Feasibility of lymph node removal after chemotherapy in breast cancer patients

ISRCTN ISRCTN31364289
DOI https://doi.org/10.1186/ISRCTN31364289
Secondary identifying numbers 1.0
Submission date
23/10/2019
Registration date
29/10/2019
Last edited
28/10/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Axillary lymph node evaluation is one of the important indicators for clinical pathological staging of breast cancer. However, for patients receiving neoadjuvant chemotherapy, the timing of sentinel lymph node biopsy is still controversial. This study will investigate the feasibility and safety of sentinel lymph node biopsy in Chinese patients with cN1 breast cancer who undergo routine radical surgery after neoadjuvant chemotherapy under current medical conditions in China

Who can participate? 
Eligible patients with cN1 breast cancer at 18-70 years of age of either sex

What does the study involve?
All enrolled patients will undergo neoadjuvant chemotherapy, radical mastectomy and intraoperative sentinel lymph node biopsy. All enrolled patients will receive this treatment and undergo lymph node diagnosis and evaluation after surgery

What are the possible benefits and risks of participating?
Eligible patients included in this study may not get direct benefits, but they will get more medical attention from investigators. Lymph node tracers methylene blue and carbon nanoparticles can cause local skin necrosis, but this risk can be avoided by rigorous intraoperative operation

Where is the study run from? 
1. The First Hospital of China Medical University (lead center)
2. Shengjing Hospital of China Medical University
3. Liaoning Cancer Hospital & Institute
4. Affiliated Zhongshan Hospital of Dalian University
5. The Second Hospital of Dalian Medical University
6. The Fourth Affiliated Hospital of China Medical University, China.

When is the study starting and how long is it expected to run for?
The anticipated start date of this study is December 2019 and the anticipated end date of this study is February 2022. The duration of the trial is approximate 2 years.

Who is funding the study?
This study will be funded by Liaoning Province Distinguished Professor Fund (LWF [2017] No.3)

Who is the main contact?
Lei Zhang, Project secretary
zhl656144@163.com

Contact information

Prof Bo Chen
Public

No.155 Nanjing North Street
Heping District
Shenyang
Liaoning Province
Shenyang
110001
China

ORCiD logoORCID ID 0000-0001-6372-8806
Phone +861 5904025211
Email chbyxl@163.com

Study information

Study designProspective multicenter diagnostic trial
Primary study designObservational
Secondary study designCase series
Study setting(s)Hospital
Study typeDiagnostic
Participant information sheet Not available in web format, please use contact details to request a participant information sheet.
Scientific titleFeasibility of sentinel lymph node biopsy using dye alone method in Chinese patients with cN1 breast cancer after neoadjuvant chemotherapy evaluated by clinical physical examination and three-dimensional ultrasound: a prospective, multicenter, diagnostic trial
Study objectivesFor patients receiving neoadjuvant chemotherapy, the timing of sentinel lymph node biopsy is still controversial. Although some results have been achieved in this respect, the results also have some limitations. Based on this, this study will investigate the feasibility and safety of sentinel lymph node biopsy in Chinese patients with cN1 breast cancer who undergo routine radical axillary lymph node dissection after neoadjuvant chemotherapy under current medical conditions in China
Ethics approval(s)Approved 06/08/2019, Medical Ethics Committee, First Hospital of China Medical University (No.155 Nanjing North Street, Heping District, Shenyang, Liaoning Province, China; yykyk@vip.163.com; +86-024-83282837), ref: KLS[2019]2019-193-2
Health condition(s) or problem(s) studiedBreast cancer
InterventionThe enrolled patients will receive neoadjuvant chemotherapy. After neoadjuvant chemotherapy and before radical axillary lymph node dissection, sentinel lymph node tracer will be injected. Before routine axillary lymph node dissection, sentinel lymph node biopsy will be performed. The dissected sentinel lymph nodes and other axillary lymph nodes will be marked separately for routine pathological examination.
Intervention typeProcedure/Surgery
Primary outcome measureFalse negative rate of sentinel lymph node biopsy at postoperative day one, according to pathological results and referencing to gold standard, false negative rate of sentinel lymph nodes = (number of patients having false negative sentinel lymph nodes/number of patients having gold standard results) ×100%
Secondary outcome measures1. At postoperative day one, the relationship between each influential factor (neoadjuvant efficacy, tumor location, surgical procedure, number of sentinel lymph nodes detected, molecular subtypes of breast cancer (luminal A, luminal B, HER2-positive, triple-negative)) and the results of sentinel lymph node biopsy after neoadjuvant chemotherapy
2. Adverse events during the trial
Overall study start date01/03/2019
Completion date20/02/2022

