Breast Cancer Clinical Trial
Official title:
Multicentre Study to Determine the Feasibility of Using an Integrated Consent Model to Compare Three Standard of Care Regimens for The Treatment of Triple-Negative Breast Cancer in the Neoadjuvant/Adjuvant Setting (REaCT-TNBC) OTT 15-04
Triple-negative breast cancer (TNBC) is a term applied to breast cancer cases that have <1%
expression of the estrogen receptor (ER) and the progesterone receptor (PR) and do not over
express HER2.
TNBC is diagnosed in 15-20% of breast cancer cases and tends to occur in younger women and
have biologically more aggressive high grade disease. Clinically, patients with TNBC have a
poorer prognosis compared to patients diagnosed with other breast cancer subtypes. Because of
the aggressive phenotype and due to observations that systemic chemotherapy offers
significantly higher benefit in ER negative disease, current treatment guidelines from
provincial and other organizations recommend that patients receive adjuvant systemic
chemotherapy for any TNBC greater than 0.5 cm in greatest diameter or node positive
independent of primary tumor size.
Currently, there is no world-wide standard recommended chemotherapy regimen for the
management of TNBC in the neoadjuvant/adjuvant setting, with treatments varying from region
and institution.
As physicians do not know what the "best" treatment for patients is, genuine uncertainty
("clinical equipoise") exists. Physicians will choose between different "standards" in their
personal practice, using idiosyncratic decision making processes, without the physician or
the patient knowing the optimal option. This is not good for patients, physicians and society
as a whole. Determining the optimal treatment remains an important medical issue for
patients, physicians and society. This study will survey opinions on a novel method to allow
comparisons of established standard of care prophylactic treatment using the "integrated
consent model" as part of a pragmatic clinical trial and attempt to compare head to head
standard chemotherapy regimens in patients with TNBC.
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