michelino De Laurentiis, MD

Role: primary

Alessandra Gennari, MD

Role: primary

Antonio Russo, MD

Role: primary

Paolo Pedrazzoli, MD

Role: primary

Chiara Cremolini, MD

Role: primary

Carmelo Bengala, MD

Role: primary

Laura Biganzoli, MD

Role: primary

Lorenzo Gianni, MD

Role: primary

Francesco Pantano, MD

Role: primary

Andrea Botticelli, MD

Role: primary

Alessandra Fabi, MD

Role: primary

Valeria Sanna, MD

Role: primary

Veronica Prati, MD

Role: primary

Elena Fiorio, MD

Role: primary

Stefania Gori, MD

Role: primary

Paola Tagliabue, MD

Role: primary

Other Identifiers

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UID 4907

Identifier Type: OTHER

Identifier Source: secondary_id

L2 - 311

Identifier Type: -

Identifier Source: org_study_id

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