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Cryoablation Therapy in Treating Patients With Invasive Ductal Breast Cancer

A Phase II Trial Exploring the Success of Cryoablation Therapy in the Treatment of Invasive Breast Carcinoma

Status
UNKNOWN
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00723294
Enrollment
99
Registered
2008-07-28
Start date
2008-09-30
Completion date
Unknown
Last updated
2017-08-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Breast Cancer

Keywords

invasive ductal breast carcinoma, male breast cancer, stage IA breast cancer, stage IB breast cancer, stage II breast cancer

Brief summary

This phase II trial is studying how well cryoablation therapy works in treating patients with invasive ductal breast cancer. Cryoablation kills tumor cells by freezing them. This may be an effective treatment for patients with invasive ductal breast cancer.

Detailed description

This is a phase II non-randomized exploratory study. All fully eligible and registered patients will undergo imaging by mammography, ultrasound, and breast MRI. Patients will then undergo complete surgical resection of the primary tumor. The primary and secondary objectives of the study are described below. OBJECTIVES: Primary * To determine the rate of complete tumor ablation in patients treated with cryoablation, with complete tumor ablation defined as no remaining invasive or in situ carcinoma present upon pathological examination of the targeted lesion Secondary * To evaluate the negative predictive value of MRI in the post-ablation setting to determine residual in situ or invasive breast carcinoma * To describe the adverse events associated with cryoablation * To prospectively gather pain assessment data on cryoablation and surgical resection * Explore technical variables that may affect the success of cryoablation

Interventions

PROCEDUREcryosurgery
PROCEDUREtherapeutic conventional surgery

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Alliance for Clinical Trials in Oncology
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Unifocal primary invasive ductal breast carcinoma diagnosed by core needle biopsy. NOTE: Patients with lobular carcinoma, multifocal and/or multicentric ipsilateral breast cancer, multifocal calcifications, or DCIS with microinvasion are NOT eligible. Patients with contralateral disease will remain eligible. 2. No history of en bloc open surgical biopsy and/or lumpectomy for diagnostic/treatment of the index breast cancer. Note: Prior rotational and/or vacuum-assisted core biopsies are permitted if no significant distortion is seen on imaging that could obscure visualization and detection of residual disease on MRI, or visualization of cancer on ultrasound for cryoablation procedure. 3. Tumor size ≤ 2.0 cm in greatest diameter. Specifically, the tumor must measure ≤ 2.0 cm in the axis parallel to the treatment probe and ≤ 1.5 cm in the axis anti-parallel to the treatment probe. Largest size measured by required scans (mammogram, ultrasound and MRI) will be used to determine eligibility. 4. Tumor enhancement on pre-study MRI. 5. Tumor with \< 25% intraductal components in the aggregate. NOTE: The percent intraductal component from the patient's diagnostic biopsy must be available prior to registration. If the biopsy pathology report does not contain the percent intraductal component, then re-review of pathology slides and creation of a report addendum or note-to-file by the reviewing pathologist will be required. 6. No prior or planned neoadjuvant chemotherapy for breast cancer. 7. Non-pregnant and non-lactating. Patients of childbearing potential must have a negative serum or urine pregnancy test. NOTE: Peri-menopausal women must be amenorrheic for \> 12 months to be considered not of childbearing potential. 8. Adequate breast size for safe cryoablation. Male breast cancer patients and female breast cancer patients with breasts too small to allow safe cryoablation are not eligible as the minimal thickness of the breast tissue does not lend itself to cryoablation. NOTE: For patients with breast implants, the treating physician must document that adequate distance exists between the lesion and the implant to ensure that the ablated lesion will not contact or jeopardize the implant. 9. Patients with prior in-situ or invasive breast carcinomas are eligible if the prior carcinomas occurred in the contralateral breast. Patients with prior in-situ or invasive carcinomas of the ipsilateral breast are not eligible.

