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Screening Magnetic Resonance Imaging of the Brain in Patients With Breast Cancer

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ClinicalTrials.gov Identifier: NCT04030507
Recruitment Status : Recruiting
First Posted : July 24, 2019
Last Update Posted : December 13, 2022
Sponsor:
Collaborator:
Conquer Cancer Foundation
Information provided by (Responsible Party):
Ayal Aizer, MD, Dana-Farber Cancer Institute

Study Description
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Brief Summary:
This research study is studying the usefulness of magnetic resonance imaging (MRI) to screen for brain metastases (spread of the breast cancer to the brain).

Condition or disease Intervention/treatment Phase
Breast Cancer HER2-positive Breast Cancer Triple Negative Breast Cancer Hormone Receptor Positive Malignant Neoplasm of Breast Inflammatory Breast Cancer Metastatic Breast Cancer Device: MRI Not Applicable

Detailed Description:

This research study is a Phase II clinical trial. Phase II clinical trials examine the safety and effectiveness of an investigational intervention, in this case magnetic resonance imaging (MRI) of the brain, to learn whether it is helpful in managing a specific disease.

In this research study, the investigators are utilizing screening MRIs of the brain to evaluate breast cancer patients for metastases to the brain. The investigators hope to understand whether screening MRIs of the brain can be implemented into the standard of care to earlier detect brain metastases in a population where screening MRIs of the brain are not currently recommended or systematically performed.

This trial will contain 4 cohorts:

1. Those with triple negative breast cancer (TNBC) will undergo screening MRI of the brain as part of a single arm, non-comparative study

2+3. Those with hormone receptor positive/(human epidermal growth factor receptor 2 (HER2) negative (HR+/HER2-) and HER2 positive (HER2+) subtypes will be randomized to receipt of screening MRI of the brain or no screening MRI of the brain to definitively test the value of MRI screening.

4. Patients with inflammatory breast cancer being treated with curative intent will undergo screening MRI of the brain as part of a single arm, non-comparative study.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 214 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Screening
Official Title: Screening Magnetic Resonance Imaging of the Brain in Patients With Metastatic Breast Cancer Managed With First/Second Line Chemotherapy or Inflammatory Breast Cancer Managed With Definitive Intent: A Prospective Study
Actual Study Start Date : July 26, 2019
Estimated Primary Completion Date : February 2024
Estimated Study Completion Date : February 2025

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: Inflammatory Breast Cancer Managed with Curative Intent
  • Patients will receive an initial screening magnetic resonance imaging (MRI) of the brain
  • If no evidence of intracranial involvement is identified, additional screening MRIs of the brain every six months for two years and at initial systemic progression.
 Device: MRI
MRI (which stands for magnetic resonance imaging) provide imaging of the brain which help look for brain metastases (spread of the breast cancer to the brain).
Other Name: Magnetic Resonance Imaging
Experimental: HR+ or HER2+ Metastatic Breast Cancer - Screening Arm
  • An initial MRI screening will be conducted
  • If negative, patients will receive a second MRI of the brain at first systemic progression after study entry
 Device: MRI
MRI (which stands for magnetic resonance imaging) provide imaging of the brain which help look for brain metastases (spread of the breast cancer to the brain).
Other Name: Magnetic Resonance Imaging
No Intervention: HR+ or HER2+ Metastatic Breast Cancer - No Screening Arm
No initial MRI screening will be conducted
Experimental: Triple Negative Breast Cancer
  • An initial MRI screening will be conducted
  • If negative, patients will receive a second MRI of the brain at first systemic progression after study entry
 Device: MRI
MRI (which stands for magnetic resonance imaging) provide imaging of the brain which help look for brain metastases (spread of the breast cancer to the brain).
Other Name: Magnetic Resonance Imaging


Outcome Measures
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Primary Outcome Measures :
  1. Neurologic Quality of Life at 12 Months using the MD Anderson Symptom Inventory - Brain Tumor Module [ Time Frame: 12 Months ]
    For patients with HR+/HER2- or HER2+ metastatic breast cancer

  2. Incidence of Symptomatic Brain Metastases [ Time Frame: Through study completion, an average of 1 year ]
    For patients with triple negative metastatic breast cancer

  3. Incidence of Brain Metastases [ Time Frame: Through study completion, an average of 1 year ]
    For patients with inflammatory breast cancer managed with curative intent


