Breastcancer Clinical Trial
— SymphonyOfficial title:
The Symphony Triple A Study: Using Symphony as an Adjunct to Histopathologic Parameters When the Doctor is Ambivalent About the Administration and Type of Adjunctive Systemic Therapy
Verified date | February 2017 |
Source | Diakonessenhuis, Utrecht |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Rationale:
Prediction of prognosis in patients with breast cancer is important to determine the
indication for adjuvant chemo-, endocrine- and immunotherapy. Apart from the
clinicopathological parameters incorporated into the Adjuvant!Online predictive model, the
validated 70-gene signature MammaPrint® is predictive of outcome too. MammaPrint® is advised
in the current Dutch CBO guideline (2012) for hormone receptor positive, invasive ductal
breast cancer in individual cases when there is 'doubt' about the indication for adjuvant
chemotherapy based on traditional prognostic factors. In the present study MammaPrint® is
used in this CBO 2012 guideline defined group of patients as an additional test for
decision-making for adjuvant chemotherapy.
Objective:
To assess the impact of MammaPrint® on clinical decision making regarding the administration
of adjuvant chemotherapy in the CBO 2012 guideline defined group of hormone receptor
positive invasive ductal carcinoma patients when there is doubt about the indication for
adjuvant chemotherapy based on traditional prognostic factors. The influence of various
factors and the impact of MammaPrint® in predefined subgroups will be analyzed too. Data
from a national registry regarding adjuvant systemic treatment in patients with similar
clinicopathological characteristics in whom MammaPrint® was not used will be obtained to
provide a control group.
Hypothesis:
In the group of patients where national guidelines advocate using systemic therapy but
doctors are ambivalent in treating patients with adjuvant chemotherapy, it is hypothesized
that using MammaPrint® as an additional test will change the indication for adjuvant therapy
in a substantial proportion of patients resulting in at least 10% less patients who receive
adjuvant chemotherapy. Thus, in the study group at least 10% less patients will receive
chemotherapy when compared to a contemporary group of patients with similar
clinicopathological characteristics but without using MammaPrint®
Study population:
Hormone receptor positive, invasive ductal breast cancer patients when there is doubt about
the indication for adjuvant chemotherapy based on traditional prognostic factors.
Study design:
This is a prospective multicentre impact study.
Status | Completed |
Enrollment | 660 |
Est. completion date | May 2016 |
Est. primary completion date | March 2016 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years and older |
Eligibility |
Inclusion criteria - Oestrogen receptor positive, invasive ductal and female breast cancer patients where the benefit of adjuvant chemotherapy is uncertain based on traditional prognostic factors - Written informed consent - Patients with multicentric or contralateral disease Exclusion criteria - Patients with a previous history of malignancy (in the five years before breast cancer diagnosis), excluding basal cell carcinoma. - Patients with confirmed distant metastasis. - Patients who undergo neoadjuvant systemic treatment. |
Country | Name | City | State |
---|---|---|---|
Netherlands | Medisch Centrum Alkmaar | Alkmaar | Noord-Holland |
Netherlands | Boven IJ ziekenhuis | Amsterdam | Noord-Holland |
Netherlands | Onze Lieve Vrouwe Gasthuis | Amsterdam | Noord-Holland |
Netherlands | Gelre ziekenhuis | Apeldoorn | Gelderland |
Netherlands | Rijnstate | Arnhem | Gelderland |
Netherlands | Whilhelmina ziekenhuis | Assen | Drenthe |
