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Praegnant Breast Cancer: Early/Advanced/Metastatic

Recruiting
Conditions
Breast Cancer (Early Breast Cancer)
Advanced/Metastatic Breast Cancer
Interventions
Procedure: Blood sampling
Registration Number
NCT02338167
Lead Sponsor
University Hospital Tuebingen
Brief Summary

Among patients with breast cancer the subgroup of patients with metastases are considered the group of patients with the worst prognosis. Not only regard-ing therapy decisions but also with regard to quality assured healthcare and health economics this entity of patients remains a challenge.

Recently, novel advances in breast cancer therapy aim at the targeted therapy of tumor entities and identification of patients, for whom the greatest therapy benefit, and the least side effects are expected.

However molecular assessment of the patient and the tumor in the metastatic situation is not performed on a routine basis and in many cases tumor character-istics from the primary tumor are considered reliable enough to make therapy decisions for the metastatic patients. Although molecular reassessment of tu-mor characteristics from tumor material of the metastasis is recommended in national guidelines, only a minority of patients is biopsied, because of the inva-siveness of the procedure, even though biopsy related complications are reported to be rare.

With modern analytic methods from blood based biomaterial there seems to be an opportunity to correlate blood based tumor assessments with actual charac-teristics of the tumor. These include expression analysis, tumor mutation analy-sis, tumor gene copy number aberrations and others. One of the main aims of the PRAEGNANT study is therefore to establish an infrastructure for the compre-hensive analysis of tumor and metastatic molecular characteristics of the patient and the tumor.

Furthermore, health care related outcomes as well as health economics provide novel approaches for integration of patients in study conduct and health care awareness and are study aims of the PRAEGNANT study.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
13500
Inclusion Criteria

Not provided

Exclusion Criteria
  • Patients who did not sign the informed consent form
  • Patients, who are not eligible for observation due to non-availability and/or severe comor-bidities as evaluated by the treating physician

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Advanced/metastatic breast cancerBlood sampling3,500 patients with locally advanced, inoperable/metastatic breast cancer in any line of treatment (e.g. 1st, 2nd, 3rd, or ≥ 4th line).
Early breast cancerBlood sampling10,000 patients with breast cancer in the neoadjuvant and adjuvant (early breast cancer) setting independent of treatment regimen.
Primary Outcome Measures
NameTimeMethod
MBC (Metastatic Breast Cancer): Discovery of biomarkers, which predict progression free survival (PFS)PFS defined as the time to the first progression after study inclusion from the last time of progression before or at study entry

Analyses will be done separately for each therapy line. Biomarkers include gene expression profiling of the primary tumor and the corresponding metastases, somatic mutations, germline genetic variation, epigenetic changes and miRNA variation up to a total of 500,000 biomarkers.

EBC (Early Breast Cancer): Assessment of disease free sur-vival (DFS)up to 60 months

DFS defined as the time to the first disease recurrence after study inclusion from time of primary diagnosis before or at study entry

Secondary Outcome Measures
NameTimeMethod
MBC: Assessment of breast cancer specific survival (BCSS)Time to death from the date of the last progression before or at study entry.

BCSS is defined as the time to to death due to breast cancer from the date of the last progression before or at study entry.

MBC: Quality of lifeStudy entry and every 3 month or following a change of a therapy line(event-associated, e.g. after progression) until Month 24. Every 6 months from Month 24 until Death or withdrawal of consent

Assessed with EORTC QlQ-C30 and Visual Analog Scala

MBC: Health economics for women with metastatic and/or locally advanced, inoperable breast cancer.Study entry and every 3 month or following a change of a therapy line (event-associated, e.g. after progression) until Month 24. Every 6 months from Month 24 until Death or withdrawal of consent

EORTC QLQ C-30 (Version 3.0) (among others) and actu-al documented costs of diagnostic procedures, therapies, treatment of side effects and care for tumor-associated symptoms will be used to calculate health care costs, quality adjusted life years (QALY) and incremental cost effectiveness ratios (ICER) between patient groups.

MBC: Description of therapies used in the metastatic settingafter 60 months (after study completion)

Therapies will be categorized and descriptive statistics will be presented.

MBC: Therapy adherenceup to 60 months

Defined as the percentage of patients in which treat-ments which are terminated as per patients' wish or because of treatment related side effect.

MBC: Incidence of adverse events, serious adverse events will be reported.up to 60 months

According to NCI Common Toxicity Criteria Version 4.03.

EBC: Assessment of overall survival (OS)OS is defined as the time to death from the date of the last progression before or at study entry.

OS is defined as the time to death from the date of the primary diagnosis before or at study entry.

EBC: Assessment of breast cancer specific survival (BCSS)Time to death due to breast cancer from the date of the primary diagnosis before or at study entry.

BCSS is defined as the time to death due to breast cancer from the date of the primary diagnosis before or at study entry.

EBC: Description of therapies used in the early breast cancer settingafter 60 months (after study completion)

Therapies will be categorized, and descriptive statistics will be presented.

