Mometasone Furoate in Preventing Radiation Dermatitis in Patients Undergoing Radiation Therapy to the Breast or Chest Wall for Invasive Breast Cancer or Ductal Carcinoma in Situ
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Purpose
RATIONALE: Steroid therapy, such as mometasone furoate, may prevent radiation dermatitis caused by radiation therapy. It is not yet known whether mometasone furoate is more effective than a placebo in preventing radiation dermatitis.
PURPOSE: This randomized phase III trial is studying mometasone furoate to see how well it works compared to a placebo in preventing radiation dermatitis in patients undergoing radiation therapy to the breast or chest wall for invasive breast cancer or ductal carcinoma in situ.
| Condition | Intervention | Phase |
|---|---|---|
|
Breast Cancer Dermatologic Complications Radiation Toxicity Skin Reactions Secondary to Radiation Therapy |
Drug: mometasone furoate Other: placebo |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Masking: Double-Blind Primary Purpose: Supportive Care |
| Official Title: | Phase III Randomized Double-Blind Study of Mometasone Furoate Versus Placebo in the Prevention of Radiation Dermatitis in Breast Cancer Patients Receiving Radiation Therapy |
- Maximum grade of radiation dermatitis as measured by NCI CTCAE v3.0 [ Designated as safety issue: Yes ]
- Incidence of severe (grade ≥ 3) radiation dermatitis [ Designated as safety issue: Yes ]
- Time to onset of severe radiation dermatitis [ Designated as safety issue: Yes ]
- Duration of severe radiation dermatitis [ Designated as safety issue: Yes ]
- Overall quality of life (QOL) as measured by Linear Analogue Self-Assessment (LASA) [ Designated as safety issue: No ]
- QOL domains as measured by LASA [ Designated as safety issue: No ]
- Skin toxicity as measured by Skindex-16 [ Designated as safety issue: Yes ]
- Skin toxicity as measured by the Skin Toxicity Assessment Tool [ Designated as safety issue: Yes ]
- Frequency and severity of adverse events reported by the patient in the Symptom Experience Diary and assessed clinically by NCI CTCAE v3.0 [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 148 |
| Study Start Date: | August 2007 |
| Primary Completion Date: | January 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I
Patients apply mometasone furoate cream once daily to the treatment area (breast or chest wall) for the duration of planned radiotherapy.
|
Drug: mometasone furoate
Applied to treatment area
|
|
Placebo Comparator: Arm II
Patients apply an identical-appearing placebo cream to the treatment area as in arm I.
|
Other: placebo
Applied to treatment area
|
Detailed Description:
OBJECTIVES:
Primary
- Compare the efficacy of mometasone furoate vs placebo, in terms of decreased maximal severity of radiation dermatitis, in patients undergoing primary or adjuvant radiotherapy to the breast or chest wall for invasive breast cancer or ductal carcinoma in situ.
Secondary
- Compare the incidence of severe (grade ≥ 3) radiation dermatitis in patients treated with these drugs.
- Compare the time to onset and duration of severe radiation dermatitis in these patients.
- Assess skin toxicity and quality of life of these patients.
- Assess the adverse event profile of mometasone furoate in these patients.
- Compare skin toxicity data, in terms of provider-completed and patient-reported assessments, of patients treated with these drugs.
OUTLINE: This is a randomized, double-blind, placebo-controlled study. Patients are stratified according to radiation field (breast [post-lumpectomy] vs chest wall [post-mastectomy]), regional lymph nodes (treated vs not treated), and planned total radiation dose (including boost) (50-55 Gy vs > 55 Gy). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients apply mometasone furoate cream once daily to the treatment area (breast or chest wall) for the duration of planned radiotherapy.
- Arm II: Patients apply an identical-appearing placebo cream to the treatment area as in arm I.
Patients complete questionnaires and a symptom experience diary at baseline and periodically during study for quality of life, skin toxicity, and adverse event assessment.
