TAILOR RT: A Randomized Trial of Regional Radiotherapy in Biomarker Low Risk Node Positive Breast Cancer
Investigating the Effects of Regional Radiation Therapy in Low Risk Breast Cancer
Brief description of study.
The purpose of this study is to compare the effects on low risk breast cancer receiving usual care that includes regional radiation therapy, with receiving no regional radiation therapy.
Detailed description of study
Researchers want to see if not giving this type of radiation treatment works as well at preventing breast cancer from coming back.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Breast Cancer
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Age: 40 years - 100 years
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Gender: Female
Inclusion Criteria
Patients must have newly diagnosed histologically proven invasive carcinoma of the breast with no evidence of metastases
Patients must have been treated by BCS or mastectomy
Patients treated by BCS or mastectomy and axillary dissection must have 1-3 positive axillary nodes (macrometastases, > 2 mm)
Patients treated by BCS and SLNB alone must have only 1-2 positive axillary nodes (macrometastases, > 2 mm)
Patients treated by mastectomy and SLNB alone must have only 1 positive axillary node (macrometastases, > 2 mm)
Patients must be ER ≥ 1% and HER2 negative on local testing
Patients must have an Oncotype DX recurrence score <18
Patient must consent to provision of, and investigator(s) must confirm access to and agree to submit to the CCTG Central Tumour Bank, a representative formalin fixed paraffin block of tumour tissue in order that the specific correlative marker assays described in the protocol may be conducted
Patient must consent to provision of samples of blood in order that the specific correlative marker assays described in the protocol may be conducted
Patients must have had endocrine therapy initiated or planned for ≥ 5 years. Endocrine therapy can be given concurrently or following RT.
Patients may or may not have had adjuvant chemotherapy
RT must be administered within 12 weeks of definitive surgery if the patient is not treated with chemotherapy. If adjuvant chemotherapy is given, RT must begin within 2-8 weeks after the last dose
Women of childbearing potential must have agreed to use an effective contraceptive method. A woman is considered to be of "childbearing potential" if she has had menses at any time in the preceding 12 consecutive months.
Exclusion Criteria
Patients with nodal disease limited to micrometastases (pN1Mi, > 0.2 mm and ≤ 2 mm) or isolated tumour cells (pN0i+ < 0.2 mm)
Any prior history, not including the index cancer, of ipsilateral invasive breast cancer or ipsilateral DCIS treated with radiation therapy. (Patients with synchronous or previous ipsilateral LCIS are eligible.)
Synchronous or previous contralateral invasive breast cancer. (Patients with contralateral DCIS not treated with radiation are eligible.)
History of non-breast malignancies except adequately treated non-melanoma skin cancers, in situ cancers treated by local excision or other cancers curatively treated with no evidence of disease for ≥ 5 years
Patients with pT3 or pT4 disease
Patients who are pregnant
Patients that have had prior ipsilateral chestwall/thoracic radiation
Patients treated with neoadjuvant chemo or endocrine therapy for breast cancer
Patients with serious non-malignant disease (e.g. cardiovascular, scleroderma etc.) which would preclude RT
Patients with any serious active or co-morbid medical conditions, laboratory abnormality, psychiatric illness, active or uncontrolled infections, or serious illnesses or medical conditions that would prevent the patient from participating or to be managed according to the protocol (according to investigator's decision)
This study investigates the effects of regional radiation therapy in patients with low risk breast cancer. The purpose is to compare the outcomes of those receiving usual care, which includes regional radiation therapy, with those not receiving this type of radiation. Researchers want to determine if skipping regional radiation therapy is as effective at preventing the return of breast cancer.
Participants will be divided into study arms, with some receiving regional radiation therapy and others not. The study will monitor the recurrence of breast cancer to assess the effectiveness of the treatment. Regional radiation therapy involves targeting the lymph nodes around the breast to prevent cancer spread. The study aims to provide insights into the necessity of this treatment in low risk cases.
- Who can participate: Women with newly diagnosed invasive breast cancer, treated by surgery, and meeting specific criteria, such as having 1-3 positive axillary nodes, are eligible. They must have an Oncotype DX recurrence score below 18 and be undergoing endocrine therapy for at least 5 years.
- Study details: Participants may receive regional radiation therapy or no radiation. Blood and tumor samples will be collected for research. A placebo is not used.