Primary Invasive Breast CancerRESCUENCT03503799
Reaching for Evidence-baSed Chemotherapy Use in Endocrine Sensitive Breast Cancer
An observational study of Primary Invasive Breast Cancer and Estrogen Receptor Positive Tumor, run by North Eastern German Society of Gynaecological Oncology at 40 sites in 2 countries.
Trial summary
Systematic assessment of survival data of patients who have been tested with EndoPredict®; prospective proof that patients with low risk classification by EndoPredict® (EPclin) can safely forgo chemotherapy and be treated with endocrine therapy alone. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Primary Invasive Breast Cancer, Estrogen Receptor Positive Tumor, Human Epidermal Growth Factor Receptor 2 Negative Tumor
- What is being tested?
- Observation
- How many people
- 1,191 participants
- Where
- 40 sitesin 2 countries
- Study dates
- 17 Jul 2018to 1 Oct 2032
- How long will I take part?
- 10 Years
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients with primary stage I or Ii breast cancer who met all inclusin and no exclusion criteria
Who may be able to join
- Informed consent
- Tested with EndoPredict within the previous 6 months before inclusion
- Age ≥ 18 years
- Patients with primary invasive breast cancer, Stage I/II
- ER-positive
- HER2-negative
- N0 or N1 (1-3 positive lymph nodes)
- T1 - T3
Who cannot join
- Inflammatory breast cancer
- Bilateral breast cancer
- Breast cancer in the last 10 years
- Other invasive malignancies in the last 5 years
Trial locations and contacts
40 sites in 2 countries.
40 sites in 2 countries
Germany37 sites
ANregiomed Ansbach
Ansbach, 91522
Vivantes Klinikum am Urban
Berlin, State of Berlin, 10967
DRK Kliniken Köpenick
Berlin, 12559
MVZ Hellersdorf - Zweigstelle Biesdorf
Berlin, 12683
Park-Klinik Weißensee
Berlin, 13086
Helios Klinikum Berlin Buch
Berlin, 13125
Klinikum Bremerhaven Reinkenheide
Bremerhaven, 27574
Klinikum Chemnitz gGmbH
Chemnitz, 09116
Krankenhaus St. Joseph Stift Dresden GmbH
Dresden, 01307
Universitätsklinikum Carl Gustav Carus
Dresden, 01307
Evangelisches Krankenhaus
Düsseldorf, 40217
Kreisklinik Ebersberg
Ebersberg, 85560
Klinikum Erding
Erding, 85435
Praxis Dr. Heinrich
Fürstenwalde, 15517
Krankenhaus St. Elisabeth und St. Barbara
Halle
Krankenhaus Jerusalem
Hamburg, 20357
Asklepios Klinik Barmbek
Hamburg, 22307
Mathilden Hospital
Herford, 32052
Frauenärzte am Bahnhofsplatz
Hildesheim, 31134
Universitätsklinikum Jena
Jena, 07747
Gemeinschaftsklinikum Mittelrhein gGmbH Kemperhof
Koblenz, 56073
VK & K Studien GbR
Landshut, 84036
Krankenhaus St. Marienstift
Magdeburg, 39110
Klinikum Magdeburg gGmbH
Magdeburg, 39130
Klinikum Fichtelgebirge
Marktredwitz, 95615
Charité - Universitätsmedizin Berlin
Mitte, 10117
Frauenklinik der Technischen Universität München
München, Bavaria, 81675
Gemeinschaftspraxis Gynäkologie Arabella
München, 81925
Oberhavel Kliniken GmbH
Oranienburg, 16515
Regioklinik Pinneberg
Pinneberg, 25421
Ernst von Bergmann Klinikum
Potsdam, 14467
Universitätsklinikum Regensburg
Regensburg, 93053
RoMed Klinikum Rosenheim
Rosenheim, 83022
Klinikum Traunstein
Traunstein, 83278
Klinikum Mutterhaus der Borromäerinnen gGmbH
Trier, 54290
Harzklinikum Dorothea Christiane Erxleben
Wernigerode, 38855
Helios Universitätsklinikum Wuppertal
Wuppertal, 42283
Switzerland3 sites
Brustzentrum Bern Lindenhofgruppe
Bern, 3012
Luzerner Kantonsspital
Lucerne, 6000
Spital Zollikerberg
Zurich
About this study
Official title: Prospective Assessment of Disease Progression in Primary Breast Cancer Patients Undergoing EndoPredict® Gene Expression Testing - a Care Research Study
Systematic assessment of survival data of patients who have been tested with EndoPredict®; prospective proof that patients with low risk classification by EndoPredict® (EPclin) can safely forgo chemotherapy and be treated with endocrine therapy alone.
Read the detailed description
The goal of the study is to receive current and comprehensive information about the diseasefree (remote metastasis free and recurrence free) interval of EndoPredict® low risk patients.
The study is organized and managed by the NOGGO e.V. (North Eastern German Society of Gynaecological Oncology e.V.) study coordination office under the existing and efficient infrastructure. All patients who receive gene expression analysis with EndoPredict® and satisfy the remaining inclusion / exclusion criteria may participate in the study. Data collection is prospective and non-interventional. The recruitment of the required patients is expected to take a maximum of 36 months .
