PRIMETIME – Post-operative avoidance of radiotherapy in minimal risk women: patient selection using biomarkers
ISRCTN | ISRCTN41579286 |
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DOI | https://doi.org/10.1186/ISRCTN41579286 |
IRAS number | 190307 |
Secondary identifying numbers | CPMS 33217, IRAS 190307 |
- Submission date
- 30/01/2017
- Registration date
- 07/03/2017
- Last edited
- 07/11/2023
- Recruitment status
- No longer recruiting
- Overall study status
- Ongoing
- Condition category
- Cancer
Plain English Summary
Contact information
Public
Sir Richard Doll Building
15 Cotswold Road
Sutton
Surrey
SM2 5NG
United Kingdom
Phone | +44 208 722 4054 |
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primetime-icrctsu@icr.ac.uk |
Study information
Study design | Non-randomized; Interventional; Design type: Treatment, Radiotherapy, Management of Care |
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Primary study design | Interventional |
Secondary study design | Non randomised study |
Study setting(s) | Hospital |
Study type | Treatment |
Participant information sheet | Not available in web format, please use the contact details to request a patient information sheet |
Scientific title | Post-operative avoidance of radiotherapy: biomarker selection of women categorised to be in a very low risk group by IHC4+C |
Study acronym | PRIMETIME |
Study hypothesis | The aim of this study is to test whether radiotherapy can be safely avoided in a patient population considered to have such a low risk of local recurrence that the potential absolute gain from radiotherapy is so small as to not outweigh the established risks associated with breast radiotherapy. |
Ethics approval(s) | East of England – Cambridgeshire and Hertfordshire Research Ethics Committee, 05/09/2016, ref: 16/EE/0305 |
Condition | Breast cancer |
Intervention | Patients consent and register for pre-screening Ki67 research testing and 5 slides from the diagnostic block are forwarded for analysis to the central laboratory. Breast conserving surgery will proceed according to standard practice. If a patient is confirmed as eligible (meets inclusion and exclusion criteria) they will then be consented for the main PRIMETIME study. The IHC4+C calculator is then utilised to direct treatment according to the patient’s risk category (i.e. if they are deemed ‘very low risk’ they will be recommended to avoid radiotherapy). All patients will then receive either standard breast radiotherapy or no radiotherapy and standard adjuvant hormone therapy and any additional anti-cancer treatments. For patients who receive radiotherapy they will have 5 years of annual mammograms, for patients who do not receive radiotherapy they will be required to attend for 10 years of annual mammograms. Patients will be followed up for 10 years in clinic and thereafter via routine data sources. |
Intervention type | Other |
Primary outcome measure | Ipsilateral breast local relapse rate 5 years from study registration is assessed through patient note review. |
Secondary outcome measures | 1. Ipsilateral breast local relapse rate is measured by patient note review 10 years from study registration 2. Regional relapse rate is measured by patient note reviewat 5 and 10 years 3. Distant relapse rate is measured by patient note review at 5 and 10 years 4. Overall survival is measured by patient note review at 5 and 10 years 5. Breast cancer specific survival is measured by patient note review at 5 and 10 years |
Overall study start date | 01/07/2015 |
Overall study end date | 19/05/2030 |
Eligibility
Participant type(s) | Patient |
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Age group | Adult |
Sex | Female |
Target number of participants | Planned Sample Size: 2400; UK Sample Size: 2400 |
Participant inclusion criteria | 1. Provision of written informed consent to participate in the PRIMETIME study 2. Provision of slides for research testing and availability of KI67 result (contact ICR-CTSU to confirm) 3. Women aged ≥60 years (younger patients are eligible if they are post-menopausal and have co-morbidities that imply a high risk of radiotherapy toxicity e.g. significant cardiovascular disease with left sided breast cancer) 4. Women having had breast conserving surgery with complete resection of tumour tissue (≥1 mm microscopic, circumferential margins of normal tissue from invasive cancer and DCIS) 5. AJCC staging of pT1/pN0/M0 (DCIS is allowed in combination with invasive breast cancer; isolated tumour cells in axillary nodes are allowed) 6. Histological confirmation of grade 1 or 2 invasive breast cancer 7. Oestrogen receptor (ER) positive according to local practice. The H score must be available. 8. Progesterone receptor (PR) positive according to local practice. The percentage positivity must be available. 9. Human epidermal growth factor receptor (HER2) negative according to local practice 10. Patients must be recommended for ≥5 years adjuvant endocrine therapy according to local policy and in the investigator’s opinion, deemed able to comply with the duration of treatment |
