A Study to Determine the Clinical Significance of Molecular Detection of Breast Cancer in the Blood of Stage IV Breast Cancer Patients

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Washington University School of Medicine
ClinicalTrials.gov Identifier:
NCT00355316
First received: July 19, 2006
Last updated: December 20, 2012
Last verified: December 2012
  Purpose

This study is designed to determine whether molecular detection of breast cancer cells in the peripheral blood of Stage IV breast cancer patients is a clinically relevant predictor of progression-free and overall survival. Stage IV breast cancer patients who have measurable breast cancer metastases and are initiating a regimen of systemic therapy are eligible for enrollment. Multi-marker real-time RT-PCR analysis will be performed on peripheral blood specimens from 92 breast cancer patients and 120 healthy volunteers. Peripheral blood specimens from breast cancer patients will be obtained at the time of study entry (prior to initiation of systemic therapy) and at serial time points during follow-up. Subjects will be followed longitudinally until death, although the study has been powered so that the primary objective can be addressed after 12 months of follow-up. Healthy volunteers will be asked to provide a blood sample at time of enrollment but will not be followed.


Condition Intervention
Breast Neoplasms
Other: Blood draw

Study Type: Observational
Study Design: Observational Model: Case Control
Time Perspective: Prospective
Official Title: Peripheral Blood Molecular Staging of Breast Cancer: A Prospective Cohort Study Designed to Determine the Clinical Significance of Molecular Detection of Breast Cancer in the Peripheral Blood of Stage IV Breast Cancer Patients

Resource links provided by NLM:


Further study details as provided by Washington University School of Medicine:

Primary Outcome Measures:
  • The prevalence of breast cancer cells in the peripheral blood [ Time Frame: 1 year ] [ Designated as safety issue: No ]

Biospecimen Retention:   Samples With DNA

Whole blood, tissue.


Estimated Enrollment: 212
Study Start Date: November 2005
Estimated Study Completion Date: May 2013
Estimated Primary Completion Date: May 2013 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
1
Patients with Stage IV breast cancer.
Other: Blood draw
Blood draws before starting treatment, then monthly for two to three months. If patient is receiving chemotherapy as standard care, they will have blood drawn prior to cycles 1, 2, and 3(approximately every 3-4 weeks for 8-10 weeks, for a total of 3 blood draws). If patients are receiving hormone therapy as standard care, they will have blood drawn prior to beginning treatment, and then approximately every 6 weeks for 12 weeks (3 blood draws total).
2
Healthy Volunteers
Other: Blood draw
One tablespoon of blood will be drawn one time.

Detailed Description:

Enrollment Stage IV breast cancer patients who have measurable breast cancer metastases and are initiating a regimen of systemic therapy are eligible for enrollment.

Phlebotomy Peripheral blood will be obtained from all subjects at the time of initial enrollment, and at serial time-points during follow-up. The first specimen will be drawn prior to the initiation of systemic therapy, and subsequent specimens will be obtained approximately every 6 weeks for approximately 12 weeks depending on the type and schedule of systemic therapy. Results of molecular analyses will not be available to clinical investigators.

Systemic Therapy Subjects initiating hormone therapy, chemotherapy, and/or immunotherapy are eligible for participation.

Restaging Results of patient imaging obtained as part of standard clinical care will be collected as available.

Survival Analysis Subjects will be followed for at least one year following enrollment. All clinical and radiographic data will be reviewed in order to determine the clinical response to therapy. Kaplan-Meier survival estimates will be compared with log-rank testing.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population

Primary care clinic and healthy volunteers.

Criteria

Inclusion Criteria:

Inclusion Criteria - Stage IV breast cancer patients

  1. Patient age must be > 21 years.
  2. Patient must have a tissue diagnosis of invasive breast cancer.
  3. Patient must have documented evidence of metastatic disease.
  4. Patient must have measurable lesions.
  5. Patients must be initiating systemic therapy. Patients receiving hormonal therapy, and/or first-,second-, or third-line chemotherapy alone or in combination with other therapies are eligible.
  6. Patient must have an ECOG performance status of 0, 1, or 2.
  7. Patient must be available for follow-up.
  8. Patient or their authorized legally acceptable representative must consent to be in the study and must have signed and dated an approved consent form which conforms to federal and institutional guidelines.
  9. The patient with a previous history of non-breast malignancy is eligible for this study only if the patient meets the following criteria for a cancer survivor. A cancer survivor is eligible provided the following criteria are met: (1) patient has undergone potentially curative therapy for all prior malignancies, (2) patients have been considered disease free for at least 5 years (with the exception of basal cell or squamous cell carcinoma of the skin or carcinoma-in-situ of the cervix).