It must be emphasized that the study is data collection only and not an interventional study. This means that the choice and implementation of the therapy as well as the treatment assessments and frequency during and after the treatment can only be determined by the Investigator.
The decision to participate in the study is independent of the patient´s therapy within the framework of a study. Patient data will be recorded at the time of inclusion and once a year thereafter. Patient follow-up will be by phone from the second year onward.
Primary objective is to show that female patients who have been tested as "low risk" by EPclin and have been treated with endocrine therapy only for at least 5 years have a 10-year DMFS rate > 90% (lower boundary of the one-sided 95% confidence interval).
Secondary objectives comprise the evaluation of DMFS (distant metastasis free survival) , DFS (disease free survival) and OS (overall survival) rates at different time points and for different groups. Assessment of the given chemotherapy regimens and the given endocrine therapy will be performed and the proportions of patients will be determined with respect to the received treatment and its duration in different groups. Furthermore, the proportion of patients in whom the tumor board recommendation follows the EndoPredict® result and the proportion of patients actually treated according to EndoPredict® result will be determined.
The association between outcome and treatment, EPclin, EP, and classical prognostic factors will be investigated in different groups of patients. The correlation and concordance between EPclin calculations derived from biopsies and surgical specimens will be assessed.
- Conditions
- Primary Invasive Breast Cancer, Estrogen Receptor Positive Tumor, Human Epidermal Growth Factor Receptor 2 Negative Tumor
- Being tested
- Observation
- Keywords
- breast cancer, EndoPredict®, endocrine therapy
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ObservationOther
Visit 1 Informed consent Medical history Demographics Result of EndoPredict® Test Status of menopause Disease status Tumor board decision Planned anti-tumor-therapy
Visit 2, 1 year after inclusion This visit will be documented at the study site Status of menopause Disease status Anti-tumor therapy Survival
Following visits For these visits, patients will be asked directly through the Center for Clinical Trials of the Philipps-University Marburg (KKS Marburg) via phone.
Status of Menopause Disease status Anti-tumor therapy Survival
Treatment after end of the study The patient will be treated during and after end of study by physician's choice.
| Study group | Role | What they receive |
|---|---|---|
| Observational Group | Patients with primary invasive breast cancer, Stage I/II; ER positive, HER2 (human epidermal growth factor receptor 2) negative, N0-N1, T1-T3, tested with EndoPredict®, age over 18 years, informed consent Receives: Other: Observation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Distant metastasis free survival
To show that female patients who have been tested as "low risk" by EndoPredict® (EPclin) and have been treated with endocrine therapy only for at least 5 years have a 10-year distant metastasis-free survival (DMFS) > 90 % (lower boundary of the one-sided 95 % confidence interval)
Measured: 10 years
Secondary outcomes (30)
DMFS "low risk"
Assessment of DMFS of patients with EPclin "low risk" (or EP "low risk" [EP score <5] if EPclin cannot be calculated after surgery in the neoadjuvant setting) (in all patients, in the relevant target group and separately in men and women and in pre- and postmenopausal women with regard to treatment).
Measured: 3, 5 and 10 years
DFS "low risk"
Assessment of DFS of patients with EPclin "low risk" (or EP "low risk" [EP score <5] if EPclin cannot be calculated after surgery in the neoadjuvant setting) (in all patients, in the relevant target group and separately in men and women and in pre- and postmenopausal women with regard to treatment).
Measured: 3, 5 and 10 years
OS "low risk"
Assessment of OS of patients with EPclin "low risk" (or EP "low risk" [EP score <5] if EPclin cannot be calculated after surgery in the neoadjuvant setting) (in all patients, in the relevant target group and separately in men and women and in pre- and postmenopausal women with regard to treatment).
Measured: 3, 5 and 10 years
DMFS "high risk"
Assessment of DMFS of patients with EPclin "high risk" in all patients and separated in men and women as well as pre- and postmenopausal women with regard to treatment).
Measured: 3, 5 and 10 years
DFS "high risk"
Assessment of DFS of patients with EPclin "high risk" in all patients and separated in men and women as well as pre- and postmenopausal women with regard to treatment).
Measured: 3, 5 and 10 years
OS "high risk"
Assessment of OS of patients with EPclin "high risk" in all patients and separated in men and women as well as pre- and postmenopausal women with regard to treatment).
Measured: 3, 5 and 10 years
DMFS "high risk + low risk"
DMFS for patients who have / have not been treated according to EPclin/ EP result (all patients and subgroup analyses as specified in secondary objectives 1 and 2).
Measured: 3, 5 and 10 years
DFS "high risk + low risk"
DFS for patients who have / have not been treated according to EPclin/ EP result (all patients and subgroup analyses as specified in secondary objectives 1 and 2).
Measured: 3, 5 and 10 years
OS "high risk + low risk"
OS for patients who have / have not been treated according to EPclin/ EP result (all patients and subgroup analyses as specified in secondary objectives 1 and 2).