Participant exclusion criteria | 1. Patients known to have lymphovascular space invasion and/or axillary nodal micrometastases or macrometastases. 2. Patients with a past history of malignancy excep: 2.1. Basal cell skin cancer and CIN cervix uteri 2.2.Treated, localised squamous cell carcinoma of the skin 2.3. Malignancies treated with curative intent and the patient has been disease free ≥5 years 3. Patients who have had an ipsilateral mastectomy 4. Patients who have received neoadjuvant therapy (endocrine or cytotoxic chemotherapy with therapeutic intent) or who are deemed by the MDT to require adjuvant cytotoxic chemotherapy 5. Patients with mammographically occult breast cancers, ie. present with lump, but not visible on mammogram |
Recruitment start date | 17/03/2017 |
Recruitment end date | 28/02/2022 |
Locations
Countries of recruitment
- England
- Scotland
- United Kingdom
- Wales
Study participating centres
Cambridge
CB2 0QQ
United Kingdom
Inverness
IV2 3UJ
United Kingdom
Wrexham
LL13 7TD
United Kingdom
Norwich
NR4 7UY
United Kingdom
London
EC1A 7BE
United Kingdom
London
NW3 2QG
United Kingdom
Northwood
HA6 2RN
United Kingdom
Stevenage
SG1 4AB
United Kingdom
Welwyn Garden City
AL7 4HQ
United Kingdom
London
W6 8RF
United Kingdom
Wythenshawe
Manchester
M23 9LT
United Kingdom
Headington
Oxford
OX3 7LE
United Kingdom
Uxbridge
UB8 3NN
United Kingdom
Clatterbridge Road
Birkenhead
Wirral
CH63 4JY
United Kingdom
London
SW3 6JJ
United Kingdom
Sutton
SM2 5PT
United Kingdom
Bournemouth
BH7 7DW
United Kingdom
Llantrisant
CF72 8XR
United Kingdom
Taunton
TA1 5DA
United Kingdom
Bury Saint Edmunds
IP33 2QZ
United Kingdom
Sponsor information
Research organisation
Royal Cancer Hospital
237 Fulham Road
London
SW3 6JB
United Kingdom
https://ror.org/043jzw605 |
Funders
Funder type
Charity
Private sector organisation / Other non-profit organizations
- Alternative name(s)
- CR_UK, Cancer Research UK - London, CRUK
- Location
- United Kingdom
Results and Publications
Intention to publish date | 19/05/2031 |
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Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Data sharing statement to be made available at a later date |
Publication and dissemination plan | Planned publication in a high-impact peer reviewed journal. |
IPD sharing plan | The current data sharing plans for the current study are unknown and will be made available at a later date. |
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
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Protocol file | version v3.0 | 03/05/2019 | 16/03/2021 | No | No |
Interim results article | 14/06/2021 | 13/08/2021 | Yes | No | |
HRA research summary | 28/06/2023 | No | No | ||
Protocol file | version 4.0 | 13/01/2021 | 07/11/2023 | No | No |
Additional files
- ISRCTN41579286_PROTOCOL_v3.0_03May2019.pdf
- Uploaded 16/03/2021
- ISRCTN41579286_PROTOCOL_V4.0_13Jan21.pdf
Editorial Notes
07/11/2023: Protocol file uploaded. Contact details updated.
02/11/2021: The following changes were made to the trial record:
1. The recruitment end date was changed from 31/10/2021 to 28/02/2022.
2. The overall trial end date was changed from 17/03/2040 to 19/05/2030.
3. The intention to publish date was changed from 17/03/2041 to 19/05/2031.
20/09/2021: Internal review.
13/08/2021: Internal review.
17/06/2021: Publication reference added.
16/03/2021: The following changes have been made:
1. The recruitment end date has been changed from 17/03/2021 to 31/10/2021.
2. The trial website has been added.
3. Uploaded protocol version 3.0, 03 May 2019 (not peer reviewed).
28/03/2019: The condition has been changed from "Specialty: Cancer, Primary sub-specialty: Breast Cancer; UKCRC code/ Disease: Cancer/ Malignant neoplasm of breast" to "Breast cancer" following a request from the NIHR.
11/08/2017: Cancer Help UK lay summary link added.
06/06/2017: Internal review