- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05912231
Ultrahypofractionation and Normal Tissue Toxicity
Proton Versus Photon Ultrahypofractionated Radiation Therapy and Its Impact on Normal Tissue
This research is being done to see if proton beam radiation therapy (PBT) results in fewer changes to a participant's heart measured with MRI-imaging than conventional or "photon" radiation therapy (XRT) for participants with non-metastatic left sided breast cancer.
The names of the two study groups in this research study are:
- Proton Radiation Therapy (PBT)
- Conventional or "Photon" Radiation Therapy (XRT)
Study Overview
Status
Conditions
Detailed Description
This is a randomized phase II trial comparing participants with stage II-III breast cancer treated with accelerated Proton Beam Radiation Therapy (PBT) versus accelerated conventional photon radiation therapy (XRT) inclusive of the regional lymph nodes.
Participants will be randomized into one of two study groups: proton beam radiation therapy versus photon radiation therapy. Randomization means that participants are put into a group by chance.
Study procedures includes screening for eligibility, study treatment visits, Cardiac Magnetic Resonance Imaging (MRI), blood tests, and questionnaires.
The National Cancer Institute, American Society of Clinical Oncology, and Claflin Grant are supporting this research by providing funding for the research study.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Rachel Jimenez, MD
- Phone Number: 617-726-8651
- Email: RBJIMENEZ@PARTNERS.ORG
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02215
- Recruiting
- Massachusetts General Hospital Cancer Center
-
Contact:
- Rachel Jimenez, MD
- Phone Number: 617-726-8651
- Email: RBJIMENEZ@PARTNERS.ORG
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- ≥18 years of age
- Non-metastatic Breast Cancer patients who are scheduled to receive conventional left-sided or bilateral breast/chest wall RT inclusive of treatment to the internal mammary lymph nodes (IMNs)
- Prior chemotherapy is permitted
- Ability to understand and the willingness to sign a written informed consent document
- No contraindication to MRI
- Patients with right-sided breast cancer or patients with left-sided patients not requiring treatment to the IMNs, but where cardiac anatomy is determined to be unfavorable by the study PI, will be considered eligible.
Exclusion Criteria:
- Person who is pregnant or breastfeeding.
- Patients receiving any other investigational agent will not be excluded from study eligibility, unless the patient is already enrolled in an interventional study evaluating cardiac toxicity. No cytotoxic therapy or radiotherapy may be used during radiation therapy.
- Contra-indication to gadolinium contrast (e.g., chronic kidney disease)
- Contra-indication to radiotherapy (e.g., scleroderma, p53 mutation)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Accelerated Proton Beam Radiation Therapy (PBT) Group
Participants will be randomized 1:1 to XRT group and stratified by receipt of chemotherapy and cardiac risk factors and will complete:
|
per protocol
|
Experimental: Accelerated Photon Radiation Therapy (XRT) Group
Participants will be randomized 1:1 to XRT group and stratified by receipt of chemotherapy and cardiac risk factors and will complete:
|
per protocol
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Myocardial Fibrosis from Baseline in Proton Beam Radiation Therapy (PBT)
Time Frame: Up to 7 months (pre-treatment period to 6 month follow up)
|
The primary outcome is to determine whether participants who receive accelerated PBT show no increase in myocardial fibrosis on Cardiac MRI (CMR) compared to an estimated 4% increase in extracellular matrix volume fraction (ECV) in participants who receive accelerated XRT.
CMR will be performed using a 3T system (Skyra, Siemens).
The T1 phase on MRI will be used to measure ECV.
|
Up to 7 months (pre-treatment period to 6 month follow up)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Global Longitudinal Strain (GLS) on CMR from Baseline
Time Frame: Up to 7 months (pre-treatment period to 6 month follow up)
|
GLS will be measured using feature tracking from the Steady-state free precession (SSFP) MRI cine images (Medis Suite, Leiden).
|
Up to 7 months (pre-treatment period to 6 month follow up)
|
Stability of Cardiac Biomarkers from Baseline
Time Frame: Up to 7 months (pre-treatment period to 6 month follow up)
|
Cardiac Biomarkers will be measured using enzyme-linked immunoassay (ELISA).
|
Up to 7 months (pre-treatment period to 6 month follow up)
|
Body Image Evaluation
Time Frame: Up to 13 months (pre-treatment period to 12 month follow up)
|
Assessed by photographic imaging of the breast, chest wall and reconstructed breast, the Breast Q: Mastectomy Module (Postoperative) 2.0, the Breast Q: Reconstruction Module (Postoperative) 2.0, and the Breast-Q: Breast Conserving Therapy Module (Postoperative) 2.0 questionnaires which are rigorous patient-report outcome measures.
Modules grade Quality of Life (QOL) and Satisfaction Domains related to post-operative care and experiences.
All BREAST-Q scales are transformed into scores that range from 0-100.
T. A higher score means greater satisfaction or better QOL (depending on the scale).
|
Up to 13 months (pre-treatment period to 12 month follow up)
|
Change in Shoulder Function from Baseline
Time Frame: Up to 13 months (pre-treatment period to 12 month follow up)
|
Assessed by the Thoracic Focused Assessment with Sonography for Trauma, Triage, and Tracking (TFAST), the Penn Shoulder Scale (PSS), and the Disabilities of the Arm, Shoulder and Hand (DASH) Shoulder Function Scale.
TFAST is an objective and highly reproducible functional assessment tool of the arm and shoulder.
The PSS is a patient-reported outcome tool which provides a shoulder-specific metric and distinguishes between finer levels of functioning.
Scores range from 0 to 100 with a score of 100 indicating low pain, high satisfaction, and high function.
DASH is a 30-item, validated, patient-reported scale that captures upper extremity functionality and mobility and maintains high construct validity and responsiveness in the breast cancer population.
Questions are graded on a Likert scale with scores ranging from "1" Strongly Disagree to "5" Strongly Agree, where a cumulative score of 0 is graded no disability and 100 is most severe disability.
|
Up to 13 months (pre-treatment period to 12 month follow up)
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Rachel Jimenez, MD, Massachusetts General Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- 23-182
- P01CA261669 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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