Measured: 3, 5 and 10 years
Portion of patients tumor board follows the EndoPredict® result
Assessment of the proportion of patients in whom the tumor board follows the EndoPredict® result in regard to treatment recommendation (in all patients and separately for men and women).
Measured: 1 year
Portion of patient treated according EndoPredict® result
Assessment of the proportion of patients who were actually treated according to the EndoPredict® result (in all patients and separately for men and women).
Measured: 1 year
Prognostic Performance of classical prognostic factors compared to EndoPredict®
Assessment of the classical prognostic factors tumor size, nodal status, grading, quantitative estrogen receptor, quantitative progesterone receptor and quantitative Ki67 and evaluation of their prognostic performance compared to EPclin and EP in univariate and multivariate analyses of DMFS, DFS, OS (in all patients, separately for men and women, only in patients who have been treated according to the EndoPredict® result).
Measured: 3, 5 and 10 years
DMFS "low risk vs. high risk"
Assessment of DMFS of patients with low risk vs. high risk as defined by national (German S3) and international (St. Gallen Consensus) guidelines based on IHC (immunohistochemistry)-classification.
Measured: 3, 5 and 10 years
DFS "low risk vs. high risk"
Assessment of DFS of patients with low risk vs. high risk as defined by national (German S3) and international (St. Gallen Consensus) guidelines based on IHC-classification.
Measured: 3, 5 and 10 years
OS "low risk vs. high risk"
Assessment of OS of patients with low risk vs. high risk as defined by national (German S3) and international (St. Gallen Consensus) guidelines based on IHC-classification.
Measured: 3, 5 and 10 years
DMFS of patient proportion of EPclin low and high risk patients in Ki67 low, intermediate and high tumors
Assessment of proportion of EPclin low and high risk patients in Ki67 low, intermediate and high tumors, respectively, and stratified analysis of DMFS of patients with ki67-values low (≤ 10%)/ intermediate (11-24%)/ high (≥ 25%) and EPclin low risk vs high risk.
Measured: 3, 5 and 10 years
DFS of patient proportion of EPclin low and high risk patients in Ki67 low, intermediate and high tumors
Assessment of proportion of EPclin low and high risk patients in Ki67 low, intermediate and high tumors, respectively, and stratified analysis of DFS of patients with ki67-values low (≤ 10%)/ intermediate (11-24%)/ high (≥ 25%) and EPclin low risk vs high risk.
Measured: 3, 5 and 10 years
OS of patient proportion of EPclin low and high risk patients in Ki67 low, intermediate and high tumors
Assessment of proportion of EPclin low and high risk patients in Ki67 low, intermediate and high tumors, respectively, and stratified analysis of OS of patients with ki67-values low (≤ 10%)/ intermediate (11-24%)/ high (≥ 25%) and EPclin low risk vs high risk.
Measured: 3, 5 and 10 years
DMFS "low risk vs. high risk" who have /have not been treated according to the S3 and St. Gallen guidelines
Assessment of DMFS after 3, 5 and 10 years of patients with low risk vs. high risk as defined by national (German S3) and international (St. Gallen Consensus) guidelines based on IHC-classification.
Measured: 3, 5 and 10 years
DFS "low risk vs. high risk" who have /have not been treated according to the S3 and St. Gallen guidelines
Assessment of DFS of patients with low risk vs. high risk as defined by national (German S3) and international (St. Gallen Consensus) guidelines based on IHC-classification.
Measured: 3, 5 and 10 years
OS "low risk vs. high risk" who have /have not been treated according to the S3 and St. Gallen guidelines
Assessment of OS of patients with low risk vs. high risk as defined by national (German S3) and international (St. Gallen Consensus) guidelines based on IHC-classification.
Measured: 3, 5 and 10 years
Chemotherapy regimens
Description of the given chemotherapy regimens (in all patients and separately for men and women).
Measured: 1 year
Given endocrine therapy
Description of the given endocrine therapy (in all patients and separately for men and women).
Measured: 10 years
Duration of endocrine therapy
Duration of the endocrine therapy (in all patients and separately for men and women).
Measured: 10 years
Proportion of patients with prolonged endocrine therapy
Proportion of patients with EPclin "low risk" and "high risk" respectively who received an extended (> 5 years) endocrine therapy in all patients and separately for men and women).
Measured: 10 years
DMFS for patients with 5 years of endocrine therapy vs. extended endocrine therapy
Assessment of DMFS according to EPclin / EP risk class for patients who have received an endocrine therapy for 5 years vs. patients who received an extended endocrine therapy (> 5 years).
Measured: 10 years
DFS for patients with 5 years of endocrine therapy vs. extended endocrine therapy
Assessment of DFS according to EPclin / EP risk class for patients who have received an endocrine therapy for 5 years vs. patients who received an extended endocrine therapy (> 5 years).
Measured: 10 years
OS for patients with 5 years of endocrine therapy vs. extended endocrine therapy
Assessment of OS according to EPclin / EP risk class for patients who have received an endocrine therapy for 5 years vs. patients who received an extended endocrine therapy (> 5 years).