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit70 Years
SexFemale
Target number of participants500
Key inclusion criteria1. Women, age at 18-70 years
2. Primary invasive breast adenocarcinoma confirmed by physical examination, breast color Doppler ultrasound, mammography, MRI evaluation, and hollow needle histological examination. Before treatment, all patients have cN1 lymph nodes, i.e., subaxillary enlarged lymph nodes palpable by clinical examination and/or suspected positive enlarged lymph nodes revealed by related examinations, which are not considered as metastatic lymph nodes;
3. Not previously received treatment for breast cancer, agree to participate in the study, and have good compliance
4. The Eastern Cooperative Oncology Group (ECOG) performance status grade 0-2
5. Before treatment, the results of hematological and biochemical examinations should meet the following conditions: white blood cells ≥ 4.0 x 109/L, absolute neutrophil count ≥ 1.5 x 109/L,  platelet count ≥ 100 x 109/L, hemoglobin ≥ 90 g/L, glutathione transaminase, alanine transaminase ≤ 1.5 x upper limit of normal, creatinine ≤ 1.5 x upper limit of normal, total bilirubin ≤ 1.5 x upper limit of normal
6. No serious heart, liver and kidney diseases
Key exclusion criteria1. No provision of written informed consent
2. Lactating or pregnant women
3. Confirmed distant metastasis of breast cancer
4. Sensory or motor neuropathy, or those diagnosed with psychiatric disorder
5. Confirmed cardiovascular diseases, serious concomitant diseases or active infections including known human immunodeficiency virus infection
6. History of other cancers
7. Allergic to drugs and excipients involved in tracers and neoadjuvant chemotherapy
Date of first enrolment30/12/2019
Date of final enrolment30/12/2021

Locations

Countries of recruitment

  • China

Study participating centres

The First Hospital of China Medical University
No.155 Nanjing North Street
Heping District
Shenyang
Liaoning Province
Shenyang
110001
China
Liaoning Cancer Hospital & Institute
No. 44 Xiaoheyan Road
Dadong District
Shenyang
Liaoning Province
Shenyang
110042
China
Affiliated Zhongshan Hospital of Dalian University
No. 6 Jiefang Street
Zhongshan District
Dalian
Liaoning Province
Dalian
116004
China
The Second Hospital of Dalian Medical University
No. 467 Zhongshan Road
Shahekou District
Dalian
Liaoning Province
Dalian
116023
China
The Fourth Affiliated Hospital of China Medical University
No. 4 Chongshan Road
Huanggu District
Shenyang
Liaoning Province
Shenyang
110033
China

Sponsor information

The First Hospital of China Medical University
Hospital/treatment centre

No.155 Nanjing North Street
Heping District
Shenyang
Liaoning Province
Shenyang
110001
China

Phone +861 5904025211
Email chbyxl@163.com
ROR logo "ROR" https://ror.org/04wjghj95

Funders

Funder type

Government

Liaoning Province Distinguished Professor Fund of China (LWF [2017] No.3)

No information available

Results and Publications

Intention to publish date30/06/2023
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryOther
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal
IPD sharing planAll data generated or analysed during this study will be included in the subsequent results publication

Editorial Notes

28/10/2019: Trial’s existence confirmed by Medical Ethics Committee, First Hospital of China Medical University