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Breast CancerVISION INCT04289935

Intelligent Vacuum Assisted Biopsy Immediately Before Surgery As an Intra- or Pre-Operative Surrogate for Patient Response to Neoadjuvant Chemotherapy for Breast Cancer

A study testing Vacuum assisted biopsy (VAB) in people with Breast Cancer, run by Klinik Hirslanden, Zurich at 26 sites in 4 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Neoadjuvant chemotherapy (NAC) is common practice in the primary treatment of breast cancer, leading to a complete pathologic remission (pCR) of the tumor in more than 50% in aggressive tumor types. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Breast Cancer
What is being tested?
Vacuum assisted biopsy (VAB)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
420 participants
Where
26 sitesin 4 countries
Study dates
17 Aug 2020to Jun 2025
Phase
Interventional
Are there results?
None posted in the registry

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

Who may be able to join

  • Written informed consent according to ICH/GCP regulations before registration and prior to any trial specific procedures
  • unifocal, histologically confirmed invasive breast cancer with IHC luminal B (with or without overexpression or amplification of the HER2 receptor) and all ER negative (ER < 10%) breast cancers
  • Initial tumor size larger than 1 and less than 5 cm (cT1c to cT2), any N, M0
  • Clipping of the primary tumor center prior to the start of neo-adjuvant chemotherapy
  • Neo-adjuvant chemotherapy resulting in a radiological complete response or near complete response on MR-Imaging (confirmed within 28 days before or on registration) as described in the trial specific MR-Imaging instructions (available on the welcome page of the study specific SecuTrial link). MRI is strongly recommended, alternative ultrasound
  • Former tumor bed must be accessible for biopsy
Show all 9Show fewer
  • Female or male aged ≥ 18 years
  • Adequate condition for breast cancer surgery
  • Patients with a previously treated malignancy are eligible, when the risk of the prior malignancy interfering with either safety or efficacy endpoints is very low

Who cannot join

  • Metastatic breast cancer
  • Multifocal/Multicentric breast cancer
  • Inflammatory breast cancer
  • Luminal-A types of breast cancers (ER ≥ 10% and PgR ≥ 10 % and G1 or 2, and/or Ki-67 ≤ 20%, HER2 negative) or low risk if assessed by a validated genomic prognostic test (e.g. Mammaprint, Endopredict, Oncotype or Nanostring)
  • Distinct radiological sign of residual disease in the breast after neo-adjuvant chemotherapy by imaging
  • Intra-/peritumoral microcalcifications larger than 2 cm at time of diagnosis
  • Any local therapy (irradiation or surgery) to the currently treated breast prior to the trial intervention
  • Any other serious underlying medical, psychiatric, psychological, familial or geographical condition, which in the judgment of the investigator may interfere with the planned staging, trial intervention and follow-up, affect patient compliance or place the patient at high risk from trial intervention-related complications

Trial locations and contacts

26 sites in 4 countries.

26 sites in 4 countries

Switzerland18 sites, 18 recruiting
  • Tumor Zentrum Aarau

    Aarau, 5000

    Andreas Jakob, MD, +41 62 836 78 30, andreas.jakob@tumor-zentrum.ch

    Andreas Jakob, MD

    Recruiting
  • Kantonsspital Baden

    Baden, 5404

    Cornelia Leo, Prof, +41 56 486 35 14, cornelia.leo@ksb.ch

    Cornelia Leo, Prof

    Recruiting
  • Universitätsspital Basel

    Basel, 4031

    Christian Kurzeder, Prof, +41 61 328 79 90, Christian.kurzeder@usb.ch

    Christian Kurzeder, Prof

    Recruiting
  • Bethesda Spital

    Basel, 4052

    Dieter Müller, MD, +41 61 823 77 00, dieter.müller@hin.ch

    Dieter Müller, MD

    Recruiting
  • St. Claraspital

    Basel

    Roberto Rodriguez, MD, +41 61 685 34 53, roberto.rodriguezrevuelto@claraspital.ch

    Roberto Rodriguez, MD

    Recruiting
  • Hirslanden Brustzentrum Bern Biel

    Bern, 3013

    Patrizia Sager, MD, +41 31 337 89 70, patrizia.sager@hirslanden.ch

    Patrizia Sager, MD

    Recruiting
  • Kantonsspital Graubünden

    Chur, 7000

    Martina Gabriella Maranta, MD, +41 81 254 81 64, martina.maranta@ksgr.ch

    Martina Maranta, MD

    Recruiting
  • Spital Thurgau AG Frauenfeld und Münsterlingen

    Frauenfeld, 8501

    Mathias Fehr, Prof, +41 52 723 72 55, mathias.fehr@stgag.ch

    Mathias Fehr, Prof

    Recruiting
  • Clinique de Genolier

    Genolier, 1272

    Magdalena Kohlik, MD, +41 22 366 93 67, mkohlik@genolier.net

    Magdalena Kohlik, MD

    Recruiting
  • Luzerner Kantonsspital

    Lucerne, 6000

    Kathrin Schwedler, MD, +41 41 205 12 36, kathrin.schwedler@luks.ch

    Kathrin Schwedler, MD

    Recruiting
  • Hirslanden Klinik St. Anna

    Lucerne, 6006

    Peter Dubsky, Prof, +41 41 208 37 54, peter.dubsky@hirslanden.ch

    Peter Dubsky, Prof

    Recruiting
  • Ente Ospedaliero Cantonale, Dipartimento di ginecologia e ostretricia

    Lugano, 6962

    Maria Luisa Gasparri, Prof., +41 91 811 61 54, marialuisa.gasparri@eoc.ch

    Maria Luisa Gasparri, Prof.