Netherlands | Alexander Monro ziekenhuis | Bilthoven | Utrecht |
Netherlands | IJsselland ziekenhuis | Capelle aan den IJssel | Zuid-Holland |
Netherlands | Jeroen Bosch ziekenhuis | Den Bosch | Brabant |
Netherlands | Gemini ziekenhuis | Den Helder | Noord-Holland |
Netherlands | Deventer ziekenhuis | Deventer | Overijssel |
Netherlands | Nij Smellinghe ziekenhuis | Drachten | Friesland |
Netherlands | Gederse Vallei | Ede | Gelderland |
Netherlands | Martini ziekenhuis | Groningen | |
Netherlands | Kennemer Gasthuis | Haarlem | Noord-Holland |
Netherlands | Ropcke Zweers ziekenhuis | Hardenberg | Overijssel |
Netherlands | Sint Jansdal | Harderwijk | Gelderland |
Netherlands | Tjongerschans | Heerenveen | Friesland |
Netherlands | Ter Gooi ziekenhuis | Hilversum | Utrecht |
Netherlands | Spaarne ziekenhuis | Hoofddorp | Noord-Holland |
Netherlands | Westfriesgasthuis | Hoorn | Noord-Holland |
Netherlands | Medisch Centrum Zuiderzee | Lelystad | Flevoland |
Netherlands | Sint Antoniusziekenhuis | Nieuwegein | Utrecht |
Netherlands | Waterland ziekenhuis | Purmerend | Noord-Holland |
Netherlands | Sint Fransiscus gasthuis | Rotterdam | Zuid-Holland |
Netherlands | Vlietland ziekenhuis | Schiedam | Noord-Holland |
Netherlands | Antoniusziekenhuis | Sneek | Friesland |
Netherlands | Ziekenhuis Rivierenland | Tiel | Gelderland |
Netherlands | Diakonessenziekenhuis | Utrecht | |
Netherlands | Zuwe Hofpoort ziekenhuis | Woerden | Utrecht |
Netherlands | Zaans medisch centrum | Zaandam | Noord-Holland |
Netherlands | Lange Land ziekenhuis | Zoetermeer | Zuid-Holland |
Netherlands | Gelre ziekenhuis | Zutphen | Gelderland |
Netherlands | Isale klinieken | Zwolle | Overijssel |
Lead Sponsor | Collaborator |
---|---|
Diakonessenhuis, Utrecht | Agendia |
Netherlands,
Bueno-de-Mesquita JM, Linn SC, Keijzer R, Wesseling J, Nuyten DS, van Krimpen C, Meijers C, de Graaf PW, Bos MM, Hart AA, Rutgers EJ, Peterse JL, Halfwerk H, de Groot R, Pronk A, Floore AN, Glas AM, Van't Veer LJ, van de Vijver MJ. Validation of 70-gene prognosis signature in node-negative breast cancer. Breast Cancer Res Treat. 2009 Oct;117(3):483-95. doi: 10.1007/s10549-008-0191-2. — View Citation
Bueno-de-Mesquita JM, van Harten WH, Retel VP, van't Veer LJ, van Dam FS, Karsenberg K, Douma KF, van Tinteren H, Peterse JL, Wesseling J, Wu TS, Atsma D, Rutgers EJ, Brink G, Floore AN, Glas AM, Roumen RM, Bellot FE, van Krimpen C, Rodenhuis S, van de Vijver MJ, Linn SC. Use of 70-gene signature to predict prognosis of patients with node-negative breast cancer: a prospective community-based feasibility study (RASTER). Lancet Oncol. 2007 Dec;8(12):1079-87. Erratum in: Lancet Oncol. 2008 Jan;9(1):10. — View Citation
Buyse M, Loi S, van't Veer L, Viale G, Delorenzi M, Glas AM, d'Assignies MS, Bergh J, Lidereau R, Ellis P, Harris A, Bogaerts J, Therasse P, Floore A, Amakrane M, Piette F, Rutgers E, Sotiriou C, Cardoso F, Piccart MJ; TRANSBIG Consortium.. Validation and clinical utility of a 70-gene prognostic signature for women with node-negative breast cancer. J Natl Cancer Inst. 2006 Sep 6;98(17):1183-92. — View Citation
Drukker CA, Bueno-de-Mesquita JM, Retèl VP, van Harten WH, van Tinteren H, Wesseling J, Roumen RM, Knauer M, van 't Veer LJ, Sonke GS, Rutgers EJ, van de Vijver MJ, Linn SC. A prospective evaluation of a breast cancer prognosis signature in the observational RASTER study. Int J Cancer. 2013 Aug 15;133(4):929-36. doi: 10.1002/ijc.28082. — View Citation
Knauer M, Mook S, Rutgers EJ, Bender RA, Hauptmann M, van de Vijver MJ, Koornstra RH, Bueno-de-Mesquita JM, Linn SC, van 't Veer LJ. The predictive value of the 70-gene signature for adjuvant chemotherapy in early breast cancer. Breast Cancer Res Treat. 2010 Apr;120(3):655-61. doi: 10.1007/s10549-010-0814-2. — View Citation
