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Breast CancerPBICNCT00681993

Trial of Partial Breast Irradiation With Various Concurrent Chemotherapy Regimens

A study testing Standard Dose Dense Doxorubucin and Cyclophosphamide, Standard Doxorubucin and Cyclophosphamide and Standard Docetaxel, Carboplatin, and Herceptin in people with Breast Cancer, run by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Breast conserving therapy, (BCT), which consists of wide local excision of the tumor followed by 6 weeks of whole breast irradiation, (WBI), is integral to the management of breast cancer. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Cancer
What is being tested?
Standard Dose Dense Doxorubucin and Cyclophosphamide, Standard Doxorubucin and Cyclophosphamide and Standard Docetaxel, Carboplatin, and Herceptin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
35 participants
Where
1 siteUnited States
Study dates
Apr 2008to 4 Mar 2016
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Eligibility Criteria:

Each of the criteria in the following section must be met in order for a patient to be considered eligible for registration.

  • Patient must be older than 18 years of age
  • Patients must have histologically confirmed (by routine H\&E staining) adenocarcinoma of the breast, with the primary tumor < 4 cm and 0 - 3 positive axillary lymph nodes (pathologic T1-2, pathologic N0 -N1, M0). Patients with squamous carcinomas or sarcomas of the breast cancer are NOT eligible.
  • Patient must have a history and physical within six weeks prior to the start of any protocol therapy.
  • Patient must have had a bilateral mammogram prior to surgery.
  • Patients must have undergone a segmental mastectomy (SM) with a level I and ll axillary dissection or sentinel lymph node biopsy. Surgical margins at time of SM must be negative (> or = 2 mm) for both invasive carcinoma and for non-invasive ductal carcinoma. Patients who have post-operative margins which are negative but less than 2mm will be considered eligible if the surgeon states that the margin in question could not be improved.
  • Patient must have a Medical Oncology consult and be recommended to receive one of the following regimens: Cyclophosphamide and Doxorubicin (AC); Taxotere, Doxorubicin and Cyclophosphamide (TAC); Taxotere and Cyclophosphamide (TC) or Taxotere, Carboplatin and Trastuzumab (TCH) prior to registration. The use of additional chemotherapy, hormonal therapy or Trastuzumab after the initial regimen is at the discretion of the medical oncologist.
  • Patients must be registered such that radiation therapy begins no sooner than 7 days prior to, but no later than 7 days after, day 1 of cycle 1 (C1D1). Patient must start chemotherapy and radiation less than 14 weeks from the last breast surgical procedure.
  • Patients must NOT have received any neo adjuvant chemo or hormonal therapy for the current cancer.
  • Patients must have a performance status 0 or 1 by ECOG criteria
  • Patients must not have received prior radiation therapy to the involved breast at any time for any reason.
  • Any patient with active local-regional disease prior to registration is not eligible.
  • No other prior malignancy is allowed except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or any other cancer from which the patient has been disease-free for 5 years.
  • Patients must not be pregnant due to the potential for fetal harm as a result of this treatment regimen. Women of child-bearing potential must use effective non hormonal contraception while undergoing radiation therapy. Women of child-bearing potential must also have a negative pregnancy test within six weeks prior to start of protocol therapy.
  • Patients must not have a serious medical or psychiatric illness which prevents informed consent or compliance with treatment.
  • All patients must be informed of the investigational nature of this study and given written informed consent in accordance with institutional and federal guidelines.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

    Baltimore, Maryland, 21231

Other trials in United States

About this study

Official title: "A Feasibility Trial of Partial Breast Irradiation With Various Concurrent Chemotherapy Regimens (PBIC)"

Breast conserving therapy, (BCT), which consists of wide local excision of the tumor followed by 6 weeks of whole breast irradiation, (WBI), is integral to the management of breast cancer. Evidence now suggests that WBI may not be necessary and treatment to the involved area only, partial breast irradiation, (PBI), may suffice. PBI can be achieved by interstitial or intracavitary brachytherapy, intra-op, or post op external beam radiation therapy. The feasibility, toxicity and efficacy of PBI are currently being studied in both the U.S. and Europe. Review of smaller studies suggests that PBI will prove to be comparable to WBI. Chemotherapy combined with radiation has been shown to increase local control in BCT when compared to radiation alone. However there is little data on how sequencing or timing of these therapies with respect to one another affect outcome. As a result there is no consensus about the optimal combination. There are real and potential benefits to concurrent chemo-radiation therapy. Concurrent therapy 1) allows both treatments to start closer to surgery, theoretically maximizing the benefits of each modality; 2) shortens the overall treatment program; and 3) may also improve local control via chemo-sensitization of residual cancer cells. However, concurrent chemotherapy and WBI have been associated with prohibitive skin toxicity. Since less breast tissue is treated with PBI, this skin toxicity may no longer be prohibitive. We have shown in J0381 that PBI and concurrent dose dense AC is safe. As a follow-up, we propose a phase I/II trial addressing the toxicity and efficacy associated with PBI delivered concurrently with various chemotherapy regimens.