Measured: 10 years
Correlation ( pT- and pN data vs. ciT and ciN-data)
Assessment of the correlation between EPclin, that has been calculated with pT- (pathological tumor size) and pN (pathological nodal status) data and the EPclin based on ciT (clinical/ imaging tumor size) and ciN (clinical/imaging nodal status)-data (in all patients and separately for men and women).
Measured: 1 year
Concordance ( pT- and pN data vs. ciT and ciN-data)
Assessment of the concordance between EPclin, that has been calculated with pT- and pN data and the EPclin based on ciT and ciN-data (in all patients and separately for men and women).
Measured: 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Apr 2018
- Study start17 Jul 2018
- Primary completion1 Oct 2032 (estimated)
- Study completion1 Oct 2032 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (15)Papers the sponsor has linked to this study.
- Other trials for Primary Invasive Breast CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case only
- Time perspective
- Prospective
- Enrolment
- 1,191 participants (actual)
- Target duration
- 10 Years
Sponsor and investigators
- Lead sponsor
- North Eastern German Society of Gynaecological Oncology
- Sponsor type
- University, hospital or other
- Collaborators
- Philipps University Marburg
- Responsible party
- Sponsor
- Investigators
- Marion Kiechle, Prof. Dr., Principal investigator, TU München (TUM) Lehrstuhl für Gynäkologie und Geburtshilfe
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03503799
- Sponsor's protocol ID
- NOGGO B3
- Acronym
- RESCUE
- Status last verified
- Apr 2026
- First submitted
- 19 Mar 2018
- Last updated
- 13 Apr 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Buus R, Sestak I, Kronenwett R, Denkert C, Dubsky P, Krappmann K, Scheer M, Petry C, Cuzick J, Dowsett M. Comparison of EndoPredict and EPclin With Oncotype DX Recurrence Score for Prediction of Risk of Distant Recurrence After Endocrine Therapy. J Natl Cancer Inst. 2016 Jul 10;108(11):djw149. doi: 10.1093/jnci/djw149. Print 2016 Nov.
PubMed 27400969Cobain EF, Hayes DF. Indications for prognostic gene expression profiling in early breast cancer. Curr Treat Options Oncol. 2015 May;16(5):23. doi: 10.1007/s11864-015-0340-x.
PubMed 25929335Denkert C, Kronenwett R, Schlake W, Bohmann K, Penzel R, Weber KE, Hofler H, Lehmann U, Schirmacher P, Specht K, Rudas M, Kreipe HH, Schraml P, Schlake G, Bago-Horvath Z, Tiecke F, Varga Z, Moch H, Schmidt M, Prinzler J, Kerjaschki D, Sinn BV, Muller BM, Filipits M, Petry C, Dietel M. Decentral gene expression analysis for ER+/Her2- breast cancer: results of a proficiency testing program for the EndoPredict assay. Virchows Arch. 2012 Mar;460(3):251-9. doi: 10.1007/s00428-012-1204-4. Epub 2012 Feb 28.
PubMed 22371223Denkert C, Pfitzner BM, Heppner BI, Dietel M. [Molecular pathology for breast cancer: Importance of the gene expression profile]. Pathologe. 2015 Mar;36(2):145-53. doi: 10.1007/s00292-015-0009-z. German.
PubMed 25836324Dubsky P, Brase JC, Jakesz R, Rudas M, Singer CF, Greil R, Dietze O, Luisser I, Klug E, Sedivy R, Bachner M, Mayr D, Schmidt M, Gehrmann MC, Petry C, Weber KE, Fisch K, Kronenwett R, Gnant M, Filipits M; Austrian Breast and Colorectal Cancer Study Group (ABCSG). The EndoPredict score provides prognostic information on late distant metastases in ER+/HER2- breast cancer patients. Br J Cancer. 2013 Dec 10;109(12):2959-64. doi: 10.1038/bjc.2013.671. Epub 2013 Oct 24.
PubMed 24157828Dubsky P, Filipits M, Jakesz R, Rudas M, Singer CF, Greil R, Dietze O, Luisser I, Klug E, Sedivy R, Bachner M, Mayr D, Schmidt M, Gehrmann MC, Petry C, Weber KE, Kronenwett R, Brase JC, Gnant M; Austrian Breast and Colorectal Cancer Study Group (ABCSG). EndoPredict improves the prognostic classification derived from common clinical guidelines in ER-positive, HER2-negative early breast cancer. Ann Oncol. 2013 Mar;24(3):640-7. doi: 10.1093/annonc/mds334. Epub 2012 Oct 3.
PubMed 23035151Early Breast Cancer Trialists' Collaborative Group (EBCTCG); Peto R, Davies C, Godwin J, Gray R, Pan HC, Clarke M, Cutter D, Darby S, McGale P, Taylor C, Wang YC, Bergh J, Di Leo A, Albain K, Swain S, Piccart M, Pritchard K. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet. 2012 Feb 4;379(9814):432-44. doi: 10.1016/S0140-6736(11)61625-5. Epub 2011 Dec 5.
