Stereotaktische ablative Strahlentherapie bei oligometastasiertem Brustkrebs (TAORMINA)
Behandlung von oligometastatischem Brustkrebs – eine randomisierte Phase-3-Studie zum Vergleich einer stereotaktischen ablativen Strahlentherapie und einer systemischen Behandlung mit einer alleinigen systemischen Behandlung als Erstlinienbehandlung
TAORMINA is an international, multicentre, randomised phase 3 trial for patients with oligometastatic breast cancer (OMBC) that will be allocated to combined stereotactic ablative radiotherapy (SABR) + systemic therapy (investigational arm) versus systemic therapy alone (control arm) as 1st line therapy.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
TAORMINA is an international, multicentre, randomised phase 3 trial for patients with oligometastatic breast cancer (OMBC) that will be allocated to combined stereotactic ablative radiotherapy (SABR) + systemic therapy (investigational arm) versus systemic therapy alone (control arm) as 1st line therapy.
Patients with 1-5 metastases in 1-2 organs (confirmed by PET-CT) with any breast cancer subtype can be enrolled. All metastases must be available for SABR.
The primary aim is to investigate if the addition of SABR to the oligometastatic sites in addition to the standard first-line treatment can improve progression-free survival (PFS).
Secondary aims are to compare overall survival (OS), response rate and time to development of new lesions, acute and late toxicity. quality of life, time to start of chemotherapy (luminal patients).
Exploratory analyses:
Circulating tumour DNA as an early sign of disease progression. Immun panel for determination of the effect of SABR on patients´ immune response.
To investigate the survival for each BC subtype (Luminal, HER2+ and TNBC). To investigate survival in patients with de novo OMBC and recurrent OMBC respectively.
Stratifications are based on subtype (luminal, HER2-positive vs TNBC) and type of OMBC (de novo vs. recurrent) without formal sample size calculation for the stratification factor (exploratory analysis).
Patients with de novo metastatic OMBC that is planned for neoadjuvant treatment are recommended to complete treatment followed by standard surgery and radiotherapy or SABR towards the primary tumour lesion(s).
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Phase 3
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Katarzyna Kulbacka-Ortiz, CTO
- Telefonnummer: +46721470685
- E-Mail: katarzyna.kulbacka-ortiz@vgregion.se
Studieren Sie die Kontaktsicherung
- Name: Annika Baan
- Telefonnummer: +46700906097
- E-Mail: annika.baan@vgregion.se
Studienorte
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Cork, Irland, T12 DC4A
- Rekrutierung
- Cork University Hospital
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Kontakt:
- Ella O'Sullivan, MD
- Telefonnummer: +353 (0) 21 4922000
- E-Mail: ella.osullivan@hse.ie
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Hauptermittler:
- Aisling Barry, Prof.
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Cork, Irland, T12 DV56
- Rekrutierung
- Bon Secours Cork In Partnership with UPMC Hillman Cancer Centre
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Kontakt:
- Karen Molan, MD
- Telefonnummer: +353 (0)21-486 1100
- E-Mail: molank@upmc.ie
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Hauptermittler:
- Kathy Rock, MD
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Dublin, Irland
- Rekrutierung
- St Luke's Radiation Oncology Network (SLRON) at St Luke's Hospital Dublin, St James Hospital Dublin and Beaumont Hospital Dublin
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Kontakt:
- Vitor Oliviera
- Telefonnummer: +353 (0) -1-420 6900
- E-Mail: Vitor.Oliveira@slh.ie
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Hauptermittler:
- Frances Duane, Prof.
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Galway, Irland, H91 YR71
- Rekrutierung
- University Hospital Galway (UHG)
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Kontakt:
- Laura Nally
- Telefonnummer: +353 91 54 2785
- E-Mail: laura.nally@hse.ie
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Hauptermittler:
- Ronan McDermott, MD
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Tel Aviv, Israel, 5265601
- Rekrutierung
- Sheba Medical Center Institute of Oncology
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Kontakt:
- Aliza Ackerstein
- Telefonnummer: +972-3-5302542
- E-Mail: aliza.ackerstein@sheba.health.gov.il
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Kontakt:
- Chen Gross
- E-Mail: Chen.Gross@sheba.health.gov.il
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Hauptermittler:
- Einav Nili Gal-Yam, MD
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Florence, Italien, 3 50134
- Rekrutierung
- Azienda Ospedaliero - Universitaria Careggi
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Kontakt:
- Michela Carracino
- Telefonnummer: +390552751828
- E-Mail: carracinom@aou-careggi.toscana.it
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Hauptermittler:
- Icro Meattini, Prof.
