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Breast Neoplasm FemalePhase 3NCT04815083

Fluorescence Imaging of Carcinoma During Breast Conserving Surgery

A Phase 3 study testing Aminolevulinic Acid Hydrochloride and Eagle V1.2 Imaging System in people with Breast Neoplasm Female and Breast Cancer, run by SBI ALApharma Canada, Inc. at 7 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Breast conserving surgery (BCS) is performed on patients with breast cancer to resect and completely remove the cancer while conserving as much of the surrounding healthy tissue as possible. Current methods do not allow surgeons to determine the completeness of surgical resection in real-time. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Neoplasm Female, Breast Cancer
What is being tested?
Aminolevulinic Acid Hydrochloride and Eagle V1.2 Imaging System
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
57 participants
Where
7 sitesUnited States
Study dates
27 Apr 2021to 20 Dec 2024
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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

Who may be able to join

  • Female, 18 years or older
  • Histologically or cytologically confirmed primary breast cancer (includes invasive lobular carcinoma, invasive ductal carcinoma, inflammatory breast cancer, papillary breast cancer, adenoid cystic carcinoma of the breast, mucinous breast cancer, metaplastic breast cancer, cribriform carcinoma and ductal carcinoma in situ, alone or in combination with invasive disease)
  • Scheduled for a lumpectomy (including bilateral lumpectomy) of a breast malignancy (eligibility for breast conserving surgery/partial mastectomy based on clinical staging using TNM staging system (AJCC Cancer Staging Manual: Breast Cancer, 8th Edition70).
  • Patient must have normal organ and bone marrow function and be appropriate surgical candidate per site standard of care
  • Women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) starting the day entering the study, and for the duration of the study period (until the Week 2 visit)

Who cannot join

  • Currently on (neo)adjuvant therapy to treat another cancer
  • Receiving or intended to receive neoadjuvant therapy to treat the primary breast cancer (including chemotherapy, endocrine therapy and radiotherapy)
  • Stage 4 cancer, inclusive of metastatic disease
  • Non-invasive diseases of the breast (includes lobular carcinoma in situ, phyllodes and Paget's disease of the breast)
  • Patients who have had the following procedures performed on the involved breast:
  • Surgery for a benign lesion(s) within 1 year of the BCS date
Show all 31Show fewer
  • Breast implants inserted within 1 year of the BCS date
  • Breast reduction, surgery for malignant disease or mastectomy (at any time prior to the BCS date)
  • Surgery for a benign lesion(s) or insertion of implants >1 year prior to the BCS date and who have signs of ongoing inflammation, active tissue healing and/or extensive scarring
  • Radiation at any time prior to the BCS date and who have signs of ongoing inflammation, active tissue healing and/or extensive scarring
  • Patients for whom intraoperative frozen section analysis is planned
  • Patients who have not recovered from adverse events due an investigational pharmaceutical or diagnostic agents administered more than 30 days prior to their scheduled surgical procedure
  • History of hypersensitivity to ALA HCl or porphyrins
  • Known or documented personal or family history of porphyria
  • Patient has a recording of any parameter as defined below:
  • Bilirubin: Above upper limit of normal
  • Aspartate aminotransferase (SGOT): > 2.5 X institutional upper limit of normal
  • Alanine aminotransferase ( (SGPT): > 2.5 X institutional upper limit of normal
  • Patient has serum creatinine >1.5 times institutional upper limit of normal, OR calculated creatinine clearance > 60 mL/min/1.73 m² for patients with creatinine levels above institutional normal.
  • Uncontrolled concurrent illness, that in the opinion of the Investigator would prevent the patient from participation in the study, including but not limited to:
  • Ongoing or active infection;
  • Cardiovascular disease (e.g. symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia).
  • Patients who have the following collagen vascular diseases:
  • Lupus
  • Scleroderma
  • Use of an investigational drug within 30 days of their scheduled surgical procedure
  • Simultaneous use of other potentially phototoxic substances (such as St. John's wort, griseofulvin, thiazide diuretics, sulfonylureas, phenothiazines, sulphonamides, quinolones and tetracyclines), and topical preparations containing ALA for 24 hours during the perioperative period.
  • Social or medical situations including uncontrolled psychiatric illnesses that would in the opinion of the Investigator limit compliance with study requirements (e.g. ability to travel for follow-up)
  • Patients who are pregnant or become pregnant (it is unknown if ALA HCl is teratogenic or has abortifacient effects)
  • Patients who are breast feeding (there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with ALA HCl, breastfeeding should be discontinued if the mother is treated with ALA HCl)
  • Inability to consent

Trial locations and contacts

7 sites in 1 country.

7 sites in 1 country

United States7 sites
  • BayCare Morton Plant Hospital

    Clearwater, Florida, 33756

  • University of Miami Sylvester Comprehensive Cancer Center

    Miami, Florida, 33136

  • Aurora St. Luke's Medical Centre

    Milwaukee, Wisconsin, 53215

  • Orlando Health, Inc.