Design outcomes

Primary

MeasureTime frameDescription
Rate of Complete Tumor AblationUp to 14 days post surgeryThe primary endpoint for this study is the rate of complete ablation. Complete ablation is defined as no remaining invasive or in situ carcinoma present upon pathological examination of the targeted lesion. The rate (percentage) will be computed as the number of patient lesions with complete tumor ablation divided by the total number of eligible patient lesions. This rate will be estimated by the binomial point estimate (number of patients with no pathological evidence of residual disease in the targeted lesion after ablation divided by the number of eligible patients) and a one-sided 90% binomial confidence interval (interval with a lower bound).

Secondary

MeasureTime frameDescription
Negative Predictive Value of MRIUp to 14 days post cryoablationNegative predictive value of MRI: The negative predictive rate of MRI will be estimated as the number of patients with no residual disease upon pathologic review of the resected tissue AND with a MRI that indicated no residual disease divided by the number of patients who had an MRI that indicated no residual disease. Both a binomial point estimate and 90% two-sided confidence interval will be computed.
Adverse EventsUp to 14 days post surgery
Pain AssessmentUp to 14 days post surgery

Countries

United States

Participant flow

Participants by arm

ArmCount
Treatment (Cryoablation)
A cryoprobe is inserted percutaneously under ultrasound guidance into the targeted lesion. Patients undergo ablation using a freeze-thaw-freeze cycle lasting approximately 6-10-6 or 8-10-8 minutes, respectively. Patients undergo surgical resection and sentinel lymph node biopsy and/or axillary dissection within 28 days after completion of cryoablation.
86
Total86

Withdrawals & dropouts

PeriodReasonFG000
Overall Study1.0-Tesla MRI1
Overall Study>25% intraductal component1
Overall StudyBenign lesion1
Overall StudyDid not undergo surgery1
Overall StudyLobular histology2
Overall StudyNo cryoabalation2
Overall StudyNo MRI tumor enhancement1
Overall StudyNo treatment due to probe failure1
Overall StudyTreated by non-credentialed surgeon1
Overall StudyTreated prior to registration1
Overall StudyWithdrawal by Subject1

Baseline characteristics

CharacteristicTreatment (Cryoablation)
Age, Continuous62 years
Region of Enrollment
United States
86 participants
Sex: Female, Male
Female
86 Participants
Sex: Female, Male
Male
0 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
48 / 90
serious
Total, serious adverse events
0 / 90

Outcome results

Primary

Rate of Complete Tumor Ablation

The primary endpoint for this study is the rate of complete ablation. Complete ablation is defined as no remaining invasive or in situ carcinoma present upon pathological examination of the targeted lesion. The rate (percentage) will be computed as the number of patient lesions with complete tumor ablation divided by the total number of eligible patient lesions. This rate will be estimated by the binomial point estimate (number of patients with no pathological evidence of residual disease in the targeted lesion after ablation divided by the number of eligible patients) and a one-sided 90% binomial confidence interval (interval with a lower bound).

Time frame: Up to 14 days post surgery

Population: One patient had bilateral disease and therefore outcomes are reported for 87 lesions.

ArmMeasureValue (NUMBER)
Treatment (Cryoablation)Rate of Complete Tumor Ablation75.9 percentage of lesions
Secondary

Adverse Events

Time frame: Up to 14 days post surgery

Secondary

Negative Predictive Value of MRI

Negative predictive value of MRI: The negative predictive rate of MRI will be estimated as the number of patients with no residual disease upon pathologic review of the resected tissue AND with a MRI that indicated no residual disease divided by the number of patients who had an MRI that indicated no residual disease. Both a binomial point estimate and 90% two-sided confidence interval will be computed.

Time frame: Up to 14 days post cryoablation

Population: One patient had bilateral disease and therefore outcomes are reported for 87 cancers.

ArmMeasureValue (NUMBER)
Treatment (Cryoablation)Negative Predictive Value of MRI81.2 percentage of cancers
Secondary

Pain Assessment

Time frame: Up to 14 days post surgery

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026