Mook S, Knauer M, Bueno-de-Mesquita JM, Retel VP, Wesseling J, Linn SC, Van't Veer LJ, Rutgers EJ. Metastatic potential of T1 breast cancer can be predicted by the 70-gene MammaPrint signature. Ann Surg Oncol. 2010 May;17(5):1406-13. doi: 10.1245/s10434-009-0902-x. — View Citation
Mook S, Schmidt MK, Viale G, Pruneri G, Eekhout I, Floore A, Glas AM, Bogaerts J, Cardoso F, Piccart-Gebhart MJ, Rutgers ET, Van't Veer LJ; TRANSBIG Consortium.. The 70-gene prognosis-signature predicts disease outcome in breast cancer patients with 1-3 positive lymph nodes in an independent validation study. Breast Cancer Res Treat. 2009 Jul;116(2):295-302. doi: 10.1007/s10549-008-0130-2. — View Citation
Mook S, Schmidt MK, Weigelt B, Kreike B, Eekhout I, van de Vijver MJ, Glas AM, Floore A, Rutgers EJ, van 't Veer LJ. The 70-gene prognosis signature predicts early metastasis in breast cancer patients between 55 and 70 years of age. Ann Oncol. 2010 Apr;21(4):717-22. doi: 10.1093/annonc/mdp388. — View Citation
Perou CM, Sørlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, Fluge O, Pergamenschikov A, Williams C, Zhu SX, Lønning PE, Børresen-Dale AL, Brown PO, Botstein D. Molecular portraits of human breast tumours. Nature. 2000 Aug 17;406(6797):747-52. — View Citation
Ravdin PM, Siminoff LA, Davis GJ, Mercer MB, Hewlett J, Gerson N, Parker HL. Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer. J Clin Oncol. 2001 Feb 15;19(4):980-91. — View Citation
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* Note: There are 12 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Frequency of adjuvant chemotherapy | We will measure and compare the proportion of patients receiving adjuvant chemotherapy in the group of patients receiving MammaPrint and the group who doesn't receive MammaPrint. In addition we'll record the type of chemotherapy given. | Within one month after surgery | |
Secondary | Changes in adjuvant systemic treatment decisions due to MammaPrint use | The percentage treatment change will be calculated for the whole study group and for the three predefined subgroups. | Within one month after (initial) surgery | |
Secondary | Influence of BluePrint and TargetPrint on adjuvant systemic treatment decisions | The percentage of adjuvant systemic treatment changes due to the use of BluePrint and/or TargetPrint for the whole studygroup, and the various subgroups will be calculated. | Within one month after (initial) surgery | |
Secondary | Clinical utility of MammaPrint in multicentric/contralateral disease. | Of patients included in the Symphony Triple A study with multicentric or contralateral breast cancer two tissue samples will be collected and a MammaPrint will be performed on both samples. In this subgroup of patients, MammaPrint, BluePrint and TargetPrint results of both tumors will be compared to evaluate the clinical utility of MammaPrint in multicentric and contralateral disease. | Within one month after (initial) surgery | |
Secondary | Concordance of TargetPrint results with locally assessed ICH/FISH ER, PR and Her2 results | The concordance between the ER, PR and Her2 results as assessed by the TargetPrint and local ICH/FISH techniques will be assessed. | Within one month after (initial) surgery | |
Secondary | Comparison of clinical subtype with BluePrint molecular subtype | Based on the ER, PR and Her2 results as assessed by local pathologist patients can be categorized in clinical molecular subtypes. Concordance between these clinical subtypes and the molecular subtype as assessed by the BluePrint will be assessed | Within one month after (initial) surgery |
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