Inclusion Criteria - Healthy volunteers

A volunteer will be eligible for inclusion in this study only if ALL of the following criteria apply:

  1. Volunteer age must be > 21 years.
  2. Volunteer or their authorized legally acceptable representative must consent to be in the study and must have signed and dated an approved consent form which conforms to federal and institutional guidelines.
  3. Patients with benign breast disease are eligible for enrollment. Patients with benign breast disease are defined as those patients who are scheduled to undergo a breast tissue sampling procedure. Breast tissue sampling procedures may include fine needle aspiration biopsy, core needle biopsy, including image-guided core needle biopsy, and open surgical biopsy including needle-localization biopsy, and/or excisional biopsy.
  4. The volunteer with a previous history of non-breast malignancy is eligible for this study only if the patient meets the following criteria for a cancer survivor. A cancer survivor is eligible provided both of the following criteria are met: (1) patient has undergone potentially curative therapy for all prior malignancies, (2) patient has been considered disease free for at least 5 years (with the exception of basal cell or squamous cell carcinoma of the skin or carcinoma-in-situ of the cervix).

Exclusion Criteria:

Exclusion Criteria - Stage IV breast cancer patients

A patient will be ineligible for inclusion in this study if ANY of the following criteria apply:

  1. No documented metastatic disease.
  2. No measurable lesions.
  3. Bone only and/or brain metastasis.
  4. Patient is not initiating a new regimen of systemic therapy.
  5. Patient has failed 3 regimens of chemotherapy for metastatic disease, not including adjuvant therapy.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00355316

Locations
United States, Missouri
Washington University School of Medicine
St. Louis, Missouri, United States, 63110
United States, South Carolina
Medical University of South Carolina
Charleston, South Carolina, United States, 29425
Sponsors and Collaborators
Washington University School of Medicine
Investigators
Principal Investigator: William E. Gillanders, M.D. Washington University School of Medicine
  More Information

Additional Information:
Publications:
Pantel, K., R.J. Cote, and O. Fodstad. 1999. Detection and lcinical importance of micrometastic disease. Journal National Cancer Institute 91:1113-1124.
Emmert-Buck, M.R., R.F. Bonner, P.D. Smith, R.F. Chuaqui, Z. Zhuang, S.R. Goldstein, R.A. Weiss, and L.A. Liotta. 1996. Laser capture microdissection. Science 274:998-1001.
Perou, C.M., T. Sorlie, M.B. Eisen, M. van de Rijn, S.S. Jeffrey, C.A. Rees, J.R. Pollack, D.T. Ross, H. Johnsen, L.A. Akslen, O. Fluge, A. Pergamenschikov, C. Williams, S.X. Zhu, P.E. Lonning, A.L. Borresen-Dale, P.O. Brown, and D. Botstein. 2000. Molecular portraits of human breast tumours. Nature 406:747-752.
Hedenfalk, I., D. Duggan, Y. Chen, M. Radmacher, M. Bittner, R. Simon, P. Meltzer, B. Gusterson, M. Esteller, O.P. Kallioniemi, B. Wilfond, A. Borg, and J. Trent. 2001. Gene-expression profiles in hereditary breast cancer. N Engl J Med 344:539-548.
Staunton, J.E., D.K. Slonim, H.A. Coller, P. Tamayo, M.J. Angelo, J. Park, U. Scherf, J.K. Lee, W.O. Reinhold, J.N. Weinstein, J.P. Mesirov, E.S. Lander, and T.R. Golub. 2001. Chemosensitivity prediction by transcriptional profiling. Proc Natl Acad Sci U S A 98:10787-10792.
Banks, R.E., M.J. Dunn, D.F. Hochstrasser, J.C. Sanchez, W. Blackstock, D.J. Pappin, and P.J. Selby. 2000. Proteomics: new perspectives, new biomedical opportunities. Lancet 356:1749-1756.
Mikhitarian, K., W.E. Gillanders, J.S. Almeida, R.H. Martin, J.C. Varela, J.S. Metcalf, D.J. Cole, and M. Mitas. 2005. Relative levels of gene expression are correlated with the ability to detect micrometastatic breast cancer: statistical analysis of data from a multi-institutional prospective cohort study and development of an innovative microarray strategy. Clin Cancer Res In Press.

Responsible Party: Washington University School of Medicine
ClinicalTrials.gov Identifier: NCT00355316     History of Changes
Other Study ID Numbers: 05-0435 / 201109033
Study First Received: July 19, 2006
Last Updated: December 20, 2012
Health Authority: United States: Institutional Review Board

Keywords provided by Washington University School of Medicine:
Breast Cancer
Peripheral
Blood

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms
Neoplasms by Site
Breast Diseases
Skin Diseases

ClinicalTrials.gov processed this record on June 18, 2013