    Orlando, Florida, 32806

  • Stamford Hospital

    Stamford, Connecticut, 06902

  • BayCare St. Joseph's Hospital

    Tampa, Florida, 33607

  • Montefiore Medical Center

    The Bronx, New York, 10467

Other trials in United States

About this study

Official title: A Prospective Multi-center Clinical Study Evaluating the Use of PD G 506 A and the Eagle V1.2 Imaging System for the Visualization of Carcinoma During Breast Conserving Surgery

Breast conserving surgery (BCS) is performed on patients with breast cancer to resect and completely remove the cancer while conserving as much of the surrounding healthy tissue as possible. Current methods do not allow surgeons to determine the completeness of surgical resection in real-time. This often results in the need for a second surgical procedure, or in some cases more than two surgical procedures in order to have confidence that all cancer has been removed.

This Phase 3 study will evaluate the safety and efficacy of the fluorescent imaging agent PD G 506 A for the real-time visualization of cancer during standard of care breast conserving surgery. PD G 506 A is an investigational drug which is converted in the body into a fluorescent molecule that accumulates in cancer cells. Patients receiving PD G 506 A will undergo standard of care breast conserving surgery followed by fluorescence imaging and removal of any potentially cancerous tissue left behind in the surgical cavity.

Read the detailed description

Re-operations due to positive margins following breast conserving surgery (BCS) increase poor cosmesis, complications, discomfort, stress, adjuvant delay, medical costs and risk of local recurrence. Reducing positive margin rates can be achieved through optimizing surgical procedures. This study evaluates a new method for surgeons to visualize carcinoma in real-time, both in the surgical cavity and on the margins of excised specimen(s) during the index BCS procedure.

The active ingredient of PD G 506A is aminolevulinic acid hydrochloride (ALA HCl). ALA HCl is a prodrug that is metabolized intracellularly to form the fluorescent molecule protoporphyrin IX (PpIX). The exogenous application of ALA HCl leads to a highly selective accumulation of PpIX in malignant tissues.

This Phase 3, 2-part, single-blind [pathologist(s)-blinded] randomized placebo-controlled trial study is designed to evaluate the efficacy and safety of PD G 506 A to aid in the visualization of carcinoma during BCS. The Eagle V1.2 Imaging System will be used in this trial to visualize PpIX fluorescence.

Part A is an open-label training phase of the study to optimize workflow and Part B of the study is randomized and single-blind and will serve as the pivotal portion of the study.

Being tested
Aminolevulinic Acid Hydrochloride, Eagle V1.2 Imaging System, Placebo
Keywords
Breast conserving surgery, Fluorescence Imaging, Intraoperative margin assessment
Medical subject headings
Breast Neoplasms

What participants receive

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

  • Aminolevulinic Acid HydrochlorideDrug

    Also called PD G 506 A

    PD G 506 A for oral solution (aminolevulinic acid [ALA] hydrochloride [HCl] granules for oral solution) is administered as a single dose (20 mg/kg body weight) approximately 3 hours (min 2 hours, max 4 hours) prior to anesthesia.

  • Eagle V1.2 Imaging SystemDevice

    Fluorescence imaging camera and associated accessories used to view and capture fluorescence and white light images and videos of the surgical cavity and excised tissue specimens during the surgical procedure.

  • PlaceboDrug

    Oral placebo is administered as a single dose approximately 3 hours (min 2 hours, max 4 hours) prior to anesthesia.

Study groups in NCT04815083
Study groupRoleWhat they receive
Standard of Care ArmPlacebo comparatorPatients in this arm will receive the placebo orally approximately 3 hrs prior to anesthesia followed by standard of care BCS. Fluorescence imaging will be performed on tissue specimens resected prior to completion of standard of care resection. Fluorescence-guided resection will not be performed in patients in this arm.
Receives: Drug: Placebo
PD G 506 A + Fluorescence-Guided Resection ArmExperimentalPatients in this arm will receive PD G 506 A orally approximately 3 hrs prior to anesthesia followed by standard of care BCS. Fluorescence imaging will be performed on tissue specimens resected prior to completion of standard of care resection. Fluorescence imaging performed after SoC BCS is complete will guide the resection of additional tissue.
Receives: Drug: Aminolevulinic Acid Hydrochloride; Device: Eagle V1.2 Imaging System

What is being measured

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

  1. Positive Margin Conversion Rate

    Percentage of patients with negative-margins following fluorescence-guided resection (FGR) among patients all patients imaged

    Measured: 2 weeks

  2. Diagnostic Performance (Specificity)

    Patient-level specificity to identify residual carcinoma

    Measured: 2 weeks

  3. Diagnostic Performance (Sensitivity)

    Patient-level sensitivity to identify residual carcinoma

    Measured: 2 weeks

Secondary outcomes (16)
  1. Orientation-level Diagnostic Performance

    Orientation-level diagnostic performance of PD G 506 A-induced fluorescence to determine the presence or absence of cancer in the surgical cavity as compared to margin histopathology.

