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A Prospective Study to Evaluate the Role of 2-[18F]Fluoro-2-deoxy-D-glucose (FDG)-Positron Emission Tomography (PET), Breast Magnetic Resonance Imaging (MRI), and Breast Ultrasonography in Monitoring Tumour Responses in Patients With Locally Advanced Breast Cancer Undergoing Neoadjuvant Chemotherapy


N/A
18 Years
N/A
Not Enrolling
Female
Locally Advanced Breast Cancer

Thank you

Trial Information

A Prospective Study to Evaluate the Role of 2-[18F]Fluoro-2-deoxy-D-glucose (FDG)-Positron Emission Tomography (PET), Breast Magnetic Resonance Imaging (MRI), and Breast Ultrasonography in Monitoring Tumour Responses in Patients With Locally Advanced Breast Cancer Undergoing Neoadjuvant Chemotherapy


Locally advanced breast cancer (LABC) is usually treated with neoadjuvant chemotherapy
followed by surgery and radiation. At present, monitoring of tumour responses to
chemotherapy is primarily carried out using physical examination at the beginning of each
chemotherapy cycle. Differentiating viable tumour tissue from inflammation or fibrotic scar
tissue can be difficult. There is a growing body of evidence that newer imaging techniques
such as positron emission tomography (PET) and magnetic resonance imaging (MRI) may be
better at determining whether or not the tumour is actually shrinking. The purpose of this
study is to determine the sensitivity and specificity of PET, MRI and ultrasound in
evaluating tumour responses to chemotherapy in patients with LABC and compare this with
physical examination, which is the current standard of care.

Two of the objectives of this study are to 1) determine whether PET, MRI or ultrasound have
a higher sensitivity/specificity than physical examination alone in determining which LABC
patients achieve a complete pathologic response following neoadjuvant chemotherapy, and 2)
to investigate whether these additional investigations might lead to changes in clinical
management by identifying non-responders earlier than with physical examination alone.

A prospective cohort study design will be conducted. Patients with LABC who receive
chemotherapy will undergo physical examination, PET, MRI, and ultrasound at baseline,
midway, and at the completion of chemotherapy. Approximately 100 patients will be accrued
over a 5-year period.

This study will give clinicians further insight into the usefulness of PET, MRI, and
ultrasound in monitoring treatment responses in patients with LABC. This could potentially
lead to changes in clinical management of these patients.


Inclusion Criteria:



- Histologic proof of breast cancer (invasive ductal or lobular carcinoma - not breast
sarcoma or lymphoma)

- Patients having a clinical diagnosis of locally advanced breast cancer (T3 or T4, or
N2 according to TNM classification) including inflammatory breast cancer.

- Patients must be able to undergo neoadjuvant chemotherapy.

- Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2 sufficient
to undergo chemotherapy

Exclusion Criteria:

- Previously treated cancer other than nonmelanotic skin cancer or carcinoma in situ of
the cervix, unless disease-free for 5 years or greater.

- Evidence of metastatic disease (found on chest X-ray, liver ultrasound or bone scan).

- Previous chemotherapy or hormonal therapy for breast cancer.

- Active infection or other significant illnesses which could hamper their ability to
tolerate chemotherapy

- Significant concurrent medical problems (e.g. uncontrolled diabetes, active cardiac
disease, severe chronic obstructive pulmonary disease) making the patient unfit for
surgery.

- Any condition that could interfere with their ability to provide informed consent
such as dementia or severe cognitive impairment.

- Pregnant or lactating females (e.g. positive serum B-hCG pregnancy test).

- Unable to lie supine for imaging with PET.

- Inadequate hematologic, renal and liver function as measured by CBC (WBC < 4.0 x 109,
Hb < 100 g/L, plt count < 100 x 109), and abnormal hepatic transaminases (AST, ALT,
GGT, alkaline phosphatase > 2x normal), elevated total bilirubin, and elevated serum
creatinine (Cr > 110 micromol/L).

- Any contraindication to undergoing MRI or PET.

Type of Study:

Observational

Study Design:

Observational Model: Cohort, Time Perspective: Prospective

Outcome Measure:

The primary outcomes are the sensitivity and specificity of physical examination, ultrasound, breast MRI and PET in predicting which patients have achieved a complete pathologic response (pCR) prior to undergoing surgery.

Outcome Time Frame:

5 years

Safety Issue:

No

Principal Investigator

Som Mukherjee, MD MSc FRCP(C)

Investigator Role:

Principal Investigator

Investigator Affiliation:

Juravinski Cancer Centre

Authority:

Canada: Health Canada

Study ID:

PETLAB-06Jan2006

NCT ID:

NCT00788489

Start Date:

January 2006

Completion Date:

April 2010

Related Keywords:

  • Locally Advanced Breast Cancer
  • breast cancer
  • FDG-PET
  • MRI
  • chemotherapy
  • ultrasonography
  • Breast Neoplasms

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