3-Day Partial Breast Radiation Therapy for Breast Cancer
Study of 3-Day Partial Breast Radiation Therapy in Women With Breast Cancer
Recruiting
Phase 2Interventional Study
Invasive Ductal Breast CarcinomaInvasive Ductal Carcinoma, BreastDCISDCIS Grade 1DCIS Grade 2Breast Cancer
No Placebo Group
Every participant receives an active treatment — no one gets a placebo.
Prior Safety Data
This treatment has already been tested in at least one earlier human trial.
Ready to participate?
Review the details below, then apply to join this clinical trial.
At a Glance
Age
45 and older
Sex
Female
Trial phase
Phase 2
Study type
Interventional
Purpose
Treatment
Participants needed
280 (estimated)
Sponsor
Memorial Sloan Kettering Cancer Center · Other
Who this trial is looking for
This trial is looking for women with breast cancer or DCIS who have had a lumpectomy. Participants will receive radiation therapy delivered over three days to see if it is effective and safe with fewer side effects.
Are You a Good Fit for This Trial?
You may be able to join if
I am female.
I am at least 45 years old.
I have been diagnosed with breast cancer or DCIS that is less than 3 cm.
I have clear tumor margins.
I have a good performance status (ECOG 0 or 1).
I am not pregnant and have a negative pregnancy test if applicable.
I can give written consent and follow the study requirements.
I will use two forms of birth control if applicable.
You may not be able to join if
I have distant metastasis.
I am currently pregnant or breastfeeding.
I have extensive suspicious microcalcifications or multicentric disease.
I have had prior radiation therapy to my breast or thorax.
I have excessive lymphovascular invasion.
I have extensive intraductal components in my tumor.
I have a currently active second malignancy other than non-melanoma skin cancer.
I am planning to conceive during the trial.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer a few quick questions to see if you may meet the eligibility requirements.
The purpose of this study is to determine if the dose of radiation therapy that is effective in producing a treatment response, delivered over a shorter treatment period, is a safe approach that causes few or mild side effects in women with newly diagnosed breast cancer or DCIS who have had a lumpectomy procedure.
Trial Locations
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Status
Eligibility Criteria
Inclusion Criteria:
* Female
* Age \>/= 45 years
* Unicentric pathological stage I (pT1 or T2 pN0\_M0) invasive ductal breast cancer or DCIS measuring \<3 cm in longest diameter on pathology and/or mammogram that is histologically confirmed. If T2, the tumor must be less than 3cm in longest diamete…
Inclusion Criteria:
* Female
* Age \>/= 45 years
* Unicentric pathological stage I (pT1 or T2 pN0\_M0) invasive ductal breast cancer or DCIS measuring \<3 cm in longest diameter on pathology and/or mammogram that is histologically confirmed. If T2, the tumor must be less than 3cm in longest diameter. Note: Women ≥ 70 years or older with T1 invasive ductal carcinoma who are estrogen- receptor positive (ER+) with clinically negative axillary nodes, and do not undergo surgical lymph node mapping or dissection (i.e., if tumor deposit is 0.2 mm or less, regardless of whether the deposit is detected by immunohistochemistry or hematoxylin and eosin staining) will also be eligible. Patients age 50 or older who are clinically node-negative by physical exam and ultrasound and have a primary tumor that is \<=2 cm and hormone-receptor positive, are also eligible.
* Histologically negative tumor margin or no tumor in a re-excision specimen on final shaved specimen.
* ECOG Performance Status of 0 or 1.
* Negative serum pregnancy test within 14 days prior to study treatment if a woman has child-bearing potential. Subjects of child bearing potential are those who have not been surgically sterilized or have not been free from menses for \> 1 year
* Written informed consent obtained from subject and ability for subject or comply with the requirements of the study
* Female subjects of childbearing potential should be willing to use 2 methods or birth control or be surgically sterile or abstain from heterosexual activity for the duration of study participation. Should a woman become pregnant while participating on study, she should inform the treating physician immediately.
Inclusion Criteria for intermediate risk substudy:
* Post-NAC cohort patients: clinical T1-T2 (less than or equal to 5cm in longest diameter on available imaging) and clinical N0-N1 (on exam and imaging) with pathological ypT0, ypTis, or ypT1 (\<=2cm) and ypN0 (any regimen of neoadjuvant chemotherapy agents is allowed)
OR
* Oncotype RS score of 26 or higher
OR
* PAM50 ROR scored as "HIGH"
OR
* Presence or LVI (focal, limited or "not otherwise specified") in the lumpectomy specimen
OR
* Age 40-49 years (ALL OF THE FOLLOWING MUST BE TRUE : 1) no history of prior benign breast biopsies, 2) no concomitant or prior atypia in either breast, 3) no concomitant or prior LCIS in either breast, 4) no family history of breast cancer in first degree relatives)
OR
* Invasive lobular carcinoma
OR
* Surgical margins less than 1 mm to invasive or in-situ disease.
Exclusion Criteria:
* Patients with distant metastasis
* Patients who are pregnant or breastfeeding
* Patients with diffuse (\>1 quadrant or \>5cm) suspicious microcalcifications or patients with known multicentric OR multifocal disease. (microscopic multifocal disease that may be unifocal and/or appear multifocal due to sectioning is allowed after review with PI).
* Prior radiation therapy to the ipsilateral or contralateral breast or thorax.
* Histological evidence of extensive lymphovascular invasion (LVI)
* Histological evidence of extensive intraductal component (EIC), defined as the presence of intraductal carcinoma both within the primary infiltrating ductal tumor (comprising at least 25% of the tumo area) and intraductal carcinoma present clearly beyond the edges of the invasive tumor.
* Patients are not required to undergo BRCA1 and BRCA2 or other genetic mutation tests in order to enroll on the study. Note: in the event a patient is tested and is found to be a mutation carrier, she would be excluded from the study. It would be an extremely rare/unlikely scenario for patients to be discovered BRCA positive after the completion of PBI, as all patients with risk factors for BRCA mutations (positive family history, Ashkenazi Jewish descent, ER-/PR-/her2-neu-negative receptor status) are usually tested prior to radiation. Should such a situation exist, these patients will be given the option of remaining on the breast conservation paradigm or opting for mastectomy (as is done in this rare scenario is standard of care practice). The patient will be replaced on the trial.
* History of cosmetic or reconstructive breast surgery.
* Medical condition such as uncontrolled infection (including HIV), uncontrolled diabetes mellitus, or connective tissue diseases (lupus, systemic sclerosis, or other collagen vascular diseases) that, in the opinion of the treating physician, would make this protocol unreasonably hazardous for the patient.
* Patients with a "currently active" second malignancy other than non-melanoma skin cancers. Patients are not considered to have "currently active" malignancies if they have completed therapy and are considered by their physicians to be at \<5% risk of relapse within 3 years.
* Patients who are already enrolled in or planning to enroll in other adjuvant systemic therapy protocols for both non-invasive or invasive breast cancer
* Expecting to conceive within the projected duration of the trials, starting with screening visit through 180 days after the last dose of trial treatment
* Concomitant anti-neoplastic treatment is not allowed during protocol treatment and should be completed at least 2 weeks prior to commencement of protocol treatment, with resolution of associated acute toxicities. Bisphosponates are permitted without restriction even during protocol treatment. Note: This does not apply to hormonal therapies such as tamoxifen or AIs, which are permitted. This does not apply to anti-Her2 therapies such as trastuzumab or TDM-1, which are also permitted.
* Ongoing therapy with other investigational agents. Patients may not be receiving any other investigational agents.
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