Read the detailed description
  1. Partial Breast Irradiation with concurrent chemotherapy (various regimens. Subjects will receive Segmental Mastectomy (Lumpectomy)
  2. Medical Oncology Evaluation
  3. Consent/Registration Pre-RT evaluation
  4. Simulation/Treatment Planning
  5. Chemo-Radiation Therapy: ddAC, Std AC, TAC, TC, TCH or TH Concurrent with PBI - (270 cGy per fraction for 15 fractions). RT may start up to 7days prior to C1D1, but no later than 7 days after C1D1 (+/- 7 days of C1D1 radiation may start)
  6. Further chemotherapy, hormonal therapy or biologic therapy at the medical oncologist's discretion
  7. F/U Schedule
Conditions
Breast Cancer
Being tested
Standard Dose Dense Doxorubucin and Cyclophosphamide, Standard Doxorubucin and Cyclophosphamide, Standard Docetaxel, Carboplatin, and Herceptin, Standard Docetaxel, Doxorubucin and Cyclophosphamide, Standard Docetaxel and Cyclophosphamide
Keywords
cosmetic, effect, breast, irradiation, concurrent, chemotherapy, potential acute, late skin, subcutaneous toxicities
Medical subject headings
Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Standard Dose Dense Doxorubucin and CyclophosphamideOther

    Also called Doxorubucin (Adriamycin, Rubex, Adriamycin RDF, Adriamycin PFS,, hydroxydaunorubicin, hydroxydaunomycin), Cyclophosphamide (Cytoxan, Neosar, CTX, CPM)

    4 cycles of Standard Dose-Dense Doxorubucin and Cyclophosphamide and concurrent radiation therapy at a dose of 270 cGy per fraction for 15 fractions to a total dose of 40.5 Gy. Treatments will be given Monday through Friday for three weeks. Radiation therapy may start 7 days before, but no later than 7 days after, day 1 of cycle 1 of chemotherapy (C1D1).

  • Standard Doxorubucin and CyclophosphamideOther

    Also called Doxorubucin (Adriamycin, Rubex, Adriamycin RDF, Adriamycin PFS,, hydroxydaunorubicin, hydroxydaunomycin), Cyclophosphamide (Cytoxan, Neosar, CTX, CPM)

    4 cycles of Standard Dose Doxorubucin and Cyclophosphamide and concurrent radiation therapy at a dose of 270 cGy per fraction for 15 fractions to a total dose of 40.5 Gy. Treatments will be given Monday through Friday for three weeks. Radiation therapy may start 7 days before, but no later than 7 days after, day 1 of cycle 1 of chemotherapy (C1D1).

  • Standard Docetaxel, Carboplatin, and HerceptinOther

    Also called Docetaxel (Taxotere), Carboplatin (CBDCA, Paraplatin, JM-8), Herceptin (Trastuzumab, RhuMAb HER2, HER2/neu, anti-HER2 humanized, monoclonal antibody)

    6 cycles of Standard Docetaxel, Carboplatin and Herceptin chemotherapy with concurrent radiation therapy at a dose of 270 cGy per fraction for 15 fractions to a total dose of 40.5 Gy. Treatments will be given Monday through Friday for three weeks. Radiation therapy may start 7 days before, but no later than 7 days after, day 1 of cycle 1 of chemotherapy (C1D1).

  • Standard Docetaxel, Doxorubucin and CyclophosphamideOther

    Also called Docetaxel (Taxotere), Cyclophosphamide (Cytoxan, Neosar, CTX, CPM)

    3 cycles of Standard Docetaxel, Doxorubucin and Cyclophosphamide chemotherapy with concurrent radiation therapy at a dose of 270 cGy per fraction for 15 fractions to a total dose of 40.5 Gy. Treatments will be given Monday through Friday for three weeks. Radiation therapy may start 7 days before, but no later than 7 days after, day 1 of cycle 1 of chemotherapy (C1D1).

