Breast Cancer
Conditions
Brief summary
Breast cancer (BC) is the most frequent cause of leptomeningeal metastases (LM) .As for brain parenchymal metastases, the incidence of LM seems to be increasing, due to the growing incidence of metastatic BC, the improvement of survival and the poor diffusion of therapeutic agents into the central nervous system (CNS). Several prognostic factors have been identified, including the age at diagnosis, the functional and neurological status, the delay between the diagnosis of cancer and that of LM. The survival of patients is poor, less than 6 months in most published series. Several neuronal biomarkers could also be good candidates, such as the neurogranin CSF and/or serum levels or the CNS neurofilaments (NF), that seem to be a good reflect of axonal injury and neuronal loss. CNS NF have been investigated in several neurological diseases including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis and multiple sclerosis, but not yet in CNS metastases. Indeed, the creation of a clinico-biological collection seems to be of high value in order to investigate future biomarkers of interest
Detailed description
Breast cancer (BC) is the most frequent cause of leptomeningeal metastases (LM). As for brain parenchymal metastases, the incidence of LM seems to be increasing, due to the growing incidence of metastatic BC, the improvement of survival and the poor diffusion of therapeutic agents into the central nervous system (CNS). Several prognostic factors have been identified, including the age at diagnosis, the functional and neurological status, the delay between the diagnosis of cancer and that of LM. Other CSF biomarkers have been evaluated for the diagnosis of leptomeningeal metastases. Finally, the CellSearch® technique allows for the characterisation of proteins expressed by CSF tumors cells (E.G., HER2) and will make possible a better understanding of the physiopathology of tumor dissemination to the CS. Other neuronal biomarkers could be interesting for the diagnosis of LM in BC patients. Among them, the protein Tau (total-Tau or T-Tau) is involved in several neurological diseases. However, to date, no study has evaluated CSF or serum T-Tau in LM from solid tumors. Several neuronal biomarkers could also be good candidates, such as the neurogranin CSF and/or serum levels or the CNS neurofilaments (NF), that seem to be a good reflect of axonal injury and neuronal loss.
Interventions
BIOLOGICALblood samples
Two EDTA tubes (5 mL) and two dried tubes (5mL) will be will be taken the same day as the first lumbar .
Sponsors
Institut du Cancer de Montpellier - Val d'Aurelle
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Male or female patient ≥ 18 years-old, no age limit; 2. Histologically confirmed diagnosis of BC; 3. Hormone receptors and HER2 statuses of the primary tumor available; 4. Suspected LM based on clinical symptoms or signs, or radiological abnormalities; 5. Indication of diagnosis lumbar puncture decided by the oncologist in charge of the patient; 6. Patients must be affiliated to a Social Security System; 7. Patient information and written informed consent form signed prior to any study specific procedures.
Exclusion criteria
1. History of other cancer(s) than the BC (except completely resected non-melanoma skin cancer or successfully treated in situ carcinoma). 2. Hormone receptors and/or HER2 statuses of the primary tumor not available; 3. Patients with a medical contra-indication to the realization of a lumbar puncture; 4. Patients with psychological, family, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; 5. Patients who are pregnant or breast-feeding. 6. Legal incapacity or limited legal capacity.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity of the CellSearch® technique on CSF samples in comparison with the conventional cytology on one to three CSF sample | through study completion, an average of 2 years | analysis of result with the 2 technical procedure |
Countries
France
Contacts
STUDY_DIRECTORmarc ychou
institut régional du Cancer de Montpellier
Outcome results
None listed