EBC: Therapy adherenceup to 60 months

Defined as the percentage of patients in which treat-ments which are terminated as per patients' wish or because of treatment related side effect

MBC: Assessment of overall survival (OS)OS is defined as the time to death from the date of the last progression before or at study entry.

OS is defined as the time to death from the date of the last progression before or at study entry.

MBC: Feasibility and satisfaction regarding receipt of molecular testing results (including hereditary genetic alterations)Once at end of study

Assessed with a physician and patient questionnaire and documentation of possible confirmatory testing for changes in therapy or eligibility for interventional clinical trial screening.

EBC: Assessment of distant disease-free survival (DDFS)Up to 60 months

DDFS defined as the time to the first distant disease recurrence after study inclusion from time of primary diagnosis before or at study entry.

EBC: Quality of lifeStudy entry and every 3 month or following a change of a therapy line (event-associated, e.g. after progression) until Month 24. Every 6 months from Month 24 until Death or withdrawal of consent

Assessed with EORTC QLQ C-30 (Version 3.0), EORTC QLQ-BR23 and the EQ-Visual Analog Scale (VAS)

EBC: Percentage of women, who will receive results of molecular tests undertaken in the context of the scientific objectives of this trial.Once at end of study

Number of patients who will receive molecular testing results compared to the total number of included pa-tients.

EBC: Feasibility and satisfaction regarding receipt of molecular testing results (including hereditary genetic alterations)Once at end of study

Assessed with a physician and patient questionnaire and documentation of possible confirmatory testing for changes in therapy or eligibility for interventional clinical trial screening.

EBC: Incidence of adverse events, serious ad-verse events will be reported.up to 60 months

NCI Common Toxicity Criteria Version 4.03.

MBC: Objective responseup to 60 months

Objective response is defined as the best-documented response to the therapy started at study entry or the last therapy started before study entry.

MBC: Influencing Factors of Depression in patients with metastatic breast cancerStudy entry and every 3 month or following a change of a therapy line (event-associated, e.g. after progression) until Month 24. Every 6 months from Month 24 until Death or withdrawal of consent

Depression will be assessed by patient reported questionnaires e.g. CESD-R.

MBC: Patient reported influencing factors on therapy adherence in patients metastatic and/or locally advanced, inoperable breast cancer.Study entry and every 3 month or following a change of a therapy line(event-associated, e.g. after progression) until Month 24. Every 6 months from Month 24 until Death or withdrawal of consent

Patient reported adherence for orally administered therapies will be assessed with suitable questionnaires.

EBC: Health economics for women with breast cancerup to 60 months

EORTC QLQ C-30 (Version 3.0) (among others) and actu-al documented costs of diagnostic procedures, thera-pies, treatment of side effects and care for tumor-associated symptoms will be used to calculate health care costs, quality adjusted life years (QALY) and incre-mental cost effectiveness ratios (ICER) between patient groups.

MBC: Percentage of women, who will receive results of molecular tests undertaken in the context of the scientific objectives of this trial.Once at end of study

Number of patients who will receive molecular testing results compared to the total number of included patients.

EBC: Influencing Factors of Depression in patients with breast cancerStudy entry and every 3 month or following a change of a therapy line(event-associated, e.g. after progression) until Month 24. Every 6 months from Month 24 until Death or withdrawal of consent

Depression will be assessed by patient reported ques-tionnaires e.g. CESD-R.

EBC: Patient reported influencing factors on therapy adherence in patients with early breast cancer.Study entry and every 3 month or following a change of a therapy line(event-associated, e.g. after progression) until Month 24. Every 6 months from Month 24 until Death or withdrawal of consent

Patient reported adherence for orally administered therapies will be assessed with suitable questionnaires.

Trial Locations

Locations (58)

