Genetic Susceptibility to Radiation-Induced Skin Reactions in Racial/Ethnic Groups of Patients With Breast Cancer
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Purpose
RATIONALE: Radiation therapy uses high-energy x rays to kill tumor cells. Radiation therapy may cause skin reactions when patients are exposed to high-energy x rays. Studying the genetic pattern of patients before and after radiation therapy may help doctors prevent toxicity and plan the best treatment.
PURPOSE: This clinical trial studies genetic susceptibility to radiation-induced skin reactions in racial/ethnic groups of patients with breast cancer.
| Condition | Intervention |
|---|---|
|
Breast Cancer Cognitive Ability, General Fatigue Pain Psychosocial Deprivation Radiation Toxicity Skin Abnormalities |
Genetic: DNA analysis Genetic: gene expression analysis Other: enzyme-linked immunosorbent assay Other: flow cytometry Other: laboratory biomarker analysis Other: questionnaire administration Procedure: adjuvant therapy Procedure: assessment of therapy complications Procedure: quality-of-life assessment Radiation: 3-dimensional conformal radiation therapy Radiation: breast irradiation Radiation: external beam radiation therapy Radiation: hypofractionated radiation therapy Radiation: intensity-modulated radiation therapy Radiation: whole breast irradiation |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
| Official Title: | Impact of Genomics and Exposures on Disparities in Breast Cancer Radiosensitivity |
- Occurrence of RT-induced early adverse skin reaction (EASR) [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]The primary endpoint is RT-related skin reactions which for consistency and clarity across the study we will use the term "Early Adverse Skin Reaction" (EASR). Skin reactions will be assessed at 4 time points from the start of radiotherapy through 2 months of the post radiotherapy follow-up period. The Modified ONS Criteria for Radiation-Induced Acute Skin Toxicity will be used for classification of EASRs related to the skin. The primary outcome variable will be the occurrence (or not) of RT-induced EASR defined as a grade 4 or higher toxicity (based on the ONS criteria) during the 2 months of the follow-up period of the study.
- Quality of life [ Time Frame: 12 months ] [ Designated as safety issue: No ]Quality of life will be assessed using the FACT-B, a modification of the Skindex-16, and a modified version of the NSABP B39 Quality of Life metric.
Biospecimen Retention: Samples With DNA
blood and urine samples
| Estimated Enrollment: | 1000 |
| Study Start Date: | September 2011 |
| Estimated Study Completion Date: | June 2014 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
-
Genetic: DNA analysis
OBJECTIVES:
- To develop and validate prediction biomarkers for radiation therapy (RT)-induced acute and chronic skin reactions and quality of life in five racial/ethnic groups of breast cancer patients, Whites*, Black/African Americans, Hispanic/Latinos, Asians/Native Hawaiians/Pacific Islanders, and American Indians/Alaskan Natives. NOTE: *This stratum is closed as of April 25, 2012.
- To develop polygenic models of RT-induced skin reactions with a comprehensive evaluation of genome-wide nonsynonymous single nucleotide polymorphisms (nsSNPs).
- To evaluate the levels of DNA damage (Comet assay) and radiosensitivity (Cell Cycle G2 Delay assay) in lymphocytes before and after RT.
- To test the effect of gene-gene and gene-smoking interactions on RT-induced skin reactions.
- To assess race-ethnic differences in RT-induced skin reactions, DNA damage, and radiosensitivity and to determine if the gene effects are consistent across race-ethnicity (gene-race/ethnic interactions).
OUTLINE: This is a multicenter study. Patients are stratified according to race/ethnicity (Whites* vs Black/African Americans vs Hispanic/Latinos vs Asians/Native Hawaiians/Pacific Islanders vs American Indians/Alaskan Natives). NOTE: *This stratum is closed as of April 25, 2012.
Patients undergo adjuvant radiotherapy after breast-conserving surgery.
Blood and urine samples are collected at baseline and last day of radiotherapy for genotyping, DNA damage, cell cycle assays, urine cotinine, inflammatory immune response biomarkers, and tumor-killing activity by BeadArray System, Comet assay, flow cytometry-based assay, Cell-Cycle G2 Delay Assay, Oxygen Radical Absorbance Capacity (ORAC) assay, and ELISA.
