Aggressive Local Therapy for Limited Bone-Only Metastasis to Improve Progression-Free Survival in Breast Cancer Patients

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00929214
Recruitment Status : Active, not recruiting
First Posted : June 26, 2009
Last Update Posted : May 10, 2018
Information provided by (Responsible Party):
M.D. Anderson Cancer Center

Brief Summary:
The goal of this clinical research study is to find out if adding local therapy (surgery and/or radiation) to standard therapy (chemotherapy or endocrine therapy) in the treatment of patients with metastatic breast cancer can help to control the disease for a longer period of time than standard therapy alone.

Condition or disease Intervention/treatment Phase
Breast Cancer Drug: Standard Therapy Procedure: Local Therapy Phase 2

  Show Detailed Description

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 75 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Aggressive Local Therapy for Limited Bone-Only Metastasis to Improve Progression-Free Survival in Breast Cancer Patients
Actual Study Start Date : June 2009
Estimated Primary Completion Date : June 2019
Estimated Study Completion Date : June 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arm Intervention/treatment
Experimental: Standard Therapy + Local Therapy
Systemic Standard Therapy (chemotherapy and/or endocrine therapy) + Local Therapy (surgery and/or radiation)
Drug: Standard Therapy

Chemotherapy and/or Endocrine Therapy:

For 3 - 9 months, all patients will receive systemic chemotherapy agents appropriate for the tumor characteristics and patient's prior treatment history, and may also be placed on endocrine therapy as determined by the treating medical oncologist.

Other Names:
  • Chemotherapy
  • Endocrine Therapy
  • Systemic Chemotherapy

Procedure: Local Therapy

Surgery and/or Radiation Therapy

With no more than 3 bone metastases, local treatments including high-dose radiation therapy and/or surgery will be given. Radiation therapy involves daily treatments during weekdays that may last 5 to 7 weeks in a row. Each daily treatment may last 30 - 40 minutes. Surgery, including recovery, may last 4 to 6 weeks.

Other Names:
  • Radiation Therapy
  • RT
  • XRT
  • Surgery

Primary Outcome Measures :
  1. Number of Patients with Progression-Free Survival (PFS) [ Time Frame: Study assessment at 9 Months ]
    Progression-free survival defined as 1) development of distant soft tissue or visceral metastasis at any time, 2) progression of bone lesion(s) that received planned local therapy (as defined by the imaging response criteria described by Hamaoka et al., and 3) development of new bone lesions after patient receives planned local therapy. Development of additional bone metastasis prior to receiving planned local therapy not be considered as event if the total number of bone metastasis is 3 or less. An event has occurred if additional bone metastasis develops and total number of bone metastasis is 4 or more.

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Breast cancer with metastasis to skeletal sites only
  2. 1 to 3 bone metastatic sites (metastatic lesions in the same bone that are within 3 cm of each other are considered as one site)
  3. KPS greater than or equals to 70
  4. Absolute neutrophil count of > 1500 per microliter and platelet count > 100,000 per microliter; AST and alkaline phosphatase < = 2.5 X normal limits, bilirubin < = 1.5 x normal limits, calculated creatinine clearance > 50 ml/min using Cockcroft-Gault formula: CrCl male = (140-age) x (wt. in kg)/(Serum Cr x 72); CrCl female = 0.85 x (CrCl male)
  5. Patients may or may not have started bis-phosphonates.
  6. Patients who have received prior chemotherapy for their original breast cancer treatment are still eligible.
  7. Previous use of systemic therapy for bone metastasis is allowable as long as the systemic therapy use fits within the treatment plan as described in Proposed Treatment/Study Plan. (If the patient received less than 3 - 9 months of systemic therapy previously, the use of additional systemic therapy may be necessary to fit within the treatment plan)
  8. Treating physician assesses tumor to be sufficiently distant from sensitive structures to be able to achieve greater than or equal to 66 Gy. (i.e., spinal cord tolerance respected in vertebral body metastasis.
  9. Patients with immanent risk of fracture(s) may receive local therapy prior to systemic therapy. Otherwise systemic therapy should be given first as outlined in abstract treatment study plan sections 1 and 2.

Exclusion Criteria:

  1. Distant metastasis to organs (local recurrence and regional lymph node recurrence are not considered as distant metastasis) other than bone
  2. Prior radiation to site(s) of distant metastasis of bone
  3. History of scleroderma and systemic lupus erythematosus which increases the risk of toxicity from radiation treatment
  4. Second primary malignancy (skin cancer other than melanoma allowed) that is disease free for less than 3 years
  5. Premenopausal and postmenopausal (amenorrheic for less than 12 months) women with either a positive or no pregnancy test (serum or urine) at baseline within 7 days study enrollment. Postmenopausal women who are amenorrheic for more than 12 months do not require pregnancy test.
  6. Women with child-bearing potential not using a reliable an appropriate contraceptive method.
  7. Patients with child-bearing potential will agree to use contraception while on study and for 30 days from the date of the last therapy on protocol.
  8. If the patient requires surgery of the bone metastasis, clinically serious comorbidities that render patient not medically fit for surgery (e.g. congestive heart failure, symptomatic coronary artery disease, cardiac arrhythmias and chronic lung disease not well controlled with medication; myocardial infarction within 12 months of enrollment)
  9. Central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant to preclude informed consent or interfere with complying with protocol treatments.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00929214

United States, Texas
University of Texas MD Anderson Cancer Center
Houston, Texas, United States, 77030
Sponsors and Collaborators
M.D. Anderson Cancer Center
Principal Investigator: Eric A. Strom, MD, BS M.D. Anderson Cancer Center

Additional Information:
Responsible Party: M.D. Anderson Cancer Center Identifier: NCT00929214     History of Changes
Other Study ID Numbers: 2008-0319
NCI-2011-02165 ( Registry Identifier: NCI CTRP )
First Posted: June 26, 2009    Key Record Dates
Last Update Posted: May 10, 2018
Last Verified: May 2018

Keywords provided by M.D. Anderson Cancer Center:
Breast Cancer
Limited bone-only metastasis
Local Therapy
Radiation Therapy
Standard Therapy
Endocrine Therapy

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasm Metastasis
Neoplasms by Site
Breast Diseases
Skin Diseases
Neoplastic Processes
Pathologic Processes