St. Vincentius-Kliniken gAG

🇩🇪

Karlsruhe, Baden-Württenmberg, Germany

Praxisklinik am Rosengarten

🇩🇪

Mannheim, Baden-Württemberg, Germany

Klinik für Frauenheilkunde, Universitätsklinikum Freiburg

🇩🇪

Freiburg, Baden-Württemberg, Germany

NCT Heidelberg

🇩🇪

Heidelberg, Baden-Württemberg, Germany

Hämato-Onkologische Schwerpunktpraxis am Klinikum Aschaffenburg

🇩🇪

Aschaffenburg, Bayern, Germany

Klinikum Bayreuth

🇩🇪

Bayreuth, Bayern, Germany

Klinikum Sindelfingen-Böblingen gGmbH

🇩🇪

Böblingen, Baden-Württemberg, Germany

Frauenklinik der St. Vincentius-Kliniken gAG

🇩🇪

Karlsruhe, Baden-Württemberg, Germany

Paracelsus Krankenhaus Ruit

🇩🇪

Ruit, Baden-Württemberg, Germany

medius Klinik Nürtingen

🇩🇪

Nürtingen, Baden-Württemberg, Germany

Hämatologische-onkologische Praxis

🇩🇪

Augsburg, Bayern, Germany

Klinikum der Universität München Frauenklinik

🇩🇪

München, Bayern, Germany

Universitätsfrauenklinik Tübingen

🇩🇪

Tübingen, Baden-Württemberg, Germany

Ruppiner Kliniken GmbH, Hochschulklinikum der Med. Hochschule Brandenburg

🇩🇪

Neuruppin, Brandenburg, Germany

Universitätsfrauenklinik Ulm

🇩🇪

Ulm, Baden-Württemberg, Germany

Frauenklinik und Poliklinik der Technischen Universität München

🇩🇪

München, Bayern, Germany

Klinikum Augsburg

🇩🇪

Augsburg, Bayern, Germany

Sozialstiftung Bamberg Klinikum am Bruderwald

🇩🇪

Bamberg, Bayern, Germany

Onkologisches Zentrum Donauwörth

🇩🇪

Donauwörth, Bayern, Germany

DONAUISAR Klinikum

🇩🇪

Deggendorf, Bayern, Germany

Rottal-Inn-Kliniken GmbH

🇩🇪

Eggenfelden, Bayern, Germany

Klinikum Fürth

🇩🇪

Fürth, Bayern, Germany

Universitätsfrauenklinik Erlangen

🇩🇪

Erlangen, Bayern, Germany

Caritas-Krankenhaus St. Josef

🇩🇪

Regensburg, Bayern, Germany

Gesundheitszentrum St. Marien GmbH

🇩🇪

Amberg, Bayer, Germany

Praxis für Frauenheilkunde und Geburtshilfe

🇩🇪

Fürstenwalde, Brandenburg, Germany

Christian-Albrechts-Universität Kiel

🇩🇪

Kiel, Christian-Albrechts-Universität Kiel, Germany

Klinikum Darmstadt Frauenklinik

🇩🇪

Darmstadt, Hessen, Germany

Centrum für Hämatologie und Onkologie Bethanien

🇩🇪

Frankfurt, Hessen, Germany

Klinikum Kassel GmbH

🇩🇪

Kassel, Hessen, Germany

Gemeinschaftspraxis für Hämatologie und Onkologie

🇩🇪

Langen, Hessen, Germany

Klinikum Wetzlar

🇩🇪

Wetzlar, Hessen, Germany

Niels-Stensen-Kliniken

🇩🇪

Georgsmarienhütte, Niedersachsen, Germany

Lahn-Dill-Kliniken GmbH Klinikum Wetzlar

🇩🇪

Wetzlar, Hessen, Germany

g.SUND Gynäkologie Kompetenzzentrum Stralsund

🇩🇪

Stralsund, Mecklenburg-Vorpommern, Germany

Onkologische Schwerpunktpraxis Leer-Emden

🇩🇪

Leer, Niedersachsen, Germany

Uniklinik RWTH Aachen

🇩🇪

Aachen, Nordrhein-Westfalen, Germany

Gynäkologie und Geburtshilfe im medizinischen Zentrum Bonn

🇩🇪

Bonn, Nordrhein-Westfalen, Germany

Universitätsfrauenklinik Düsseldorf

🇩🇪

Düsseldorf, Nordrhein-Westfalen, Germany

Universitätsklinik Dresden

🇩🇪

Dresden, Sachsen, Germany

Charité

🇩🇪

Berlin, Germany

Gesellschaft für Medizinische Studien Würselen

🇩🇪

Würselen, Nordrhein-Westfalen, Germany

Marienhospital

🇩🇪

Bottrop, Nordrhein-Westfalen, Germany

Kliniken Essen-Mitte

🇩🇪

Essen, Nordrhein-Westfalen, Germany

Schwerpunktpraxis für Hämatologie und Onkologie

🇩🇪

Kaiserslautern, Rheinland-Pfalz, Germany

Institut für Versorgungsforschung in der Onkologie GbR

🇩🇪

Koblenz, Nordrhein-Westfalen, Germany

Universitätsklinikum Halle (Saale)

🇩🇪

Halle, Sachsen-Anhalt, Germany

Klinikum Chemnitz gGmbH

🇩🇪

Chemnitz, Sachsen, Germany

St. Vincenz-Krankenhaus GmbH

🇩🇪

Paderborn, Nordrhein-Westfalen, Germany

Praxis Onkologie und Hämatologie

🇩🇪

Recklinghausen, Nordrhein-Westfalen, Germany

Institut für Versorgungsforschung

🇩🇪

Mayen, Rheinland-Pfalz, Germany

Universitäres Krebszentrum Leipzig

🇩🇪

Leipzig, Sachsen, Germany

Universitätsklinikum Schleswig-Holstein

🇩🇪

Lübeck, Schleswig-Holstein, Germany

Kreiskrankenhaus Torgau

🇩🇪

Torgau, Sachsen, Germany

Klinik für Gynäkologie und Geburtshilfe, Helios Kliniken

🇩🇪

Berlin, Germany

Universitätsklinikum Hamburg-Eppendorf

🇩🇪

Hamburg, Germany

Onkologie Lerchenfeld

🇩🇪

Hamburg, Germany

Klinik für Gynäkologie und Geburtshilfe

🇩🇪

Kiel, Schleswig-Holstein, Germany

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