    Recruiting
  • Brustzentrum Rheinfelden

    Rheinfelden, 4310

    Maik Hauschild, MD, +41 61 835 62 20, maik.hauschild@gzf.ch

    Maik Hauschild, MD

    Recruiting
  • Kantonsspital St. Gallen

    Sankt Gallen, 9007

    Christine Strub, MD, +41 71 494 97 14, christine.strub@kssg.ch

    Christine Strub, MD

    Recruiting
  • Tumor- und BrustZentrum Ostschweiz

    Sankt Gallen, 9016

    Michael Knauer, Prof, +41 71 552 33 33, michael.knauer@tbz-ost.ch

    Michael Knauer, Prof

    Recruiting
  • Kantonsspital Winterthur

    Winterthur, 8401

    Denise Vorburger, MD, +41 52 266 31 73, denise.vorburger@ksw.ch

    Denise Vorburger, MD

    Recruiting
  • Brust-Zentrum Seefeld

    Zurich, 8008

    Christoph Tausch, MD, +41 44 533 81 00, c.tausch@brust-zentrum.ch

    Christoph Tausch, MD

    Recruiting
  • Universitäts Spital Zürich

    Zurich, 8091

    Heike Frauchiger-Heuer, MD, +41 44 255 42 37, heike.frauchiger-heuer@usz.ch

    Heike Frauchiger-Heuer, MD

    Recruiting

Other trials in Switzerland

Germany4 sites, 4 recruiting
  • Agaplesion Markus Krankenhaus

    Frankfurt, 60431

    Marc Thill, Prof., +49 69 9533 2228, marc.thill@agaplesion.de

    Marc Thill, Prof.

    Recruiting
  • Brustzentrum Heidelberg

    Heidelberg, 69121

    Jörg Heil, Prof., +49 6221 488 60 20, joerg.heil@kse-hd.de

    Joerg Heil, Prof.

    Recruiting
  • UFK Klinikum Südstadt Rostock

    Rostock, 18059

    Steffi Hartmann, MD, +49 381 4401 47 00, steffi.hartmann@kliniksued-rostock.de

    Steffi Hartmann, MD

    Recruiting
  • Helios Universitätsklinikum Wuppertal

    Wuppertal, 42283

    Vesna Bjelic-Radisic, Prof., +49 202 896 14 11, vesna.bjelic-radisic@helios-gesundheit.de

    Vesna Bjelic-Radisic, Prof.

    Recruiting

Other trials in Germany

Austria3 sites, 3 recruiting
  • Universitätsspital Salzburg

    Salzburg, 5020

    Andreas Sir, +43 572 555 74 34, a.sir@salk.at

    Andreas Sir, MD

    Not yet recruiting
  • Brustzentrum Schwaz

    Schwaz, 6130

    Michael Hubalek, MD, +43 5242 655 290, office@dr-hubalek.at

    Michael Hubalek, MD

    Recruiting
  • St. Josef Krankenhaus Wien

    Vienna, 1130

    Ulrich Schmidbauer, MD, +43 187 844 8200, ulrich.schmidbauer@sjk-wien.at

    Ulrich Schmidbauer, MD

    Recruiting

Other trials in Austria

United Arab Emirates1 site, 1 recruiting
  • Mediclinic City Hospital Dubai

    Dubai

    Annett Al-Hamadi, MD, +971 4555 9112, annett.hamadi@mediclinic.ae

    Annett Al Hamadi, MD

    Recruiting

Other trials in United Arab Emirates

About this study

Official title: Intelligent Vacuum Assisted Biopsy Immediately Before Surgery As an Intra- or Pre-Operative Surrogate for Patient Response to Neoadjuvant Chemotherapy for Breast Cancer (VISION I): a Multicenter Prospective Feasibility Trial

Neoadjuvant chemotherapy (NAC) is common practice in the primary treatment of breast cancer, leading to a complete pathologic remission (pCR) of the tumor in more than 50% in aggressive tumor types. As NAC induces different response patterns, radiologic imaging is not sufficiently accurate in predicting residual disease. Because of this uncertainty, surgery is so far the only valid option to either ascertain complete response or to remove the complete residual disease.