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Milan, Italien
- Rekrutierung
- Humanitas Cancer Centre
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Kontakt:
- Marta Scorsetti, MD, PhD
- Telefonnummer: +39 02 8224 8524
- E-Mail: marta.scorsetti@hunimed.eu
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Hauptermittler:
- Marta Scorsetti, Prof.
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Milan, Italien
- Rekrutierung
- Istituto Nationale Tumori (INT)
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Kontakt:
- Maria Carmen De Santis, MD
- Telefonnummer: +39-0223903280
- E-Mail: mariacarmen.desantis@istitutotumori.mi.it
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Hauptermittler:
- Maria Carmen De Santis, Prof.
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Bergen, Norwegen, 5021
- Rekrutierung
- Haukeland University Hospital
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Kontakt:
- Vidhi Shukla, MD
- Telefonnummer: +47 55 97 50 00
- E-Mail: vidi.shukla@helse-bergen.no
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Hauptermittler:
- Vidhi Shukla, MD
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Oslo, Norwegen, 0424
- Rekrutierung
- Oslo University Hospital, Radiumhospitalet
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Kontakt:
- Veronica Feilum
- Telefonnummer: +47-942244
- E-Mail: uxfeve@ous-hf.no
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Kontakt:
- Maria Elena Rodriguez Aguillar
- E-Mail: maerod@ous-hf.no
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Hauptermittler:
- Vidar Gordon Flote, MD, PhD
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Tromsø, Norwegen, 9019
- Rekrutierung
- Universitetssykehuset Nord-Norge
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Kontakt:
- Kristin Iren Jensen
- Telefonnummer: + 47 77 66 92 12
- E-Mail: Kristin.Iren.Jensen@unn.no
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Kontakt:
- Maria Therese Danielsen
- E-Mail: maria.theres.danielsen@unn.no
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Hauptermittler:
- Hanna Stromholt Bremnes, MD
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Trondheim, Norwegen, 7006
- Rekrutierung
- St. Olavs Hospital
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Kontakt:
- Kjerstin Olaussen
- Telefonnummer: +47-72825782
- E-Mail: Kjerstin.Olaussen@stolav.no
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Kontakt:
- Britt Torun Fjær Nydal
- E-Mail: Britt.Torunn.Fjer.Nydal@stolav.no
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Hauptermittler:
- Solveig Hoff
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Region Jönköpings Län
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Jönköping, Region Jönköpings Län, Schweden, 551 85
- Rekrutierung
- Ryhov County Hospital
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Hauptermittler:
- Maria Ekholm, MD, PhD
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Kontakt:
- Therese Karlsson, Study nurse
- Telefonnummer: +46 10-242 59 62
- E-Mail: therese.i.karlsson@rjl.se
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Region Skåne
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Malmö, Region Skåne, Schweden
- Rekrutierung
- Skånes University Hospital
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Kontakt:
- Charlotta Wollheim, Study nurse
- Telefonnummer: +46 40 337461
- E-Mail: charlotta.wollheim@skane.se
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Hauptermittler:
- Muhammad Kadum, MD
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Region Stockholm
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Stockholm, Region Stockholm, Schweden, 17176
- Rekrutierung
- Karolinska University Hospital
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Kontakt:
- Karin Hedgren, Study nurse
- Telefonnummer: +46-8-123 71746
- E-Mail: karin.hedgren@regionstockholm.se
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Hauptermittler:
- Caroline Boman, MD
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Region Västerbotten
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Umeå, Region Västerbotten, Schweden, 901 85
- Rekrutierung
- Norrlands University Hospital
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Kontakt:
- Dmitry Domkin, Study nurse
- Telefonnummer: +46 90-785 35 95
- E-Mail: dmitry.domkin@regionvasterbotten.se
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Kontakt:
- Jeanette Johansson, Study nurse
- Telefonnummer: +46-90-785 06 89
- E-Mail: jeanette.johansson@regionvasterbotten.se
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Hauptermittler:
- Kristina Weibring, MD, PhD
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Region Örebro Län
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Örebro, Region Örebro Län, Schweden, SE-701 85
- Rekrutierung
- Örebro University Hospital
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Kontakt:
- Emma Nordh, Study nurse
- Telefonnummer: +46 19 602 27 19
- E-Mail: emma.nordh@regionorebrolan.se
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Kontakt:
- Jenny Larsson, Study nurse
- Telefonnummer: +46-31-3426791
- E-Mail: jenny.larsson4@regionorebrolan.se
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Hauptermittler:
- Eva Tegnelius, MD
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Västra Götalandsregionen
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Gothenburg, Västra Götalandsregionen, Schweden, 41345
- Rekrutierung
- Sahlgrenska University Hospital
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Kontakt:
- Katarzyna Kulbacka, Head CTO
- E-Mail: katarzyna.kulbacka-ortiz@vgregion.se
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Kontakt:
- Mitra Sharifi Jahanfard, Study nurse
- Telefonnummer: +46-31-3426791
- E-Mail: mitra.sharifi-jahanfard@vgregion.se
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Ljubljana, Slowenien, 1000
- Rekrutierung
- Institute of Oncology Ljubljana
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Kontakt:
- Minka Macanovic
- Telefonnummer: +386 (0)1 58 79 550
- E-Mail: mmacanovic@onko-i.si
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Kontakt:
- Erika Primc
- E-Mail: eprimc@onko-i.si
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Hauptermittler:
- Ivica Ratoša, MD
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
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Histologically or cytological confirmed recurrent OMBC.