Patients are assessed for acute toxicity by research staff using the ONS Criteria for Radiation-Induced Acute Skin Toxicity at baseline, week 3, and at 1 and 2 months after radiotherapy. Patients are also assessed for chronic toxicity by research staff using the Chronic skin toxicity questionnaire (RTOG SOMA Criteria for RT- Induced Breast/Chest Wall Late Skin Toxicity) at 6 and 12 months after completion of radiotherapy. Photographs of the breast, chest wall, and contralateral breast are also taken at baseline, week 3, last day of radiotherapy, and at 1, 2, 6, and 12 months after completion of radiotherapy.
Patients complete the Breast Cancer Risk Study Questionnaire, the Functional Assessment of Cancer Therapy Breast (FACT-B), the Modified Skindex, and the B39 Quality-of-Life (QOL) Questionnaire at baseline, last day of radiotherapy, and at 1, 2, 6, and 12 months after radiotherapy.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
Race/ethnicity to include Whites*, Black/African Americans (AA), Hispanic/Latinos, Asians/Native Hawaiians/Pacific Islanders, and Native American or Alaskan
DISEASE CHARACTERISTICS:
Female patients newly diagnosed with breast carcinoma including ductal carcinoma in situ (DCIS)
- Stage 0-IIIA disease
- Status post-lumpectomy, -quadrantectomy, or -mastectomy
- Plan to receive adjuvant radiation to the whole breast or chest wall and/or regional lymph nodes
- No sites that cannot send blood/urine specimens to Wake Forest by overnight (next day) express shipping
PATIENT CHARACTERISTICS:
- *This stratum is closed as of April 25, 2012.
- No patients who do not understand English and are unable to complete form with assistance
PRIOR CONCURRENT THERAPY:
- Total dose > 40 Gy, dose per fraction > 1.8 - 2.0 Gy, use of 2D, 3D-conformal, or intensity-modulated radiation therapy (IMRT) treatment techniques allowed; a daily fraction of 2.7 Gy to the whole breast is suggested for hypofractionated regimens
- Concurrent and sequential boost techniques are allowed for both standard and hypofractionated regimens
- Adjuvant hormonal therapy will be allowed prior to, during, and/or after radiotherapy (RT) at the discretion of a medical oncologist
- Targeted therapies, such as Herceptin, will be allowed prior to, during, and/or after RT at the discretion of the medical oncologist
- No prior radiation to the involved breast or chest wall
- No concurrent chemotherapy
No patients who underwent breast reconstruction following mastectomy
- Placement of tissue expanders and implants are not allowed
- No patients who have undergone MammoSite® or any other form of brachytherapy as well as those who will be treated with skin-sparing IMRT
Patients may not be concurrently enrolled in a protocol that involves treatment of the skin, i.e., applying lotions/moisturizers
- Protocols that do not involve treatment of the skin are allowed
Contacts and Locations| Contact: Robin Rosdhal, RN | (336) 713-6519 |
| United States, North Carolina | |
| Wake Forest University Comprehensive Cancer Center | Recruiting |
| Winston-Salem, North Carolina, United States, 27157-1096 | |
| Contact: Robin Rosdhal, RN 336-713-6519 rosdhal@wakehealth.edu | |
| Principal Investigator: | James J. Urbanic, MD | Comprehensive Cancer Center of Wake Forest University |
More Information
Additional Information:
No publications provided
| Responsible Party: | Wake Forest Cancer Center CCOP Research Base |
| ClinicalTrials.gov Identifier: | NCT01407770 History of Changes |
| Other Study ID Numbers: | CCCWFU97609, U10CA081851 |
| Study First Received: | July 30, 2011 |
| Last Updated: | April 3, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Wake Forest Cancer Center CCOP Research Base:
|
radiation toxicity skin reactions secondary to radiation therapy pain fatigue psychosocial effects of cancer and its treatment depression |
cognitive/functional effects stage IA breast cancer stage IB breast cancer stage II breast cancer stage IIIA breast cancer ductal breast carcinoma in situ |
Additional relevant MeSH terms:
|
Congenital Abnormalities Breast Neoplasms Disease Susceptibility Genetic Predisposition to Disease Fatigue Skin Abnormalities Radiation Injuries Neoplasms by Site |
Neoplasms Breast Diseases Skin Diseases Disease Attributes Pathologic Processes Signs and Symptoms Wounds and Injuries |
ClinicalTrials.gov processed this record on May 16, 2013