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Adjuvant Radiation Therapy Compared With Observation After Surgery in Treating Women With Estrogen Receptor Positive or Progesterone Receptor Positive Ductal Carcinoma In Situ of the Breast Who Are Receiving Tamoxifen or Anastrozole

Basic Trial Information
Trial Description
     Summary
     Further Trial Information
     Eligibility Criteria
Trial Contact Information

Basic Trial Information

PhaseTypeStatusAgeSponsorProtocol IDs
Phase IIBiomarker/Laboratory analysis, TreatmentClosed40 to 70OtherCDR0000349580
ICR-DCIS-II, EU-20341, NCT00077168

Trial Description

Summary

RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known whether radiation therapy after surgery is effective in preventing a recurrence of ductal carcinoma in situ.

PURPOSE: This randomized phase II trial is studying adjuvant radiation therapy to see how well it works compared to observation after surgery in treating women with estrogen receptor positive or progesterone receptor positive ductal carcinoma in situ and are also receiving either tamoxifen or anastrozole.

Further Study Information

OBJECTIVES:

Primary

  • Compare ipsilateral tumor relapse and breast cancer metastases in women with completely excised low-risk estrogen receptor- or progesterone receptor-positive ductal carcinoma in situ of the breast receiving adjuvant tamoxifen or anastrozole and treated with adjuvant radiotherapy vs observation alone.
  • Compare the quality of life of patients treated with these regimens.

Secondary

  • Determine the minimal surgical margins required to minimize the local recurrence rate in patients treated with these regimens.
  • Identify molecular markers that predict ipsilateral tumor recurrence in patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating center. Patients are randomized to 1 of 2 treatment arms.

All patients receive adjuvant tamoxifen or anastrozole for 5 years.

  • Arm I: Patients undergo radiotherapy 5 days a week for 3 or 5 weeks.
  • Arm II: Patients undergo observation alone. Quality of life is assessed at baseline, at 6 months, and then at 1, 2, and 5 years.

Patients are followed every 6 months for 1 year and then annually for up to 10 years.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 2,000 patients (1,000 per treatment arm) will be accrued for this study within 5 years.

Eligibility Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of unifocal ductal carcinoma in situ of the breast without an invasive component
  • Microinvasion (defined as 1 or more foci of invasion each < 1 mm) allowed
  • Prior complete microscopic excision (within the past 6 months) with a minimum radial margin of 1 mm by specimen x-ray required
  • Maximum microscopic tumor diameter < 30 mm (< 15 mm if grade 3 tumor)
  • Planning to receive adjuvant tamoxifen or anastrozole for 5 years
  • Eligible patients may receive adjuvant endocrine therapy on ICR-IBIS-II
  • Hormone receptor status:
  • Estrogen receptor positive OR
  • Progesterone receptor positive
  • More than 10% tumor staining for receptor OR a cutpoint of ≥ 2

PATIENT CHARACTERISTICS:

Sex

  • Female

Menopausal status

  • Premenopausal, perimenopausal, or postmenopausal

Performance status

  • Not specified

Life expectancy

  • Not specified

Hematopoietic

  • Not specified

Hepatic

  • Not specified

Renal

  • Not specified

Cardiovascular

  • No prior deep vein thrombosis

Pulmonary

  • No prior pulmonary embolus

Other

  • No unexplained postmenopausal bleeding
  • No contraindication to full-dose radiotherapy to the breast
  • No other cancer within the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • Not specified

Endocrine therapy

  • See Disease Characteristics
  • No prior tamoxifen or raloxifene use for more than 3 months in duration

Radiotherapy

  • Not specified

Surgery

  • See Disease Characteristics
  • No prior mastectomy

Other

  • No concurrent anticoagulants

Trial Contact Information

Trial Lead Organizations/Sponsors

Institute of Cancer Research - Sutton

Ronald Kaggwa

Link to the current ClinicalTrials.gov record.
NLM Identifer NCT00077168
Information obtained from ClinicalTrials.gov on December 14, 2011

Note: Information about this trial is from the ClinicalTrials.gov database. The versions designated for health professionals and patients contain the same text. Minor changes may be made to the ClinicalTrials.gov record to standardize the names of study sponsors, sites, and contacts. Cancer.gov only lists sites that are recruiting patients for active trials, whereas ClinicalTrials.gov lists all sites for all trials. Questions and comments regarding the presented information should be directed to ClinicalTrials.gov.

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