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Age ≥18 years old.
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OMBC defined as 1-5 metastases in a maximum of two organs confirmed by PET-CT.
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Patients already on 1st line systemic treatment can be enrolled if repeated tumour evaluations show stable disease.
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Patients with de novo stage IV OMBC must have a controlled primary tumour regardless of primary surgery or primary systemic treatment.
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Patients with local recurrence and OMBC must have a controlled local recurrence.
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ECOG/WHO 0-2.
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Life expectancy > 6 months.
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Known ER, PgR and HER2 status of either primary tumour or metastasis (preferred).
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Symptomatic bone metastases are allowed if ablative therapy can be delivered.
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Adequate organ function for the planned treatment according to local guide-lines.
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For patients with liver metastasis:
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No cirrhosis or hepatitis
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Hepatic function:
- Total bilirubin level < 3.0 x institutional ULN
- ALT, AST, GGT, and alkaline phosphatase levels < 3.0 x institutional ULN
- Albumin > 2.5 mg/dL
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Metastasis not adjutant to stomach or small bowel.
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For patients with abdominal metastases: adequate renal function with a calculated creatinine clearance of > 60mL/min.
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Toxicities from previous adjuvant therapies (excluding alopecia) must have recovered to grade 1 (defined by CTCAE 5.0). Stable grade 2 peripheral neuropathy are considered individually by the investigator.
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Negative pregnancy test within 14 days prior to start of treatment*.
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If childbearing potential, willing to use an effective form of contraception*.
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No other malignancy during the last 5 years except for radically treated basal or squamous cell carcinoma of the skin or CIS of the cervix.
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Signed informed consent and willingness to follow the trial procedures.
Exclusion Criteria:
- > 1 line of systemic treatment for OMBC due to previous progressing disease (previous treatment of isolated local recurrences with a 2nd adjuvant treatment not included). Change due to toxicity allowed.
- Oligometastases in brain.
- Malignant pleural effusion or ascites.
- Metastasis growth that involves > 3 vertebra and adjacent spinal cord, spine instability or neurological deficit resulting from compression, 25% spinal canal compromise or progressive neurological deficit.
- Unable to undergo imaging by either CT scan or MRI.
- Evidence of any other medical conditions (such as psychiatric illness, infectious diseases, neurological conditions, physical examination or laboratory findings) that may interfere with the planned treatment or affect patient compliance.
- Pregnancy or breast-feeding.
- Concurrent malignancy requiring therapy (excluding non-invasive carcinoma or carcinoma in situ).
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Experimental: Experimental SABR arm
Standard first line systemic therapy + SABR. |
Stereotactic Ablative Radiotherapy is delivered to all metastatic lesions. |
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Kein Eingriff: Control systemic therapy arm
Standard first line systemic therapy. |
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Progression-free survival (PFS)
Zeitfenster: 3 years after the last patient inclusion
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Time from the date of randomisation to the date of disease-progression at any site or death from any cause. |
3 years after the last patient inclusion
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Overall survival (OS)
Zeitfenster: 3 years after the last patient inclusion
|
Time from the date of randomisation to the date of death from any cause. |
3 years after the last patient inclusion
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Local Control Rate (LCR)
Zeitfenster: 3 years after the last patient inclusion
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Time from the date of randomisation to the date of progress in previously treated metastases |
3 years after the last patient inclusion
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Safety analysis - acute toxicity
Zeitfenster: From the first dose of SABR to 3 months after the last dose of SABR
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Reported according to CTCAE v.5.0 |
From the first dose of SABR to 3 months after the last dose of SABR
|
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Safety analysis - late toxicity
Zeitfenster: From the first dose of SABR to 3 years after the last dose of SABR
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Reported according to CTCAE v.5.0 |
From the first dose of SABR to 3 years after the last dose of SABR
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Health-related quality of life Cancer-30
Zeitfenster: At base-line and after 3, 6, 9, 12, 18, 24 and 36 months after registration.