Vacuum-assisted biopsy (VAB) with the possibility of obtaining tissue of the former tumor center could contribute more reliably to detect any residual tumor or respectively, rule out residual disease. Ultrasound (US) or mammographically (MG) guided VAB will be used in this trial in order to detect residual tumor lesions in patients with radiological complete response (rCR) after NAC. The investigators will evaluate the diagnostic accuracy of the post-NAC VAB sample in comparison to the sample obtained in open surgery.

Read the detailed description

Neoadjuvant chemotherapy (NAC), initially indicated to downstage tumors to achieve the option of breast conserving surgery, has lately become common practice in the primary treatment of breast cancer. The use of modern NAC regimens lead to a complete pathologic remission (pCR) of the tumor in more than 50% in aggressive tumor types.

In general, it is difficult to predict pCR in the absence of invasive surgical techniques, as it depends on several factors such as biological subtype, the used chemotherapy regimen and anatomic stage. The most common imaging methods beside clinical examination are breast ultrasound, mammography and breast magnetic resonance imaging (MRI). As NAC induces different response patterns, radiologic imaging is not sufficiently accurate in predicting residual disease. Because of this uncertainty, surgery (and the standardized assessment of resected tissue) is so far the only valid option to either ascertain complete response or to remove the complete residual disease.

Vacuum-assisted biopsy (VAB) with the possibility of obtaining tissue of the former tumor center could contribute more reliably to detect any residual tumor or respectively, rule out residual disease. Ultrasound (US) or mammographically (MG) guided VAB will be used in this trial in order to detect residual tumor lesions in patients with radiological complete response (rCR) after NAC. The investigators will evaluate the diagnostic accuracy of the post-NAC VAB sample in comparison to the sample obtained in open surgery.

The main objective of the trial is to determine the diagnostic accuracy of I-VAB using the full pathologic specimen evalutation obtained after open surgery to detect residual tissue.

Conditions
Breast Cancer
Being tested
Vacuum assisted biopsy (VAB)
Keywords
Neoadjuvant chemotherapy, VISION I, breast cancer, Vacuum assisted biopsy
Medical subject headings
Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Vacuum assisted biopsy (VAB)Procedure or surgery

    The trial intervention consists of a diagnostic interventional procedure, US-guided or mammographically guided VAB post-NAC, prior to the standard breast surgery.

Study groups in NCT04289935
Study groupRoleWhat they receive
single armExperimental* Unicentric histologically confirmed invasive luminal B, HER2- enriched, triple negative breast cancer + Clipping + Neoadjuvant chemotherapy * rCR / near-rCR in MRI / US * Registration * US-guided VAB * Breast conserving surgery / mastectomy * Pathology examination 1. Preoperative VAB, 2. Surgical specimen
Receives: Procedure: Vacuum assisted biopsy (VAB)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Sensitivity

    Sensitivity of I-VAB is defined as proportion of true positive patients (Both VAB and surgery showing non pCR) given patients with non pCR assessed using surgical specimen.

    Measured: max. 6 weeks after registration

Secondary outcomes (6)
  1. Specificity

    Specificity of I-VAB is defined as proportion of true negative patients (Both VAB and surgery showing pCR) given patients with pCR assessed using surgical specimen.

    Measured: max. 6 weeks after registration

  2. Positive predictive value (PPV)

    PPV of I-VAB is defined as proportion of true positive patients given patients with non pCR assessed using VAB

    Measured: max. 6 weeks after registration

  3. Negative predictive value (NPV)

    NPV of I-VAB is defined as proportion of true negative patients given patients with pCR assessed using VAB

    Measured: max. 6 weeks after registration

  4. Accuracy (ACC)

    ACC of I-VAB is defined as the proportion of true positive and true negative patients.

    Measured: max. 6 weeks after registration

  5. Surgical lymph node status

    Surgical lymph node status (positive vs. negative) is categorized by the pathologist according to surgical specimen.

    Measured: max. 6 weeks after registration

  6. Adverse events

    Proportion of patients with bleeding/hematoma causing immediate surgical intervention and breast infection, which are related to VAB.

    Measured: From US-guided VAB (max. 6 weeks after registration) until 2 weeks after breast surgery (max 1 day after VAB).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Feb 2020
  2. Study start17 Aug 2020
  3. Primary completionJun 2025 (estimated)
  4. Study completionJun 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Sequential
Model description
multicenter, prospective, single arm, feasibility trial
Masking
None (open label)
Enrolment
420 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04289935
Sponsor's protocol ID
HIRSLANDEN 01 OPBC SAKK 23/18
Acronym
VISION I
Status last verified
Oct 2024
First submitted
25 Feb 2020
Last updated
23 Oct 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Vacuum assisted biopsy (VAB) in people with Breast Cancer, run by Klinik Hirslanden, Zurich at 26 sites in 4 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 9 inclusion and 8 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: status not confirmed, as of the sponsor's last update on 23 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 26 sites in Switzerland, Germany, Austria, United Arab Emirates. 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Daniel Tschopp (+41 44 387 9545, daniel.tschopp@hirslanden.ch), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Sensitivity (time frame: max. 6 weeks after registration). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 23 Oct 2024.

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