  • Standard Docetaxel and CyclophosphamideOther

    Also called Docetaxel (Taxotere), Cyclophosphamide (Cytoxan, Neosar, CTX, CPM)

    4 cycles of Standard Docetaxel and Cyclophosphamide chemotherapy with concurrent radiation therapy at a dose of 270 cGy per fraction for 15 fractions to a total dose of 40.5 Gy. Treatments will be given Monday through Friday for three weeks. Radiation therapy may start 7 days before, but no later than 7 days after, day 1 of cycle 1 of chemotherapy (C1D1).

Study groups in NCT00681993
Study groupRoleWhat they receive
Standard ddAC chemotherapy with concurrent radiation therapyActive comparatorStandard dose-dense Adriamycin and Cyclophosphamide (ddAC) chemotherapy and concurrent radiation therapy (RT)
Receives: Other: Standard Dose Dense Doxorubucin and Cyclophosphamide
Standard AC chemotherapy with concurrent RTActive comparatorStandard Adriamycin and Cyclophosphamide (AC) chemotherapy and concurrent radiation therapy
Receives: Other: Standard Doxorubucin and Cyclophosphamide
Standard TCarbo H chemotherapy with concurrent RTActive comparatorStandard Taxotere, Carboplatin and Herceptin (TCarbo H) chemotherapy and concurrent radiation therapy
Receives: Other: Standard Docetaxel, Carboplatin, and Herceptin
Standard TAC chemotherapy with concurrent RTActive comparatorStandard Taxotere, Adriamycin and Cyclophosphamide (TAC) chemotherapy with concurrent radiation therapy
Receives: Other: Standard Docetaxel, Doxorubucin and Cyclophosphamide
Standard TC chemotherapy with concurrent RTActive comparatorStandard Taxotere and Cyclophosphamide (TC) chemotherapy with concurrent radiation therapy
Receives: Other: Standard Docetaxel and Cyclophosphamide

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Acute skin toxicities of partial breast irradiation concurrent with chemotherapy (PBIC)

    Acute Skin toxicity will be scored on a scale ranging from 0-4, where a higher score reflects more severe toxicity:

    0= no change; 1= follicular, fain or dull erythema/epilation/dry/desquamation/decreased swelling; 2= tender or bright erythemal patchy moist desquamation/moderate edema; 3= confluent moist desquamation other than skin folds, pitting edema; 4= ulceration, hemorrhage, necrosis.

    Measured: up to 5 years post-intervention

  2. Late skin toxicities of PBIC

    Late Skin toxicity will be scored on a scale ranging from 0-4, where a higher score reflects more severe toxicity:

    0= none; 1= slight atrophy, pigmentation change, some hair loss; 2= patchy atrophy, moderate telangiectasias, total hair loss; 3= marked atrophy, gross telangiectasias; 4= ulceration

    Measured: up to 5 years post-intervention

  3. Subcutaneous tissue toxicities of PBIC

    Subcutaneous tissue toxicity will be scored on a scale ranging from 0-4, where a higher score reflects more severe toxicity:

    0= none; 1= slight induration (fibrosis) and loss of subcutaneous fat; 2= moderate fibrosis but asymptomatic; slight field contracture; <10% linear reduction; 3= severe induration and loss subcutaneous tissue; field contracture >10% linear reduction; 4= necrosis

    Measured: up to 5 years post-intervention

Secondary outcomes (2)
  1. Cosmetic effect of PBIC

    Number of participants with Poor, Fair, Good, or Excellent cosmetic effect after PBIC. Cosmetic effect will be graded by the investigator and participant as specified by the grading criteria in the Study Protocol (grading criteria description too large for this field).

    Measured: up to 5 years post-intervention

  2. Local control rate of patients treated with PBIC.

    Measured: up to 5 years post-intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 May 2008 (estimated)
  2. Study startApr 2008
  3. Primary completionJun 2012
  4. Study completion4 Mar 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00681993
Sponsor's protocol ID
J0805
Other IDs
IRB00063221
Acronym
PBIC
Status last verified
Jan 2019
First submitted
19 May 2008
Last updated
22 Jan 2019
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A study testing Standard Dose Dense Doxorubucin and Cyclophosphamide, Standard Doxorubucin and Cyclophosphamide and Standard Docetaxel, Carboplatin, and Herceptin in people with Breast Cancer, run by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Jan 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Acute skin toxicities of partial breast irradiation concurrent with chemotherapy (PBIC) (time frame: up to 5 years post-intervention). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jan 2019.

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