E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
All patients with a local regional recurrence of invasive breast cancer in previously irradiated area with measurable lesions not suitable for resection are eligible for this trial. Patients with metastases are allowed if their life expectancy is considered 1 year or more, i.e. a limited bone metastases. |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10008456 |
E.1.2 | Term | Chemotherapy single agent systemic |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To explore if there is an indication of a positive effect on local control rate of adding Cisplatin to local reirradiation and hyperthermia to patients with local regional recurrent breast cancer in previously irradiated area
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E.2.2 | Secondary objectives of the trial |
- To describe the effect of adding Cisplatin to the standard treatment on acute toxicity - To describe the effect of adding Cisplatin to the standard treatment on clinical complete response rate - To explore the effect of adding Cisplatin to the standard treatment on time to disease progression local, regional or distant - To explore the effect of adding Cisplatin to the standard treatment on time to death by any cause - To describe the effect of adding Cisplatin to the standard treatment on late toxicity |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Translational study on PET-CT, same date/version and objectives as main study.
Primary objectives:
1. To compare the accuracy of GTV assessment by simulation PET-CT with conventional means, clinical assessment and conventional CT-smulation. 2. Prognostic value of SUVmax of the simulation PET-CT in relation to local control rate 3. Predictive value of the early response PET-CT including change in SUVmax on final response and ultimate local control 4. To compare the accuracy of the evaluation PET-CT response assessment with the clinical and/or radiological assessment (2 months after therapy) 5. To correlate the δ SUV (difference between SUVmax of the simulation PET and SUV-max of the evaluation PET-CT) to local control rate.
Secondary objectives:
1. To assess stage migration from N0 to N1-3 and/ or M0 to M1 and detect unexpected (for instance contralateral regional) tumour foci 2. To asses the non-specific effects of the reirradiation and hyperthermia treatment on the early response PET-CT 3. To compare the RECIST (Response Evaluation Criteria In Solid Tumours) criteria38 with the PERCIST (PET Response Criteria In Solid Tumours) criteria.
Translational study on tumour biology: DNA Damage response and hypoxia, same date/version and objectives as main study.
Objectives
1. a. To determine the DNA damage response (DDR) by means of determination of radiation induced gamma-H2AX foci and expression of DNA repair proteins (BRCA1, RAD 51 and MRE11) in biopsies irradiated ex vivo (see 10.6 tumor tissue biopsy).
b. Determine the relation between the DDR and tumor hypoxia.
c. Determine the treatment induced gamma-H2AX foci and DNA repair proteins in biopsies taken 1 week after therapy and correlate the DDR with hypoxia and treatment outcome.
2. a. Determine the relationship between tumor hypoxia (measured by Eppendorf polarographic electrode system) and expression of endogenous hypoxia markers in plasma samples
b. Determine the relationship between tumor hypoxia (measured by Eppendorf polarographic electrode system) and expression of endogenous hypoxia markers (Hif1- alfa and CA-9) in the tumor sample
3. To determine the relationship between hypoxia and plasma levels of the cytokine VEGF and PAI-1.
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E.3 | Principal inclusion criteria |
• Macroscopic local regional recurrence of breast cancer in previously irradiated area, not suitable for resection • recurrence is measurable by clinical examination and/or radiological (CT-scan, MRI or ultrasound) assessment • Confirmation of diagnosis of the local regional recurrence including all subtypes of invasive adenocarcinoma by histology or FNA (fine needle aspiration) • Local regional recurrence of breast cancer must be treatable with radiation and hyperthermia at the discretion of the treating physician (i.e. thickness ≤ 4 cm; cross-sectional diameter ≤ 30 cm). • Digital photograph of recurrence • WBC ≥ 3,000, NG≥ 1,000, platelets ≥ 100,000, ANC ≥ 1500 • serum bilirubin ≤ 1.5 times upper limit of normal, transaminase ≤ 3 times upper limit of normal • calculated creatinine clearance > 60 ml/liter (Cockroft) • distant metastases are allowed if life expectancy is ≥ 1 year i.e. limited bone metastases • Concurrent endocrine/hormonal therapy is allowed • ECOG performance score ≤ 2 • Written informed consent • Patients must be older than 18 year • Patient must not be pregnant or lactating. If appropriate effective contraception must be used.
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E.4 | Principal exclusion criteria |
Concurrent chemotherapy other than study medication * Uncontrolled infection * Other previous malignancy that could conceivably be active. * Patients with pacemakers or implanted defibrillators on the same site as the treatment (if this is the case, the pacemaker or implanted defibrillator should be replaced if possible)
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E.5 End points |
E.5.1 | Primary end point(s) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | 0 |