- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01221688
Sentinel Lymph Node Detection After Neoadjuvant Chemotherapy for Large Operable Breast Cancer (GANEA2)
Evaluation of Sentinel Lymph Node Detection After Neoadjuvant Chemotherapy for Large Operable Breast Cancer
Neoadjuvant chemotherapy (NAC) is frequently proposed to patients with large tumours that can be operated in order to increase the chances of breast conservation. After NAC, patients are operated with systematic axillary lymph node dissection (ALND), although more than half of these patients do not have lymph node involvement. These results lead us to consider the indication of the sentinel lymph node (SLN) technique after NAC in order to avoid unnecessary ALND in patients whose SLN is free of involvement.
We need to validate the SLN technique after NAC in patients who have proven lymph node involvement prior to NAC.
GANEA2 is a new trial based on patient treated for a large breast tumor with proven axillary involved nodes. Patients enrolled in this trial will have first an axillary sonography with fine needle punction in case of suspected nodes before NAC. This primary evaluation allow to determine two groups of patients : group 1 (pN+) : patients with proven involved axillary nodes and group 2, patients without proven axillary involved nodes (cN0). Patients of group 1, will undergo SLNB and complete level I-II axillary lymphadenectomy. Patients of group 2 will undergo SLNB and a complete axillary level I-II lymphadenectomy only in the case of detection failure or involved SLN and a SLNB alone in the others cases. Patients of this last group will be followed 5 years in order to evaluate the risk of axillary relapse without lymphadenectomy.
Study Overview
Status
Conditions
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Angers, France, 49055
- Institut de cancerologie de l'ouest
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Angers, France, 49 933
- CHU
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Bordeaux, France, 33000
- Institut Bergonie
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Brest, France, 29609
- CHU
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Clermont Ferrand, France
- Centre Jean Perrin
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La Roche-sur-Yon, France, 85925
- CH
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Lille, France, 59000
- Centre Oscar Lambret
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Lyon, France, 69 000
- Centre Leon Berard
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Marseille, France, 13009
- Institut Paoli Calmette
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Montpellier, France, 34298
- Institut de Cancérologie de Montpellier Val d'Aurelle
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Nancy, France, 54511
- Institut de Cancérlogie de Lorraine
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Paris, France, 75908
- HEGP
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Paris, France, 75000
- Hôpital Lariboisière
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Paris, France, 75000
- Hôpital Européen Georges Pompidou
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Paris, France, 75 000
- Institut Curie
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Saint Herblain, France, 44805
- Institut de cancerologie de l'ouest
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Saint-Cloud, France, 92210
- Institut Curie
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Strasbourg, France
- ICANS
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- T2-T3 operable infiltrating breast carcinoma
- No allergy to Patent Blue
- Pre-operative diagnosis of unifocal infiltrating breast carcinoma.
- Patient planned to be treated by NAC.
- Informed consent.
- Surgery available 4 to 6 weeks after the last chemotherapy course (radical or conservative surgery)
Exclusion Criteria:
- pT4d (inflammatory breast cancer)
- Locally advanced or metastatic breast cancer
- Any previous chemotherapy of contra-lateral breast cancer.
- Breast cancer local relapse
- Previous surgical removal of breast Cancer.
- Inadequate biopsy for pathological analysis.
- Dementia or altered mental disorder
- Pregnant woman or breast feeding or without efficacious contraceptive method.
- Contra-indication to NAC NAC interrupted due to progressive disease.
- Neoadjuvant radiotherapy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: group 2 (cN0)
Patients without proven axillary involved nodes will undergo SLN biopsy and a complete axillary level I-II lymphadenectomy only in the case of detection failure or involved SLN and a SLN biopsy alone in the others cases.
Patients of this last group will be followed 5 years in order to evaluate the risk of axillary relapse without lymphadenectomy.
|
Group 2 : Patients without proven axillary involved nodes will undergo SLNB and a complete axillary level I-II lymphadenectomy only in the case of detection failure or involved SLN and a SLNB alone in the others cases.
Patients of this last group will be followed 5 years in order to evaluate the risk of axillary relapse without lymphadenectomy.
|
Experimental: group 1 (pN+)
group 1 : patients with proven involved axillary nodes will undergo SLN biopsy and complete level I-II axillary lymphadenectomy.
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group 1 : patients with proven involved axillary nodes will undergo SLNB and complete level I-II axillary lymphadenectomy.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
false-negative (FN) rate for the Sentinel Lymph Node Detection
Time Frame: after surgery
|
Ratio of the number of FN cases to the total number of patients with at least one lymph node involved, sentinel or not. a FN case was defined as a patient with a successful mapping, SLN(s) without any metastasis, and a metastasis in at least one node from the ALND |
after surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Detection rate
Time Frame: after surgery
|
Percentage of patients with SLN detected and isolated intraoperatively
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after surgery
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Sataloff score on breast tumour
Time Frame: after surgery
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The Sataloff classification assesses the response of the NAC on the breast tissue. TA: total or almost total therapeutic effect. TB: therapeutic effect > 50%. TC: < 50% therapeutic effect but obvious effect. TD: no therapeutic effect |
after surgery
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Sataloff score on lymph nodes
Time Frame: after surgery
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The Sataloff classification assesses the response of the NAC on the lymph nodes NA: clear therapeutic effect, no metastases.
NB: no therapeutic effect, no metastases.
NC: aspects of therapeutic effect, but presence of metastases.
ND: no therapeutic effect, viable metastases.
|
after surgery
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Homolateral axillary recurrence rate
Time Frame: 5 years post surgery
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Recurrence observed groupe 2 patients (cN0) whitout ALND
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5 years post surgery
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jean-Marc CLASSE, MD, Institut de cancerologie de l'ouest
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- BRD 09/9-G
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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