RecruitingNCT05866458

Radiation OmisSion in PAtients With CLinically Node Negative Breast Cancer Undergoing Lumpectomy

Radiation OmisSion in PAtients With CLinically Node Negative Breast Cancer Undergoing Lumpectomy and With a PathologIc Complete REsponse After Neoadjuvant Chemotherapy


Sponsor

Ontario Clinical Oncology Group (OCOG)

Enrollment

352 participants

Start Date

Mar 12, 2024

Study Type

OBSERVATIONAL

Conditions

Summary

To de-escalate radiation therapy in women with breast cancer.


Eligibility

Sex: FEMALEMin Age: 50 Years

Inclusion Criteria6

  • Female patient with a new histological diagnosis of clinical T1-3 N0 breast cancer (any tumour sub-type).
  • Negative lymph node involvement at initial presentation, documented by imaging (US or MRI), fine needle aspiration (FNA) or core needle biopsy.
  • Treated with a minimum of 8 weeks NAC, with patients with Her2+ disease receiving targeted anti-Her2+ therapy.
  • Marker clip placed in the tumour bed prior to or during neoadjuvant chemotherapy when the tumour can still be identified.
  • Treated by BCS with complete excision of the tumour bed and axillary staging surgery (either sentinel lymph node biopsy or axillary lymph node dissection).
  • Final pathology demonstrating a pCR \[defined as absence of residual invasive and in-situ breast cancer within the breast or lymph nodes (ypT0N0)\].

Exclusion Criteria12

  • Age less than 50 years.
  • Inflammatory breast cancer or breast cancer invading the skin or chest wall (T4 disease).
  • Multicentric disease (i.e., breast cancer involving more than one quadrant in the same breast).
  • Prior history of ipsilateral or contralateral in-situ or invasive breast cancer. Patients with a history of lobular carcinoma in-situ (LCIS) are ineligible.
  • Synchronous contralateral in-situ or invasive breast cancer.
  • BRCA (breast cancer gene) 1 or 2 genetic mutation carrier, or other genetic mutation present associated with increased risk of breast cancer.
  • Other previous non-breast malignancies except adequately treated non-melanoma skin cancers, in situ cancers or other cancers curatively treated with no evidence of disease for ≥ 5 years.
  • Inability to complete entire course of neoadjuvant therapy (minimum of 8 weeks of treatment).
  • Patients with HR+ (hormone receptor) disease who are not planned to have endocrine therapy initiated.
  • Patients with Her2+ disease who have not received or are not planned to receive Her2 targeted therapy.
  • ECOG (Eastern Cooperative Oncology Group) performance status \> 3.
  • Inability to provide informed consent.

Locations(12)

BC Cancer - Centre for the North

Prince George, British Columbia, Canada

Royal Victoria Regional Health Centre

Barrie, Ontario, Canada

Juravinski Cancer Centre

Hamilton, Ontario, Canada

Cancer Centre of Southeastern Ontario at Kingston

Kingston, Ontario, Canada

Thunder Bay Regional Health Sciences Centre

Thunder Bay, Ontario, Canada

Sunnybrook Health Sciences -Odette Cancer Centre

Toronto, Ontario, Canada

CHUM - Centre Hospitalier de L'Université de Montréal

Montreal, Quebec, Canada

Jewish General Hospital

Montreal, Quebec, Canada

CHU de Quebec - Universite Laval

Québec, Quebec, Canada

Centre hospitalier de Lanaudière

Saint-Charles-Borromée, Quebec, Canada

Centre Hospitalier Trois Rivieres Ste-Marie

Trois-Rivières, Quebec, Canada

McGill University Health Centre (MUHC)

Montreal, Q, Canada

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NCT05866458


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