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临床试验/NCT02407613
NCT02407613撤回不适用

Efficacy of Magnetic Resonance-guided High Intensity Focused Ultrasound for the Ablation of Breast Cancer

UMC Utrecht2 个研究点 分布在 1 个国家开始时间: 2015年3月最近更新:
适应症

试验速览

阶段
不适用
状态
撤回
发起方
UMC Utrecht
试验地点
2
主要终点
Presence of non-perfused volumes on DCE-MRI

研究概览

简要总结

This study evaluates the efficacy of MR-HIFU ablation of breast cancer. Ten patients with early-stage breast cancer with a maximum diameter of 3 cm will undergo MR-HIFU ablation, followed by MRI and surgical resection to evaluate treatment effect. The main purpose of the study is to demonstrate the feasibility of total tumor ablation with MR-HIFU. The secondary objective is safety assessment.

研究设计

研究类型
Interventional
分配方式
Na
干预模型
Single Group
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
Female
接受健康志愿者

入选标准

  • Women, aged 18 years and older.
  • Able to give informed consent herself.
  • World Health Organization (WHO) performance score ≤
  • Biopsy proven cT1-2 N0-2 MX invasive breast cancer with a size of ≤ 3.0 cm.
  • Histological type of tumor: invasive ductal carcinoma (IDC), not otherwise specified (NOS) or no special type (NST).
  • The target breast fits in the cup of the dedicated MR-HIFU breast system.
  • Patient weight is limited to ≤ 90 kg, because of restrictions to the HIFU table top.
  • Additional inclusion criteria based on DCE-MRI findings:
  • The distance of the tumor, including a 5 mm margin around the tumor, from the skin, nipple and pectoral wall is at least 1.0 cm measured on MRI.
  • The tumor is located within the reach of the HIFU beam produced by the transducers in the HIFU breast system.

排除标准

  • Prior treatment with: neo-adjuvant systemic therapy in the past 3 months or radiotherapy or thermal therapy or surgery of any kind in the targeted breast.
  • Contraindications to MR imaging according to the hospital guidelines (e.g. pacemaker in situ, severe claustrophobia, big metal implants, body size incompatible with MR bore).
  • Contraindications to administration of gadolinium-based contrast agent, including: prior allergic reaction to a gadolinium-based contrast agent, kidney disease (e.g. nephrogenic systemic fibrosis, nephrogenic fibrosing dermopathy) and/or renal failure (GFR < 30 ml/min/1,73m2).
  • Contra-indications for procedural sedation analgesia with Propofol and Esketamine or Propofol and Remifentanil.
  • Extensive intraductal components in the lesion determined by biopsy.
  • Scar tissue or surgical clips in the HIFU beam path.
  • Inability to lie in prone position.
  • Pregnancy or lactation.
  • Communication barrier with patient.
  • The following groups of patients will be excluded because the risk of adjuvant over- or undertreatment due to performing the Bloom and Richardson (B&R) grading on the tumor biopsy is considered to high:
  • N0, Her2neu negative, <35 years, ≤1cm (T1a/b) with B&R grade 1 or 2 on biopsy.
  • N0 Her2neu negative, ER/PR negative (triple negative), 35-70yr, 1.1-2cm (T1c) with B&R grade 1 or 2 on biopsy.
  • N0, Her2neu negative, ER/PR positive > 50%, ductal carcinoma, 60-70yr, 1.1-2cm (T1c), with B&R grade 3 on biopsy and if the MammaPrint is not reimbursed by health insurance also for grade 1 on biopsy.
  • N0, Her2neu negative, ER/PR positive, ductal carcinoma, 35-60yr, 1.1-2cm (T1c) with B&R grade 1 on biopsy.
  • N0, Her2neu negative, ER/PR positive, but ≤50%, ductal carcinoma, 60-70yr, 1.1-2cm (T1c) with B&R grade
  • The following group of patients will be excluded based on the results of the MammaPrint:
  • Only if the MammaPrint is reimbursed by health insurance: N0, Her2neu negative, ER/PR positive, > 50% ductal carcinoma, 60-70yr, 1.1-2cm (T1c), with B&R grade 1 and MammaPrint high risk.

结局指标

主要结局

Presence of non-perfused volumes on DCE-MRI

时间窗: 1 week after MR-HIFU ablation

Efficacy will be assessed by the presence of non-perfused volumes on DCE-MRI. A pre-treatment MRI is used as comparison.

Amount of ablated tissue at histopathological examination

时间窗: 2-3 weeks (after surgery is performed)

The amount of ablated tissue and residual viable tumor tissue will be assessed in all tumor slices.

次要结局

  • Number of patients with adverse events(Approximately 2 to 3 weeks)

研究者

发起方
UMC Utrecht
申办方类型
Other
责任方
Principal Investigator
主要研究者

Manon Braat

MD

UMC Utrecht

研究点 (2)

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