PubMed 22152853Ettl J, Klein E, Hapfelmeier A, Grosse Lackmann K, Paepke S, Petry C, Specht K, Wolff L, Hofler H, Kiechle M. Decision impact and feasibility of different ASCO-recommended biomarkers in early breast cancer: Prospective comparison of molecular marker EndoPredict and protein marker uPA/PAI-1. PLoS One. 2017 Sep 6;12(9):e0183917. doi: 10.1371/journal.pone.0183917. eCollection 2017.
PubMed 28877230Filipits M, Rudas M, Jakesz R, Dubsky P, Fitzal F, Singer CF, Dietze O, Greil R, Jelen A, Sevelda P, Freibauer C, Muller V, Janicke F, Schmidt M, Kolbl H, Rody A, Kaufmann M, Schroth W, Brauch H, Schwab M, Fritz P, Weber KE, Feder IS, Hennig G, Kronenwett R, Gehrmann M, Gnant M; EP Investigators. A new molecular predictor of distant recurrence in ER-positive, HER2-negative breast cancer adds independent information to conventional clinical risk factors. Clin Cancer Res. 2011 Sep 15;17(18):6012-20. doi: 10.1158/1078-0432.CCR-11-0926. Epub 2011 Aug 1.
PubMed 21807638Fitzal F, Filipits M, Rudas M, Greil R, Dietze O, Samonigg H, Lax S, Herz W, Dubsky P, Bartsch R, Kronenwett R, Gnant M. The genomic expression test EndoPredict is a prognostic tool for identifying risk of local recurrence in postmenopausal endocrine receptor-positive, her2neu-negative breast cancer patients randomised within the prospective ABCSG 8 trial. Br J Cancer. 2015 Apr 14;112(8):1405-10. doi: 10.1038/bjc.2015.98. Epub 2015 Mar 24.
PubMed 25867274Kronenwett R, Bohmann K, Prinzler J, Sinn BV, Haufe F, Roth C, Averdick M, Ropers T, Windbergs C, Brase JC, Weber KE, Fisch K, Muller BM, Schmidt M, Filipits M, Dubsky P, Petry C, Dietel M, Denkert C. Decentral gene expression analysis: analytical validation of the Endopredict genomic multianalyte breast cancer prognosis test. BMC Cancer. 2012 Oct 5;12:456. doi: 10.1186/1471-2407-12-456.
PubMed 23039280Martin M, Brase JC, Calvo L, Krappmann K, Ruiz-Borrego M, Fisch K, Ruiz A, Weber KE, Munarriz B, Petry C, Rodriguez CA, Kronenwett R, Crespo C, Alba E, Carrasco E, Casas M, Caballero R, Rodriguez-Lescure A. Clinical validation of the EndoPredict test in node-positive, chemotherapy-treated ER+/HER2- breast cancer patients: results from the GEICAM 9906 trial. Breast Cancer Res. 2014 Apr 12;16(2):R38. doi: 10.1186/bcr3642.
PubMed 24725534Muller BM, Brase JC, Haufe F, Weber KE, Budzies J, Petry C, Prinzler J, Kronenwett R, Dietel M, Denkert C. Comparison of the RNA-based EndoPredict multigene test between core biopsies and corresponding surgical breast cancer sections. J Clin Pathol. 2012 Jul;65(7):660-2. doi: 10.1136/jclinpath-2012-200716. Epub 2012 Mar 23.
PubMed 22447922Muller BM, Keil E, Lehmann A, Winzer KJ, Richter-Ehrenstein C, Prinzler J, Bangemann N, Reles A, Stadie S, Schoenegg W, Eucker J, Schmidt M, Lippek F, Johrens K, Pahl S, Sinn BV, Budczies J, Dietel M, Denkert C. The EndoPredict Gene-Expression Assay in Clinical Practice - Performance and Impact on Clinical Decisions. PLoS One. 2013 Jun 27;8(6):e68252. doi: 10.1371/journal.pone.0068252. Print 2013.
PubMed 23826382Poremba C, Uhlendorff J, Pfitzner BM, Hennig G, Bohmann K, Bojar H, Krenn V, Brase JC, Haufe F, Averdick M, Dietel M, Kronenwett R, Denkert C. Preanalytical variables and performance of diagnostic RNA-based gene expression analysis in breast cancer. Virchows Arch. 2014 Oct;465(4):409-17. doi: 10.1007/s00428-014-1652-0. Epub 2014 Sep 14.