After completion of radiotherapy, patients are followed for 2 weeks.
PROJECTED ACCRUAL: A total of 148 patients will be accrued for this study.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
- Histologically confirmed diagnosis of primary invasive breast cancer or ductal carcinoma in situ
Planning to undergo ≥ 5 weeks of continuous definitive or adjuvant external-beam radiotherapy to 1 of the following sites:
- Whole breast (as part of breast-conservation therapy)
Chest wall (as part of post-mastectomy irradiation)
- Treatment of regional lymph nodes (i.e., axillary, supraclavicular, or internal mammary) allowed
Must meet the following criteria for planned radiotherapy:
- Planned total radiation dose ≥ 5,000 Gy and daily radiation dose between 1.75 and 2.12 Gy
- No planned split-course radiotherapy
- No partial breast treatment, defined as treatment of < 75% of the breast parenchyma
- Intensity-modulated radiotherapy planning and delivery, conventional radiotherapy, or 3-dimensional radiotherapy techniques allowed
Must be entered on study within 7 days prior to beginning radiotherapy
- Must start study drug prior to receiving the third radiotherapy fraction
- No preexisting skin breakdown within the planned radiotherapy field at the time of study entry
- No bilateral breast cancer treatment
- No inflammatory carcinoma of the breast
- Hormone receptor status not specified
PATIENT CHARACTERISTICS:
- Male or female
- Menopausal status not specified
- ECOG performance status 0-2
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Able to complete questionnaires independently or with assistance
- No known allergy or hypersensitivity to mometasone furoate (Elocon® or generic cream), imidazolidinyl urea, or formaldehyde
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior radiotherapy to the planned radiotherapy treatment area
No concurrent or planned leukotriene inhibitors, including the following:
- Zafirleukast
- Monteleukast
- Zileuton
No concurrent or planned use of any prescription or over-the-counter medications containing hydrocortisone or any other cortisone or steroid-containing preparations (systemic, local, or topical) including, but not limited to, the following creams or ointments:
- Cortaid®
- Cortizone 10®
- Tucks®
- Preparation H®
- No other concurrent topical agents (e.g., lotions, aloe vera) to radiotherapy field during study treatment
Contacts and Locations
Show 189 Study Locations| Study Chair: | Robert C. Miller, MD | Mayo Clinic |
| Investigator: | Patricia Griffin, MD | Gibbs Regional Cancer Center at Spartanburg Regional Medical Center |
| Investigator: | James A. Martenson, MD | Mayo Clinic |
More Information
Additional Information:
Publications:
| Responsible Party: | Charles L. Loprinzi, North Central Cancer Treatment Group |
| ClinicalTrials.gov Identifier: | NCT00438659 History of Changes |
| Other Study ID Numbers: | CDR0000530309, NCCTG-N06C4 |
| Study First Received: | February 20, 2007 |
| Last Updated: | September 20, 2011 |
| Health Authority: | United States: Federal Government |
Keywords provided by National Cancer Institute (NCI):
|
dermatologic complications skin reactions secondary to radiation therapy radiation toxicity breast cancer in situ recurrent breast cancer stage I breast cancer stage II breast cancer |
stage IIIA breast cancer stage IIIB breast cancer stage IIIC breast cancer male breast cancer ductal breast carcinoma in situ stage IV breast cancer |
Additional relevant MeSH terms:
|
Breast Neoplasms Carcinoma in Situ Carcinoma, Intraductal, Noninfiltrating Dermatitis Radiodermatitis Radiation Injuries Neoplasms by Site Neoplasms Breast Diseases Skin Diseases Carcinoma |
Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Adenocarcinoma Neoplasms, Ductal, Lobular, and Medullary Wounds and Injuries Mometasone furoate Anti-Allergic Agents Therapeutic Uses Pharmacologic Actions Anti-Inflammatory Agents |
ClinicalTrials.gov processed this record on May 21, 2013