PRIMETIME – Post-operative avoidance of radiotherapy in minimal risk women: patient selection using biomarkers

ISRCTN ISRCTN41579286
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
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English Summary

https://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/study-radiotherapy-women-small-risk-breast-cancer-returning-primetime

Study website

Contact information

Ms Lorna Smith
Public

Sir Richard Doll Building
15 Cotswold Road
Sutton
Surrey
SM2 5NG
United Kingdom

Phone +44 208 722 4054
Email primetime-icrctsu@icr.ac.uk

Study information

Study designNon-randomized; Interventional; Design type: Treatment, Radiotherapy, Management of Care
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titlePost-operative avoidance of radiotherapy: biomarker selection of women categorised to be in a very low risk group by IHC4+C
Study acronymPRIMETIME
Study hypothesisThe 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
ConditionBreast cancer
InterventionPatients 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 typeOther
Primary outcome measureIpsilateral breast local relapse rate 5 years from study registration is assessed through patient note review.
Secondary outcome measures1. 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 date01/07/2015
Overall study end date19/05/2030

Eligibility

Participant type(s)Patient
Age groupAdult
SexFemale
Target number of participantsPlanned Sample Size: 2400; UK Sample Size: 2400
Participant inclusion criteria1. 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 criteria1. 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 date17/03/2017
Recruitment end date28/02/2022

Locations

Countries of recruitment

  • England
  • Scotland
  • United Kingdom
  • Wales

Study participating centres

Addenbrookes Hospital
Hills Road
Cambridge
CB2 0QQ
United Kingdom
Raigmore Hospital
Old Perth Road
Inverness
IV2 3UJ
United Kingdom
Wrexham Maelor
Cresnewydd Road
Wrexham
LL13 7TD
United Kingdom
Norfolk and Norwich University Hospital
Colney Lane
Norwich
NR4 7UY
United Kingdom
Barts Hospital
W Smithfield
London
EC1A 7BE
United Kingdom
Royal Free Hospital
Pond Street
London
NW3 2QG
United Kingdom
Mount Vernon Hospital
Rickmansworth Road
Northwood
HA6 2RN
United Kingdom
Lister Hospital
Coreys Mill Lane
Stevenage
SG1 4AB
United Kingdom
Queen Elizabeth II Hospital
Howlands
Welwyn Garden City
AL7 4HQ
United Kingdom
Charing Cross Hospital
Fulham Palace Road
London
W6 8RF
United Kingdom
University Hospital of South Manchester
Southmoor Road
Wythenshawe
Manchester
M23 9LT
United Kingdom
Churchill Hospital
Old Road
Headington
Oxford
OX3 7LE
United Kingdom
The Hillingdon Hospital
Pield Heath Road
Uxbridge
UB8 3NN
United Kingdom
Clatterbridge Cancer Centre
Clatterbridge Health Park
Clatterbridge Road
Birkenhead
Wirral
CH63 4JY
United Kingdom
The Royal Marsden
203 Fulham Road
London
SW3 6JJ
United Kingdom
The Royal Marsden
Downs Road
Sutton
SM2 5PT
United Kingdom
The Royal Bournemouth Hospital
Castle Lane East
Bournemouth
BH7 7DW
United Kingdom
Royal Glamorgan Hospital
Ynysmaerdy
Llantrisant
CF72 8XR
United Kingdom
Musgrove Park Hospital
Parkfield Drive
Taunton
TA1 5DA
United Kingdom
West Suffolk Hospital
Hardwick Lane
Bury Saint Edmunds
IP33 2QZ
United Kingdom

Sponsor information

Institute of Cancer Research
Research organisation

Royal Cancer Hospital
237 Fulham Road
London
SW3 6JB
United Kingdom

ROR logo "ROR" https://ror.org/043jzw605

Funders

Funder type

Charity

Cancer Research UK
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 date19/05/2031
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planPlanned publication in a high-impact peer reviewed journal.
IPD sharing planThe 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?
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

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