PubMed 25218890
Study at a glance
From the registry record, last updated by the sponsor on 13 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Prospective Assessment of Disease Progression in Primary Breast Cancer Patients Undergoing EndoPredict® Gene Expression Testing - a Care Research Study
- ClinicalTrials.gov ID
- NCT03503799
- Acronym / sponsor ID
- RESCUE / NOGGO B3
- Conditions
- Primary Invasive Breast Cancer, Estrogen Receptor Positive Tumor, Human Epidermal Growth Factor Receptor 2 Negative Tumor
- Keywords
- breast cancer, EndoPredict®, endocrine therapy
- Study type
- Observational
- Recruitment status
- Active, not recruiting
- Enrolment
- 1,191 participants (actual)
- Lead sponsor
- North Eastern German Society of Gynaecological OncologyUniversity, hospital or other
- Collaborators
- Philipps University Marburg
- Study start
- 17 Jul 2018 (actual)
- Primary completion
- 1 Oct 2032 (estimated)
- Study completion
- 1 Oct 2032 (estimated)
- First posted
- 20 Apr 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Systematic assessment of survival data of patients who have been tested with EndoPredict®; prospective proof that patients with low risk classification by EndoPredict® (EPclin) can safely forgo chemotherapy and be treated with endocrine therapy alone.
Detailed description
The goal of the study is to receive current and comprehensive information about the diseasefree (remote metastasis free and recurrence free) interval of EndoPredict® low risk patients.
The study is organized and managed by the NOGGO e.V. (North Eastern German Society of Gynaecological Oncology e.V.) study coordination office under the existing and efficient infrastructure. All patients who receive gene expression analysis with EndoPredict® and satisfy the remaining inclusion / exclusion criteria may participate in the study. Data collection is prospective and non-interventional. The recruitment of the required patients is expected to take a maximum of 36 months .
It must be emphasized that the study is data collection only and not an interventional study. This means that the choice and implementation of the therapy as well as the treatment assessments and frequency during and after the treatment can only be determined by the Investigator.
The decision to participate in the study is independent of the patient´s therapy within the framework of a study. Patient data will be recorded at the time of inclusion and once a year thereafter. Patient follow-up will be by phone from the second year onward.
Primary objective is to show that female patients who have been tested as "low risk" by EPclin and have been treated with endocrine therapy only for at least 5 years have a 10-year DMFS rate > 90% (lower boundary of the one-sided 95% confidence interval).
Secondary objectives comprise the evaluation of DMFS (distant metastasis free survival) , DFS (disease free survival) and OS (overall survival) rates at different time points and for different groups. Assessment of the given chemotherapy regimens and the given endocrine therapy will be performed and the proportions of patients will be determined with respect to the received treatment and its duration in different groups. Furthermore, the proportion of patients in whom the tumor board recommendation follows the EndoPredict® result and the proportion of patients actually treated according to EndoPredict® result will be determined.
The association between outcome and treatment, EPclin, EP, and classical prognostic factors will be investigated in different groups of patients. The correlation and concordance between EPclin calculations derived from biopsies and surgical specimens will be assessed.
Study design
- Observational model
- Case only
- Time perspective
- Prospective
- Target follow-up
- 10 Years
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Observational Group | – | Other: ObservationPatients with primary invasive breast cancer, Stage I/II; ER positive, HER2 (human epidermal growth factor receptor 2) negative, N0-N1, T1-T3, tested with EndoPredict®, age over 18 years, informed consent |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients with primary stage I or Ii breast cancer who met all inclusin and no exclusion criteria
Key inclusion criteria (8 listed)
- Informed consent
- Tested with EndoPredict within the previous 6 months before inclusion
- Age ≥ 18 years
- Patients with primary invasive breast cancer, Stage I/II
- ER-positive
Key exclusion criteria (4 listed)
- Inflammatory breast cancer
- Bilateral breast cancer
- Breast cancer in the last 10 years
- Other invasive malignancies in the last 5 years
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ObservationVisit 1 Informed consent Medical history Demographics Result of EndoPredict® Test Status of menopause Disease status Tumor board decision Planned anti-tumor-therapy Visit 2, 1 year after inclusion This visit will be documented at the study site Status of menopause Disease status Anti-tumor therapy Survival Following visits For these visits, patients will be asked directly through the Center for Clinical Trials of the Philipps-University Marburg (KKS Marburg) via phone. Status of Menopause Disease status Anti-tumor therapy Survival Treatment after end of the study The patient will be treated during and after end of study by physician's choice. | Other | Observational Group |