Secondary Outcome Measures :
  1. Number of brain metastases [ Time Frame: Through study completion, an average of 1 year ]
  2. Size of brain metastases [ Time Frame: Through study completion, an average of 1 year ]
  3. Development of metastases in the brainstem as seen on magnetic resonance imaging of the brain [ Time Frame: Through study completion, an average of 1 year ]
  4. Development of leptomeningeal carcinomatosis as seen on magnetic resonance imaging of the brain [ Time Frame: Through study completion, an average of 1 year ]
  5. Radiographic appearance of brain metastases [ Time Frame: Through study completion, an average of 1 year ]
  6. Development of symptomatic brain metastases based on review of medical notes / history [ Time Frame: Through study completion, an average of 1 year ]
  7. Neurologic death [ Time Frame: Through study completion, an average of 1 year ]
  8. All-cause mortality [ Time Frame: Through study completion, an average of 1 year ]
  9. Development of seizures based on review of medical notes / history [ Time Frame: Through study completion, an average of 1 year ]
  10. Receipt of whole brain radiation due to brain metastases [ Time Frame: Through study completion, an average of 1 year ]
  11. Receipt of neurosurgical resection due to brain metastases [ Time Frame: Through study completion, an average of 1 year ]
  12. Quality of life assessment via EuroQol Group 5D Instrument [ Time Frame: Through study completion, an average of 1 year ]
  13. Neurocognitive function using the Hopkins Verbal Learning Test Instrument [ Time Frame: Through study completion, an average of 1 year ]
  14. Neurocognitive function using the Trail Making Test Instrument [ Time Frame: Through study completion, an average of 1 year ]
  15. Neurocognitive function using the Controlled Oral Word Association Test [ Time Frame: Through study completion, an average of 1 year ]
  16. Neurocognitive function using the Mini-Mental Status Exam Instrument [ Time Frame: Through study completion, an average of 1 year ]

Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Participants must have histologically or cytologically confirmed breast cancer with pathologic assessment of estrogen receptor (ER), progesterone receptor (PR), and (human epidermal growth factor receptor 2 (HER2) status. If subtype has changed over the course of a patient's disease, the treating clinician and/or study PI is responsible for selecting the subtype that most likely reflects the preponderance of oncologic disease at the time of enrollment.
  • Participants must have radiographic evidence of extracranial, distant metastases or unresectable, locally recurrent breast cancer and be initiating (within 8 weeks of registration) first-line or second-line chemotherapy for their metastatic/recurrent disease OR inflammatory breast cancer being managed with curative intent within six months of diagnosis.
  • Participants must be age 18 years or older.
  • Participants must have a life expectancy of greater than 12 weeks.
  • Participants must be willing to undergo study procedures.
  • The effects of gadolinium / other magnetic resonance imaging (MRI)-based contrast agents on the developing human fetus are unknown. For this reason, women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately.
  • Participants must possess the ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • Participants who have a contraindication to MRI (e.g. noncompatible implanted metallic device for which MRI is absolutely contraindicated).
  • Participants who have chronic kidney disease stage IV-V or end stage renal disease.
  • Participants with a history of anaphylactic reactions to gadolinium.
  • Pregnant women are excluded from this study because gadolinium-based agents have not been proven to be safe to administer to a developing fetus. Similarly, breastfeeding women will be excluded from this study.
  • Patients with a prior diagnosis of brain metastases
Contacts and Locations
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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 ClinicalTrials.gov identifier (NCT number): NCT04030507


Contacts
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Contact: Ayal Aizer, MD, MHS 617-732-7560 aaaizer@partners.org

Locations
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United States, Massachusetts
Brigham and Women's Hospital Recruiting
Boston, Massachusetts, United States, 02115
Contact: Ayal Aizer    617-732-7560    aaaizer@partners.org   
Principal Investigator: Ayal Aizer, MD, MHS         
Sponsors and Collaborators
Dana-Farber Cancer Institute
Conquer Cancer Foundation
Investigators
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Principal Investigator: Ayal Aizer, MD, MHS Brigham and Women's Hospital
More Information
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Responsible Party: Ayal Aizer, MD, Principal Investigator, Dana-Farber Cancer Institute
ClinicalTrials.gov Identifier: NCT04030507    
Other Study ID Numbers: 19-066
First Posted: July 24, 2019    Key Record Dates
Last Update Posted: December 13, 2022
Last Verified: December 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: [contact information for Sponsor Investigator or designee]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Informed Consent Form (ICF)
Time Frame: Data can be shared no earlier than 1 year following the date of publication
Access Criteria: BWH - Contact the Partners Innovations team at http://www.partners.org/innovation DFCI - Contact the Belfer Office for Dana-Farber Innovations (BODFI) at innovation@dfci.harvard.edu

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: Yes
Product Manufactured in and Exported from the U.S.: No
Keywords provided by Ayal Aizer, MD, Dana-Farber Cancer Institute:
Breast Cancer
HER2-positive Breast Cancer
Triple Negative Breast Cancer
 Hormone Receptor Positive Malignant Neoplasm of Breast
Inflammatory Breast Cancer
Metastatic breast cancer
Additional relevant MeSH terms:
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Breast Neoplasms
Neoplasms
Triple Negative Breast Neoplasms
Inflammatory Breast Neoplasms
 Neoplasms by Site
Breast Diseases
Skin Diseases