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European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaires Cancer-30 (EORTC-QLQ C30) |
At base-line and after 3, 6, 9, 12, 18, 24 and 36 months after registration.
|
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Health-related quality of life Breast-23
Zeitfenster: At base-line and after 3, 6, 9, 12, 18, 24 and 36 months after registration.
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European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire Breast-23 (EORTC-QLQ B23) |
At base-line and after 3, 6, 9, 12, 18, 24 and 36 months after registration.
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Hauptermittler: Barbro K Linderholm, MD, PhD, Sahlgrenska University Hospital, Gothenburg
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Milano MT, Katz AW, Zhang H, Okunieff P. Oligometastases treated with stereotactic body radiotherapy: long-term follow-up of prospective study. Int J Radiat Oncol Biol Phys. 2012 Jul 1;83(3):878-86. doi: 10.1016/j.ijrobp.2011.08.036. Epub 2011 Dec 13.
- Milano MT, Zhang H, Metcalfe SK, Muhs AG, Okunieff P. Oligometastatic breast cancer treated with curative-intent stereotactic body radiation therapy. Breast Cancer Res Treat. 2009 Jun;115(3):601-8. doi: 10.1007/s10549-008-0157-4. Epub 2008 Aug 22.
- Trovo M, Furlan C, Polesel J, Fiorica F, Arcangeli S, Giaj-Levra N, Alongi F, Del Conte A, Militello L, Muraro E, Martorelli D, Spazzapan S, Berretta M. Radical radiation therapy for oligometastatic breast cancer: Results of a prospective phase II trial. Radiother Oncol. 2018 Jan;126(1):177-180. doi: 10.1016/j.radonc.2017.08.032. Epub 2017 Sep 21.
- Milano MT, Katz AW, Zhang H, Huggins CF, Aujla KS, Okunieff P. Oligometastatic breast cancer treated with hypofractionated stereotactic radiotherapy: Some patients survive longer than a decade. Radiother Oncol. 2019 Feb;131:45-51. doi: 10.1016/j.radonc.2018.11.022. Epub 2018 Dec 28.
- Palma DA, Olson R, Harrow S, Gaede S, Louie AV, Haasbeek C, Mulroy L, Lock M, Rodrigues GB, Yaremko BP, Schellenberg D, Ahmad B, Senthi S, Swaminath A, Kopek N, Liu M, Moore K, Currie S, Schlijper R, Bauman GS, Laba J, Qu XM, Warner A, Senan S. Stereotactic Ablative Radiotherapy for the Comprehensive Treatment of Oligometastatic Cancers: Long-Term Results of the SABR-COMET Phase II Randomized Trial. J Clin Oncol. 2020 Sep 1;38(25):2830-2838. doi: 10.1200/JCO.20.00818. Epub 2020 Jun 2.
- Chalkidou A, Macmillan T, Grzeda MT, Peacock J, Summers J, Eddy S, Coker B, Patrick H, Powell H, Berry L, Webster G, Ostler P, Dickinson PD, Hatton MQ, Henry A, Keevil S, Hawkins MA, Slevin N, van As N. Stereotactic ablative body radiotherapy in patients with oligometastatic cancers: a prospective, registry-based, single-arm, observational, evaluation study. Lancet Oncol. 2021 Jan;22(1):98-106. doi: 10.1016/S1470-2045(20)30537-4.
- Scorsetti M, Franceschini D, De Rose F, Comito T, Villa E, Iftode C, Navarria P, D'Agostino GR, Masci G, Torrisi R, Testori A, Tinterri C, Santoro A. Stereotactic body radiation therapy: A promising chance for oligometastatic breast cancer. Breast. 2016 Apr;26:11-7. doi: 10.1016/j.breast.2015.12.002. Epub 2016 Jan 3.
- David S, Tan J, Savas P, Bressel M, Kelly D, Foroudi F, Loi S, Siva S. Stereotactic ablative body radiotherapy (SABR) for bone only oligometastatic breast cancer: A prospective clinical trial. Breast. 2020 Feb;49:55-62. doi: 10.1016/j.breast.2019.10.016. Epub 2019 Nov 6.
- Li MP, Kelly D, Tan J, Siva S, Kron T, David S. Single-fraction stereotactic ablative body radiotherapy for sternal metastases in oligometastatic breast cancer: Technique and single institution experience. J Med Imaging Radiat Oncol. 2020 Aug;64(4):580-585. doi: 10.1111/1754-9485.13075. Epub 2020 Jun 25.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- SABO 21-01
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