Primary outcome
Distant metastasis free survival
Time frame: 10 years
To show that female patients who have been tested as "low risk" by EndoPredict® (EPclin) and have been treated with endocrine therapy only for at least 5 years have a 10-year distant metastasis-free survival (DMFS) > 90 % (lower boundary of the one-sided 95 % confidence interval)
30 secondary outcomes
DMFS "low risk"
Time frame: 3, 5 and 10 years
DFS "low risk"
Time frame: 3, 5 and 10 years
OS "low risk"
Time frame: 3, 5 and 10 years
DMFS "high risk"
Time frame: 3, 5 and 10 years
DFS "high risk"
Time frame: 3, 5 and 10 years
OS "high risk"
Time frame: 3, 5 and 10 years
DMFS "high risk + low risk"
Time frame: 3, 5 and 10 years
DFS "high risk + low risk"
Time frame: 3, 5 and 10 years
OS "high risk + low risk"
Time frame: 3, 5 and 10 years
Portion of patients tumor board follows the EndoPredict® result
Time frame: 1 year
Portion of patient treated according EndoPredict® result
Time frame: 1 year
Prognostic Performance of classical prognostic factors compared to EndoPredict®
Time frame: 3, 5 and 10 years
DMFS "low risk vs. high risk"
Time frame: 3, 5 and 10 years
DFS "low risk vs. high risk"
Time frame: 3, 5 and 10 years
OS "low risk vs. high risk"
Time frame: 3, 5 and 10 years
DMFS of patient proportion of EPclin low and high risk patients in Ki67 low, intermediate and high tumors
Time frame: 3, 5 and 10 years
DFS of patient proportion of EPclin low and high risk patients in Ki67 low, intermediate and high tumors
Time frame: 3, 5 and 10 years
OS of patient proportion of EPclin low and high risk patients in Ki67 low, intermediate and high tumors
Time frame: 3, 5 and 10 years
DMFS "low risk vs. high risk" who have /have not been treated according to the S3 and St. Gallen guidelines
Time frame: 3, 5 and 10 years
DFS "low risk vs. high risk" who have /have not been treated according to the S3 and St. Gallen guidelines
Time frame: 3, 5 and 10 years
OS "low risk vs. high risk" who have /have not been treated according to the S3 and St. Gallen guidelines
Time frame: 3, 5 and 10 years
Chemotherapy regimens
Time frame: 1 year
Given endocrine therapy
Time frame: 10 years
Duration of endocrine therapy
Time frame: 10 years
Proportion of patients with prolonged endocrine therapy
Time frame: 10 years
DMFS for patients with 5 years of endocrine therapy vs. extended endocrine therapy
Time frame: 10 years
DFS for patients with 5 years of endocrine therapy vs. extended endocrine therapy
Time frame: 10 years
OS for patients with 5 years of endocrine therapy vs. extended endocrine therapy
Time frame: 10 years
Correlation ( pT- and pN data vs. ciT and ciN-data)
Time frame: 1 year
Concordance ( pT- and pN data vs. ciT and ciN-data)
Time frame: 1 year
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Apr 2026.
- Background: PubMed 27400969Buus R, Sestak I, Kronenwett R, Denkert C, Dubsky P, Krappmann K, Scheer M, Petry C, Cuzick J, Dowsett M. Comparison of EndoPredict and EPclin With Oncotype DX Recurrence Score for Prediction of Risk of Distant Recurrence After Endocrine Therapy. J Natl Cancer Inst. 2016 Jul 10;108(11):djw149. doi: 10.1093/jnci/djw149. Print 2016 Nov.
- Background: PubMed 25929335Cobain EF, Hayes DF. Indications for prognostic gene expression profiling in early breast cancer. Curr Treat Options Oncol. 2015 May;16(5):23. doi: 10.1007/s11864-015-0340-x.
- Background: PubMed 22371223Denkert C, Kronenwett R, Schlake W, Bohmann K, Penzel R, Weber KE, Hofler H, Lehmann U, Schirmacher P, Specht K, Rudas M, Kreipe HH, Schraml P, Schlake G, Bago-Horvath Z, Tiecke F, Varga Z, Moch H, Schmidt M, Prinzler J, Kerjaschki D, Sinn BV, Muller BM, Filipits M, Petry C, Dietel M. Decentral gene expression analysis for ER+/Her2- breast cancer: results of a proficiency testing program for the EndoPredict assay. Virchows Arch. 2012 Mar;460(3):251-9. doi: 10.1007/s00428-012-1204-4. Epub 2012 Feb 28.
- Background: PubMed 25836324Denkert C, Pfitzner BM, Heppner BI, Dietel M. [Molecular pathology for breast cancer: Importance of the gene expression profile]. Pathologe. 2015 Mar;36(2):145-53. doi: 10.1007/s00292-015-0009-z. German.
- Background: PubMed 24157828Dubsky P, Brase JC, Jakesz R, Rudas M, Singer CF, Greil R, Dietze O, Luisser I, Klug E, Sedivy R, Bachner M, Mayr D, Schmidt M, Gehrmann MC, Petry C, Weber KE, Fisch K, Kronenwett R, Gnant M, Filipits M; Austrian Breast and Colorectal Cancer Study Group (ABCSG). The EndoPredict score provides prognostic information on late distant metastases in ER+/HER2- breast cancer patients. Br J Cancer. 2013 Dec 10;109(12):2959-64. doi: 10.1038/bjc.2013.671. Epub 2013 Oct 24.
- Background: PubMed 23035151Dubsky P, Filipits M, Jakesz R, Rudas M, Singer CF, Greil R, Dietze O, Luisser I, Klug E, Sedivy R, Bachner M, Mayr D, Schmidt M, Gehrmann MC, Petry C, Weber KE, Kronenwett R, Brase JC, Gnant M; Austrian Breast and Colorectal Cancer Study Group (ABCSG). EndoPredict improves the prognostic classification derived from common clinical guidelines in ER-positive, HER2-negative early breast cancer. Ann Oncol. 2013 Mar;24(3):640-7. doi: 10.1093/annonc/mds334. Epub 2012 Oct 3.
