Pragmatic Randomized Trial of Proton vs. Photon Therapy for Patients With Non-Metastatic Breast Cancer: A Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial
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ClinicalTrials.gov Identifier: NCT02603341 |
Recruitment Status :
Recruiting
First Posted : November 11, 2015
Last Update Posted : March 20, 2023
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Breast Cancer | Radiation: Photon Radiation: Proton | Not Applicable |
Because no one knows which radiation treatment is best, if you decide to take part in this study, you will be randomly assigned to 1 of 2 treatment groups, and then you will begin radiation treatment according to usual medical practice. Randomly assigning you to a group helps makes sure that each group has a similar mix of patients and makes the study better - and is only done when doctors are not sure whether one treatment is better than the other. You have an equal chance of getting into either treatment group, like a coin flip. Both you and your doctor will be told which treatment you will get.
No matter which group patients are in, doctors will work very carefully to reduce the radiation to healthy tissues. Both groups will followed for at least 10 years after completing radiation therapy. The results of this study will help decide which radiation is best for future patients with your type of breast cancer.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 1278 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Pragmatic Randomized Trial of Proton vs. Photon Therapy for Patients With Non-Metastatic Breast Cancer: A Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial |
Study Start Date : | February 2016 |
Estimated Primary Completion Date : | August 2024 |
Estimated Study Completion Date : | November 2036 |

Arm | Intervention/treatment |
---|---|
Active Comparator: Photon
Photon therapy: once a day, 5 days a week, for 5 to 7 weeks
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Radiation: Photon
Photon Therapy:once a day, 5 days a week, for 5 to 7 weeks |
Active Comparator: Proton
Proton therapy: once a day, 5 days a week, for 5 to 7 weeks
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Radiation: Proton
Proton Therapy: once a day, 5 days a week, for 5 to 7 weeks |
- Effectiveness of proton therapy vs. photon therapy [ Time Frame: 10 years ]Compare the effectiveness of proton vs. photon therapy in reducing major cardiovascular events (MCE), defined as atherosclerotic coronary heart disease or other heart disease death, myocardial infarction, coronary revascularization, or hospitalization for major cardiovascular event (heart failure, valvular disease, arrhythmia, or unstable angina).
- Disease Control [ Time Frame: 5 years ]Compare the non-inferiority of proton vs. photon therapy in reducing ipsilateral breast cancer local-regional recurrence and in reducing any recurrence, defined as the first reported breast cancer recurrence of any type (local-regional or distant or cancer-specific mortality)
- Patient-reported Body Image and Function, Fatigue and Other Measures of Health-related Quality of Life (HRQOL) [ Time Frame: 5 years ]Compare the effectiveness of proton vs. photon therapy in improving patient-reported body image and function, fatigue and other measures of health-related quality of life (HRQOL) (anxiety, social roles, financial toxicity, general satisfaction) and adverse events.
- Radiation Dose and Quality of Life and Cardiac Toxicity [ Time Frame: 5 years ]Develop predictive models to examine the association of radiation dose distribution (to heart and other normal tissues) and major cardiovascular events and quality of life outcomes.
- Long Term Survival [ Time Frame: 15 years ]To assess longer-term rates of breast cancer specific and overall survival and development of second malignancies.

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 21 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Females or males diagnosed with pathologically (histologically) proven invasive mammary carcinoma (ductal, lobular or other) of the breast who have undergone either mastectomy or lumpectomy with any type of axillary surgery or axillary sampling.
- For patients who have undergone lumpectomy, any type of mastectomy and any type of reconstruction (including no reconstruction) are allowed.
- For patients who have undergone lumpectomy, there are no breast size limitations.
- Patients with non-metastatic breast cancer are eligible. This includes American Joint Committee on Cancer (AJCC) 7th edition left- or right-sided breast cancer clinical or pathologic stage I, II, III or loco-regionally recurrent at time of diagnosis. For patients that receive neoadjuvant chemotherapy, AJCC 7th edition left- or right-sided breast cancer pathologic stage yp 0, I, II, III are eligible.
- Bilateral breast cancer is permitted. Patients with bilateral breast cancer will be stratified as left-sided.
- Must be proceeding with breast/chest wall and nodal radiation therapy including internal mammary node treatment.
- Must have a pertinent history/physical examination within 90 days prior to registration.
- Age ≥ 21 years
- ECOG Performance Status 0 - 2 (asymptomatic to symptomatic but capable of self-care) within 90 days prior to randomization.
- Confirmation that the patient's health insurance will pay for the treatment in this study (patients may still be responsible for some costs, such as co-pays and deductibles). If the patient's insurance will not cover a specific treatment in this study and the patient still wants to participate, confirmation that the patient would be responsible for paying for any treatment received.
- Patients who are HIV positive are eligible, provided they are under treatment with highly active antiretroviral therapy (HAART) and have a CD4 count ≥ 200 cells/microliter within 180 days prior to registration as documented in the medical record. HIV testing is not required for eligibility for this protocol.
- The patient must provide study-specific informed consent prior to study entry.
Exclusion Criteria
- Definitive clinical or radiologic evidence of metastatic disease, as documented by the treating institution.
- Prior radiotherapy to the ipsilateral chest wall or ipsilateral breast or thorax. Individuals with prior radiotherapy in the contralateral breast or chest wall are eligible.
- Any radiation therapy for the currently diagnosed breast cancer prior to randomization.
- Dermatomyositis with a CPK level above normal or with an active skin rash or scleroderma.
- Other non-malignant systemic disease that would preclude the patient from receiving study treatment or would prevent required follow-up.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02603341
Contact: Justin Bekelman, MD | 215-662-7266 | bekelman@uphs.upenn.edu | |
Contact: Hien Lu | 215-662-6694 | hien.lu@pennmedicine.upenn.edu |

Principal Investigator: | Justin Bekelman, MD | Abramson Cancer Center at Penn Medicine | |
Study Chair: | Oren Cahlon, MD | Memorial Sloan Kettering Cancer Center | |
Study Chair: | Shannon MacDonald, MD | Massachusetts General Hospital |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Abramson Cancer Center at Penn Medicine |
ClinicalTrials.gov Identifier: | NCT02603341 |
Other Study ID Numbers: |
UPCC 19115 |
First Posted: | November 11, 2015 Key Record Dates |
Last Update Posted: | March 20, 2023 |
Last Verified: | March 2023 |
Breast Neoplasms Neoplasms by Site Neoplasms Breast Diseases Skin Diseases |