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NCT Number: NCT04698252

Local Therapy for ER/PR-positive Oligometastatic Breast Cancer

Randomized phase 2 trial to evaluate the efficacy of local therapy for oligometastasis from ER/PR-positive breast cancer. The study hypothesis is that local therapy in addition to systemic therapy improves progression-free survival in comparison with systemic therapy alone.

Recruiting

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Key information

Age range

18 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Phase 2

Primary location

About this study

Patients with estrogen receptor/ progesterone receptor-positive oligometastatic breast cancer with disease controlled after at least six months of systemic therapy will be enrolled in the study. Patients will be randomized to receive local therapy for oligometastatic sites in addition to systemic therapy or systemic therapy alone. Local therapy strategies will include surgery, radiotherapy, and radiofrequency ablation.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Female sex
  • ≥ 18 years of age
  • Histologically confirmed invasive breast cancer, with oligometastatic disease defined as one of the following criteria: 1) One to four bone lesions; 2) One to four lung and/ or hepatic lesions; 3) Distant metastasis limited to ipsilateral cervical lymph nodes; 4) Distant metastasis limited to contralateral axillary lymph nodes
  • Oligometastatic sites amenable to treatment with a local therapy modality, including surgical resection, stereotactic radiotherapy, or radiofrequency ablation
  • Estrogen receptor-positive and/ or progesterone receptor-positive breast cancer
  • Partial response or stable disease after at least six months of systemic therapy for breast cancer
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Measurable or non-measuble disease according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
  • Life expectancy of at least 12 weeks
  • For women in childbearing age, negative pregnancy test until 21 days before the date of study enrollment.
  • Signed informed consent form
  • Disposition and aptitude to fulfill the study protocol during the study duration

Exclusion criteria

  • HER2-positive breast cancer
  • Progressive disease during the last systemic treatment received for metastatic disease
  • Previous local therapy for distant metastasis
  • Current or previous history of severe diseases, such as clinically relevant heart failure, acute myocardium infarction in the last six months, chronic obstructive lung disease, HIV infection, chronic active hepatitis B or C infection, current serious uncontrolled infections or other severe diseases that may impact patients' expected survival)
  • Current or previous history of other invasive malignancy within the last five years, excluding non-melanoma skin cancer

Treatment and study plan

Radiotherapy

Radiation

Radiation therapy for oligometastatic sites

Surgery

Procedure

Surgery for oligometastatic sites

radiofrequency ablation

Other

Radiofrequency ablation for oligometastatic sites

Primary outcomes

  1. 2-year progression-free survival (PFS)

    Time frame: from baseline up to 2 years

    PFS will be defined as the time from randomization until the date of progression or death. 2-year PFS rate will represent the probability of a patient being free of progression after 2 years of randomization and will be estimated using the Kaplan-Meier method.

Secondary outcomes

  1. Overall-survival (OS)

    Time frame: from baseline up to 10 years

    OS will be calculated from the date of randomization until the date of death from any cause.

  2. Local therapy complication rate

    Time frame: from baseline up to 10 years

    Local therapy complications will be registered, including the occurrence of bleeding, local infections, pneumothorax, or other events attributed to local therapy by the medical team. Acute complications will be considered as those occurring until one month after procedure, while late complication will be those occurring later than one month.

  3. 1. European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30)

    Time frame: from baseline up to 1 year

    The EORTC QLQ-C30 provide points for questions related to global health status, functional scales, and symptom scales, providing scores ranging from 0-100. Higher scores represent higher health status, higher functioning, and higher symptom burden.

  4. 2. European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Breast Cancer (QLQ-BR23)

    Time frame: from baseline up to 1 year

    EORTC-QLQ-BR23 is composed of questions related to functional scales and symptom scales specific for breast cancer, providing scores ranging from 0-100. Higher scores for functional scales represent better functioning, while higher scores for symptom scales represent higher levels of symptoms.

  5. Chemotherapy-free survival

    Time frame: from baseline up to 10 years

    Chemotherapy-free survival will be calculated from the date of randomization until the first date of application of a new chemotherapy line.

  6. Subgroup analysis - PFS according to type of metastatic disease (de novo versus recurrent) and metastatic sites

    Time frame: from baseline up to 10 years

    PFS will be calculated for subgroups, according to type of metastatic disease (de novo versus recurrent) and sites of oligometastasis

Study contacts

Contact information is provided by the study sponsor or research team.

Renata C. Bonadio, MD

CONTACT

[email protected]

+5511989554040

Sponsors and collaborators

Lead sponsor

Instituto do Cancer do Estado de São Paulo

Other

Registry information

Official study title

Local Therapy for Hormone Receptor-positive Oligometastatic Breast Cancer - a Phase II Randomized Trial

Acronym: LARA

Important dates

Study start
2021
Primary completion
2024
Study completion
2031
First posted
Jan 6, 2021
Registry last updated
Aug 8, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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