Clinical trial NCT03161834: Plasma Circulating Tumor DNA Analyses in ER+ Metastatic Breast Cancer
Official title: LCCC 1642: Plasma Circulating Tumor DNA (ctDNA) Analyses in ER+ Metastatic Breast Cancer
Study type: OBSERVATIONAL
Overall status: WITHDRAWN
Conditions: Metastatic Breast Cancer
Keywords: DNA
Circulating tumor cells
Lead sponsor: UNC Lineberger Comprehensive Cancer Center
Sponsor class: OTHER
First posted: 2017-05-22
Enrollment: 0
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 99
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Females with ER+ metastatic breast cancer receiving 2nd, 3rd, or 4th line systemic endocrine therapy

Brief summary: The purpose of this study is to evaluate whether increased mutant ESR1 allele fraction in plasma ctDNA 3-6 weeks after initiating salvage endocrine therapy is predictive of progression free survival in patients with ER+ metastatic breast cancer.

Detailed description: The primary objective of this 110 patient correlative biomarker study is to evaluate whether changes in mutant ESR1 allele fraction in plasma circulating tumor DNA (ctDNA) are predictive of progression-free survival in metastatic ER+ breast cancer patients who are receiving 2nd, 3rd, or 4th line systemic endocrine therapy. A secondary goal of this study is to explore the prevalence and kinetics of hotspot and non-hotspot ctDNA ESR1 mutations in this patient population, prior to initiating a new line of endocrine therapy as well as upon clinical progression, to identify potential mechanisms of resistance. Although initially to be opened at UNC Chapel Hill, our goal is to expand enrollment to include Rex Cancer Center in Raleigh, North Carolina, and collaborating institutions through the Translational Breast Cancer Research Consortium.

Eligibility criteria: Inclusion Criteria:

* Age ≥ 18 years of age
* Female gender
* Biopsy proven diagnosis of breast cancer
* Stage IV disease diagnosed either by radiographic studies or biopsy
* ER+ by immunohistochemistry on primary and/or metastatic tissue biopsy (\>10%)
* HER2 non-amplified (1+ or below by immunohistochemistry, and/or Her2 FISH \<2 HER2-to-CEP17 ratio)
* Progressed on at least one prior line of endocrine therapy for metastatic disease
* Three or fewer prior endocrine-containing therapies for recurrent/metastatic disease
* Two or fewer prior lines of cytotoxic chemotherapy for recurrent/metastatic disease
* Plans to initiate 2nd, 3rd, or 4th line endocrine therapy for metastatic disease
* Recent re-staging scans within 4 weeks of study enrollment, with radiographically identifiable disease
* No concurrent or prior diagnosis of malignancy other than breast cancer for the past 5 years. Patients with a history of in situ cancer or basal or localized squamous cell skin cancer remain eligible
* Intends to pursue treatment as well as clinical and radiographic follow-up at UNC Health Care
* Signed an institutional review board (IRB)-approved informed consent document for this protocol and HIPAA consent form

Exclusion Criteria:

* \< 18 years of age
* Tissue biopsies that support the presence of both ER+ and ER- metastatic breast cancer in the same patient
* Dementia, altered mental status, or any psychiatric condition that would prohibit the understanding or rendering of informed consent
* Pregnant or lactating women

Primary outcomes:
measure: Progression-free Survival Prediction
timeFrame: Through study completion, an average of 3-6 weeks
Secondary outcomes:
measure: DNA Analysis of Hotspot Mutation Prevalence
timeFrame: Through study completion, an average of 3-6 weeks
measure: DNA Analysis of Mutation and Radiographic Response Correlation
timeFrame: Through study completion, an average of 3-6 weeks
Other outcomes:
Locations:
city: Chapel Hill
country: United States
facility: University of North Carolina at Chapel Hill Cancer Hospital
state: North Carolina
Study officials:
affiliation: University of North Carolina, Chapel Hill
name: Gaorav P Gupta, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References: