PRECISE: Preoperative Radiotherapy to Elicit Critical Immune Stimulating Effects
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|ClinicalTrials.gov Identifier: NCT03359954|
Recruitment Status : Recruiting
First Posted : December 2, 2017
Last Update Posted : July 24, 2018
The goal of this clinical research study is to compare changes to the tumor(s) in your breast before and after radiation.
Radiation treatment is standard treatment after surgery for women with breast cancer. This radiation treatment is typically delivered to the larger breast area for 3-5 weeks of treatment, followed by 1 week of treatment (called a radiation boost) to the area where the tumor used to be. In this study, the radiation boost will be given before surgery rather than after it.
Researchers want to learn about how radiation changes the immune system's response to the tumor, about side effects that develop after radiation treatment, and how radiation kills breast cancer cells.
This is an investigational study. The radiation treatment will be delivered using FDA-approved and commercially available methods. The timing of the radiation boost is considered investigational.
Up to 20 participants will be enrolled in this study. All will be enrolled at MD Anderson.
|Condition or disease||Intervention/treatment||Phase|
|Malignant Neoplasm of Breast||Radiation: Preoperative Boost (RT) Procedure: Breast Surgery Radiation: XRT||Phase 2|
If you agree to take part in this study, you will have an ultrasound of the breast to check the status of the disease.
Leftover tumor tissue from the biopsy performed to diagnose you (called a diagnostic biopsy), if available, will be collected. This is collected so researchers have a baseline (control) sample to compare to the results of testing performed later in this study.
Then, if there is enough tissue to biopsy, image-guided biopsies will be taken of the tumor in the breast. Depending on how you feel, up to 6 biopsies will be performed. To perform an image-guided biopsy, a needle is inserted into the affected area using an ultrasound to collect cells or tissue from the tumor. The doctor will use the imaging to guide the needle into the area. Two (2) types of samples will be collected. A single fine needle aspirate will collect cells and up to 5 core biopsies will be performed to collect small pieces of tissue.
If it is found that there is not enough tissue to biopsy, then you will not have these biopsies, and you will be taken off study.
You will have blood drawn (about 1 teaspoon each time) for tests of your immune system:
- On the same day as your biopsies
- At the time of surgery, while you are in the operating room
About 6 to 8 days before your surgery, you will receive the radiation boost. The radiation boost will be delivered in a similar way it would if you were to receive it after surgery.
You will have an MRI done before surgery.
You will then have your surgery and radiation therapy as scheduled.
You will receive separate consent forms for the radiation therapy and surgery that explains the procedures and the risks.
Information about any side effects you may be having from radiation and/or surgery will be collected from your medical record for up to 6 months after the end of radiation.
Length of Study:
Your participation on this study will be over after your standard, 6-month follow-up visit after the end of radiation therapy.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||20 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||PRECISE: Preoperative Radiotherapy to Elicit Critical Immune Stimulating Effects|
|Actual Study Start Date :||November 16, 2017|
|Estimated Primary Completion Date :||October 2019|
|Estimated Study Completion Date :||October 2020|
Experimental: Preoperative Boost Radiotherapy (RT)
Participants receive preoperative boost RT after completion of neoadjuvant systemic therapy. Participants then undergo definitive oncologic breast surgery followed by standard of practice breast or chest wall RT.
Preoperative boost RT scheduled to occur 6-8 days prior to the date of the participant's definitive breast surgery. Radiation boost delivered to a dose of 7.5Gy in 1 fraction using conformal treatment.
Radiation: Preoperative Boost (RT)
Participants receive preoperative boost RT to breast after completion of neoadjuvant systemic therapy. Preoperative boost RT scheduled to occur 6-8 days prior to the date of the participant's definitive breast surgery. Radiation boost delivered to a dose of 7.5Gy in 1 fraction using conformal treatment.
Procedure: Breast Surgery
Participants undergo definitive oncologic breast surgery after preoperative boost RT.
Participants undergo standard of practice breast or chest wall radiation therapy (RT) after definitive oncologic breast surgery.
Other Name: RT
- Evaluation of Change in Percent of Tumor-Infiltrating Lymphocytes (TIL) [ Time Frame: 6 to 8 days after preoperative radiotherapy ]With 20 patients, a 95% confidence interval for the mean difference between TIL measurements would extend 0.44*s units from the mean (where "s" is the standard deviation of the TIL differences). If the differences are not normally distributed, researchers will report the median difference along with appropriate 95% confidence intervals. Appropriate graphs used to visualize the data.
- Delay Rate of Surgery Following Boost RT [ Time Frame: 4 weeks after boost RT ]
Delay rate defined as the proportion of patients experiencing a > 4 week interval between boost RT and surgery.
The method of Thall, Simon, and Estey employed to perform interim delay rate monitoring.
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 ClinicalTrials.gov identifier (NCT number): NCT03359954
|Contact: Simona F. Shaitelman, MDfirstname.lastname@example.org|
|United States, Texas|
|University of Texas MD Anderson Cancer Center||Recruiting|
|Houston, Texas, United States, 77030|
|Principal Investigator:||Simona F. Shaitelman, MD||M.D. Anderson Cancer Center|