Targeted Intra-Operative Radiotherapy for the Management of Ductal Carcinoma In-Situ of the Breast
Targeted Intra-Operative Radiotherapy for the Management of Ductal Carcinoma In-Situ of the Breast (TARGIT-DCIS Trial): Use of Mammography and Breast MRI to Identify Candidates for IORT.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
California
-
Los Angeles, California, United States, 90033
- USC/Norris Comprehensive Cancer Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients with biopsy-proven DCIS, mammographic and CE-MRI evidence of DCIS measuring great then equal to 4cm, and a desire to receive breast conserving therapy, will be considered for participation in this study.
- Patient history, physical examination findings, and demographics (sex, age, height, weight, bra size, etc.) will be performed and documented.
Inclusion Criteria for Initial Registration (all patients cohorts):
All cohorts
- Signed informed consent and HIPAA documents
- Female sex
- Age great then equal to 40 years
- Localized ductal carcinoma in situ
- Clinically and/or histologically negative axillary lymph nodes
- No imaging or clinical findings suggestive of invasive carcinoma.
Cohort 1 (Immediate IORT group)
- Localized DCIS measuring less then equal to 4 cm on preoperative imaging.
- Cohort 2 (Delayed IORT group)
- Localized DCIS measuring less then equal to4 cm or less on surgical pathology
- Delayed IORT could be performed for the explicit purpose of administering IORT or performed following re-excision of a previously operated breast to achieve clear surgical margins.
- This cohort includes patients who were excluded from immediate IORT based on pre-operative imaging suggesting ineligibility for immediate IORT, but who are subsequently found to meet histological criteria (localized DCIS less then equal to 4 cm and no invasive cancer) for IORT based on surgical pathology.
- Unifocal microinvasive (T1mic or invasive focus less then equal to 1mm in maximal diameter) is allowed following initial WLE if surgical pathology margins were less then equal to2 mm for both the invasive and non-invasive components.
- Delayed IORT must be performed within 3 months of initial WLE.
- Cohort 3 Subjects who received IORT at the time of initial WLE but whose surgical pathology showed them to be unsuitable candidates for IORT alone on the basis of:
- DCIS measuring greater than 5 cm on surgical pathology.
- T1a (less than 1 mm) or larger invasive carcinoma associated with extensive DCIS.
- Surgical margins width less than1 mm.
Exclusion Criteria:
- Male sex
- Age less than 40
- DCIS associated with any evidence of microinvasion or invasive carcinoma on pre-operative imaging or core biopsy of the breast or axillary nodes.
- DCIS that is multicentric in the ipsilateral breast. Multicentricity will be defined at 2 or more lesions separated by more than 3 cm in the same breast.
- Non-epithelial breast malignancies such as sarcoma or lymphoma
- DCIS associated with diffuse suspicious or indeterminate microcalcifications
- Pregnancy or lactation
- Collagen vascular diseases, including Systemic lupus erythematosus, Systemic sclerosis (scleroderma), CREST Syndrome (calcinosis, Raynaud phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia, and the presence of anticentromere antibodies), polymyositis, dermatomyositis with a CPK level above normal or with an active skin rash, inclusion-body myositis, or amyloidosis
- Serious psychiatric or addictive disorders
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: 1
Patients will receive IORT
|
20Gy to surface of tumor bed and 5Gy at depth of 1cm from surface of tumor bed
Other Names:
20gy to tumor bed, 5gy at depth of 1cm from surface of tumor bed
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Reoperation (Re-excision or Mastectomy) Rates Following WLE or IORT
Time Frame: 30 days
|
These are the rates of reoperation for re-excision or mastectomy following Wide Local Excision (WLE) or Intraoperative Radiation Therapy (IORT).
The number of patients who required reoperation were reported below.
|
30 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Serious Adverse Events.
Time Frame: 2 years
|
Assessment of the overall serious adverse event rate.
|
2 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Heather Macdonald, MD, University of Southern California
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Breast Carcinoma In Situ
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Neoplasms, Glandular and Epithelial
- Adenocarcinoma
- Skin Diseases
- Breast Diseases
- Carcinoma
- Neoplasms, Ductal, Lobular, and Medullary
- Carcinoma in Situ
- Skin and Connective Tissue Diseases
- Breast Neoplasms
- Carcinoma, Intraductal, Noninfiltrating
Other Study ID Numbers
Other Study ID Numbers
- 1B-06-9
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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