- Background: PubMed 22152853Early Breast Cancer Trialists' Collaborative Group (EBCTCG); Peto R, Davies C, Godwin J, Gray R, Pan HC, Clarke M, Cutter D, Darby S, McGale P, Taylor C, Wang YC, Bergh J, Di Leo A, Albain K, Swain S, Piccart M, Pritchard K. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet. 2012 Feb 4;379(9814):432-44. doi: 10.1016/S0140-6736(11)61625-5. Epub 2011 Dec 5.
- Background: PubMed 28877230Ettl J, Klein E, Hapfelmeier A, Grosse Lackmann K, Paepke S, Petry C, Specht K, Wolff L, Hofler H, Kiechle M. Decision impact and feasibility of different ASCO-recommended biomarkers in early breast cancer: Prospective comparison of molecular marker EndoPredict and protein marker uPA/PAI-1. PLoS One. 2017 Sep 6;12(9):e0183917. doi: 10.1371/journal.pone.0183917. eCollection 2017.
- Background: PubMed 21807638Filipits M, Rudas M, Jakesz R, Dubsky P, Fitzal F, Singer CF, Dietze O, Greil R, Jelen A, Sevelda P, Freibauer C, Muller V, Janicke F, Schmidt M, Kolbl H, Rody A, Kaufmann M, Schroth W, Brauch H, Schwab M, Fritz P, Weber KE, Feder IS, Hennig G, Kronenwett R, Gehrmann M, Gnant M; EP Investigators. A new molecular predictor of distant recurrence in ER-positive, HER2-negative breast cancer adds independent information to conventional clinical risk factors. Clin Cancer Res. 2011 Sep 15;17(18):6012-20. doi: 10.1158/1078-0432.CCR-11-0926. Epub 2011 Aug 1.
- Background: PubMed 25867274Fitzal F, Filipits M, Rudas M, Greil R, Dietze O, Samonigg H, Lax S, Herz W, Dubsky P, Bartsch R, Kronenwett R, Gnant M. The genomic expression test EndoPredict is a prognostic tool for identifying risk of local recurrence in postmenopausal endocrine receptor-positive, her2neu-negative breast cancer patients randomised within the prospective ABCSG 8 trial. Br J Cancer. 2015 Apr 14;112(8):1405-10. doi: 10.1038/bjc.2015.98. Epub 2015 Mar 24.
- Background: PubMed 23039280Kronenwett R, Bohmann K, Prinzler J, Sinn BV, Haufe F, Roth C, Averdick M, Ropers T, Windbergs C, Brase JC, Weber KE, Fisch K, Muller BM, Schmidt M, Filipits M, Dubsky P, Petry C, Dietel M, Denkert C. Decentral gene expression analysis: analytical validation of the Endopredict genomic multianalyte breast cancer prognosis test. BMC Cancer. 2012 Oct 5;12:456. doi: 10.1186/1471-2407-12-456.
- Background: PubMed 24725534Martin M, Brase JC, Calvo L, Krappmann K, Ruiz-Borrego M, Fisch K, Ruiz A, Weber KE, Munarriz B, Petry C, Rodriguez CA, Kronenwett R, Crespo C, Alba E, Carrasco E, Casas M, Caballero R, Rodriguez-Lescure A. Clinical validation of the EndoPredict test in node-positive, chemotherapy-treated ER+/HER2- breast cancer patients: results from the GEICAM 9906 trial. Breast Cancer Res. 2014 Apr 12;16(2):R38. doi: 10.1186/bcr3642.
- Individual participant dataSharing planned: No
Related trials for Primary Invasive Breast Cancer
RecruitingObservational study
Biospecimen and Medical Data Collection and Tumor Biopsy in Creating Research Tissue Registry in Patients With Inflammatory or Invasive Breast Cancer
Inflammatory Breast Carcinoma, Invasive Breast Carcinoma
Active, not recruitingPhase 2
Carboplatin and Paclitaxel With or Without Panitumumab in Treating Patients With Invasive Triple Negative Breast Cancer
Breast Carcinoma, Breast Lump
Active, not recruitingObservational study
National Cancer Institute "Cancer Moonshot Biobank"
Acute Myeloid Leukemia, Anatomic Stage III Breast Cancer AJCC v8
Active, not recruitingPhase 2
Genetic Testing in Predicting Tumor Response in Patients With Stage I-III HER2 Negative Invasive Breast Cancer
Anatomic Stage I Breast Cancer AJCC v8, Anatomic Stage IA Breast Cancer AJCC v8
RecruitingObservational study
To Identify Primary Resistance to CDK4/6 Inhibitors in Breast Cancer
Metastatic Breast Cancer, ER Positive Breast Cancer
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Marion Kiechle, Prof. Dr. principal investigator
TU München (TUM) Lehrstuhl für Gynäkologie und Geburtshilfe
40 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Primary Invasive Breast Cancer and Estrogen Receptor Positive Tumor, run by North Eastern German Society of Gynaecological Oncology at 40 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 13 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 40 sites in Germany, Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Distant metastasis free survival (time frame: 10 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03503799, which also lists 15 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2026.