    Measured: 2 weeks

  2. Positive Margin Conversion Rate Among All Patients

    Percentage of patients with at least one histopathology-positive margin following SoC who then have ALL histopathology-negative margins following FGR, among all patients imaged.

    Measured: 2 weeks

  3. Patient-level Diagnostic Performance

    Patient-level sensitivity, specificity, NPV, PPV of PD G 506 A-induced fluorescence to determine the presence or absence of residual cancer.

    Measured: 2 weeks

  4. Patient-level Diagnostic Performance of PD G 506 A to Detect Residual Cancer at the End of FGR With Modified Patient-level Definitions

    Patient-level sensitivity, specificity, PPV and NPV to determine the presence or absence of residual cancer in the surgical cavity at the end of FGR (using modified patient-level definitions).

    Measured: 2 weeks

  5. Patient-level Diagnostic Performance of PD G 506 A to Detect Cancer After SoC BCS

    Patient-level sensitivity, specificity, PPV and NPV to determine the presence or absence of cancer in the surgical cavity after SoC BCS.

    Measured: 2 weeks

  6. Patient-level Diagnostic Performance of PD G 506 A to Detect Cancer After SoC With Modified Patient-level Definitions

    Patient-level sensitivity, specificity, PPV and NPV to determine the presence or absence of cancer in the surgical cavity after SoC (using modified patient-level definitions).

    Measured: 2 weeks

  7. Patient-level False Negative Rate of at the End of FGR

    Percentage of patients assessed as residual tumor negative at the end of FGR who had positive final margins on histopathology.

    Measured: 2 weeks

  8. Patient-level False Positive Rate

    Percentage of patients in whom SOC final margins were carcinoma negative and all FL-driven shave specimens are carcinoma-negative.

    Measured: 2 weeks

  9. Patients With Carcinoma-negative Margins After SoC Found to Have Residual Tumor Following SoC That Was Identified With FL Imaging

    Percentage of patients with histopathology-negative margins at the end of SoC who have at least one orientation that was both FL-positive and histopathology-positive among (1) patients with histopathology negative final margins after SOC and (2) all patients imaged.

    Measured: 2 weeks

  10. Patient-level True Negative Rate at the End of SoC

    Percentage of patients with no fluorescence identified at the end of SoC in whom all final margins after SoC are histopathologically confirmed to be negative for carcinoma.

    Measured: 2 weeks

  11. Patient-level Diagnostic Performance to Identify in Vivo Residual Carcinoma After FGR

    Patient-level in vivo diagnostic performance of PD G 506 A-induced fluorescence to determine the presence or absence of residual cancer in the surgical cavity at the end of FGR as compared to the final margin histopathology.

    Measured: 2 weeks

  12. Orientation Discordant Fluorescence Status

    Percentage of orientations where in vivo and ex vivo fluorescence assessments are discordant.

    Measured: 2 weeks

  13. Patient-level Re-operation Rate

    Percentage of patients receiving a 2nd surgery on the ipsilateral breast within 1 year of index BCS to remove suspected residual disease.

    Measured: 1 year

  14. Patient-level Early Re-operation Rate

    Percentage of patients receiving an early 2nd surgery (planned or actual) on the ipsilateral breast related to positive final margins.

    Measured: 3 - 6 months

  15. Amount of Tissue Removed With FGR Beyond SoC

    Weight (mg) of all tissue removed based on SoC and/of FGR.

    Measured: 3 - 6 months

  16. Patient Satisfaction With Breast

    Patient satisfaction with the cosmetic outcome of breast conserving surgery performed based on SoC in combination with PD G 506 A and the Eagle V1.2 Imaging System.

    Measured: 2 weeks, 3-, 6- and 12-months

Timeline

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

  1. First posted24 Mar 2021
  2. Study start27 Apr 2021
  3. Primary completion22 Oct 2024
  4. Study completion20 Dec 2024

Why it stopped: Study terminated due to closure of Sponsor business

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Sequential
Model description
Part A of the study is open-label. All patients in Part A will receive the investigational drug and will undergo standard of care breast conserving surgery (BCS) followed by fluorescence-guided resection. Part B of the study is randomized and placebo controlled; patients will be randomized to receive placebo + standard of care BCS alone or PD G 506 A + SoC BCS followed by fluorescence-guided resection.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
57 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04815083
Sponsor's protocol ID
SBI-CIP 20-002
Status last verified
Aug 2025
First submitted
22 Mar 2021
Last updated
3 Sep 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Aminolevulinic Acid Hydrochloride and Eagle V1.2 Imaging System in people with Breast Neoplasm Female and Breast Cancer, run by SBI ALApharma Canada, Inc. at 7 sites 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?

The sponsor lists 5 inclusion and 31 exclusion criteria. 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: stopped early, as of the sponsor's last update on 3 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 3 Sep 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Positive Margin Conversion Rate (time frame: 2 weeks). 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 3 Sep 2025.

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