Breast CancerMINIMAXNCT04486495
Minimal Invasive Axillary Staging and Treatment After Neoadjuvant Systemic Therapy in Node Positive Breast Cancer
An observational study of Breast Cancer and Neoadjuvant Therapy, run by Maastricht University Medical Center at 35 sites in Netherlands.
Trial summary
Today, the majority of clinically node positive (cN+) breast cancer patients is treated with neoadjuvant systemic therapy (NST). Axillary staging and treatment after NST in cN+ patients are areas of controversy. Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Breast Cancer, Neoadjuvant Therapy, Lymph Node Metastases
- How many people
- 549 participants
- Where
- 35 sitesNetherlands
- Study dates
- 16 Jul 2020to 1 Jul 2027
- How long will I take part?
- 5 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
- Women only
- No healthy volunteers
- Adult, Older adult
Study population: Female patients with unilateral invasive breast cancer and cN1-3, with a minimum of one pathologically proven positive axillary lymph node, treatment with neoadjuvant chemotherapy (± immunotherapy), followed by staging and treatment of the breast and axilla.
Who may be able to join
- Female patient with unilateral invasive breast cancer and cN1-3
- Pathologically proven positive axillary lymph node
- Planned to undergo neoadjuvant chemotherapy (± immunotherapy), followed by staging and treatment of the breast and axilla
Who cannot join
- Clinically node negative breast cancer before NST
- Bilateral invasive breast cancer
- Neoadjuvant endocrine therapy
- Distant metastases (including oligometastatic disease)
- History of invasive breast cancer
- Other malignancies, except for basal/squamous cell skin cancer, and in situ carcinoma of the cervix or breast
- Axillary surgery or radiotherapy before NST (this includes SLNB prior to NST)
Trial locations and contacts
35 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Janine Simons, MD, PhD contact
35 sites in 1 country
Netherlands35 sites, 35 recruiting
- Recruiting
Jeroen Bosch Hospital
's-Hertogenbosch
- Recruiting
Northwest Clinics
Alkmaar
- Recruiting
The Netherlands Cancer Institute
Amsterdam
- Recruiting
Gelre Hospital
Apeldoorn
- Recruiting
Rijnstate Hospital
Arnhem
- Recruiting
Red Cross Hospital
Beverwijk
- Recruiting
Alexander Monro Hospital
Bilthoven
- Recruiting
Amphia Hospital
Breda
- Recruiting
Van Weel-Bethesda
Dirksland
- Recruiting
Slingeland Hospital
Doetinchem
- Recruiting
Albert Schweitzer Hospital
Dordrecht
- Recruiting
Gelderse Vallei Hospital
Ede
- Recruiting
Catharina Hospital
Eindhoven
- Recruiting
Máxima Medical Center
Eindhoven
- Recruiting
Medisch Spectrum Twente
Enschede
- Recruiting
Martini Hospital
Groningen
- Recruiting
Saxenburgh Medical Center
Hardenberg
- Recruiting
Ziekenhuisgroep Twente
Hengelo
- Recruiting
Tergooi Hospital
Hilversum
- Recruiting
Spaarne Gasthuis
Hoofddorp
- Recruiting
Dijklander Hospital
Hoorn
- Recruiting
Medical Center Leeuwarden
Leeuwarden
- Recruiting
Leiden University Medical Center
Leiden
- Recruiting
Alrijne Hospital
Leiderdorp
- Recruiting
Haaglanden Medical Center
Leidschendam
- Recruiting
Maastricht University Medical Center
Maastricht
- Recruiting
Canisius Wilhelmina Hospital
Nijmegen
- Recruiting
Erasmus Medical Center
Rotterdam
- Recruiting
Franciscus Gasthuis
Rotterdam
- Recruiting
Ikazia Hospital
Rotterdam
- Recruiting
Maasstad Hospital
Rotterdam
- Recruiting
Spijkenisse Medical Center
Spijkenisse
- Recruiting
ZorgSaam Hospital
Terneuzen
- Recruiting
Diakonessenhuis
Utrecht
- Recruiting
Isala Hospital
Zwolle
About this study
Official title: Minimal Invasive Axillary Staging and Treatment After Neoadjuvant Systemic Therapy in Node Positive Breast Cancer (MINIMAX): a Dutch Multicenter Observational Study to Gain Insight in Less and More Invasive Axillary Staging and Treatment in Relation to Oncologic Safety and Quality of Life to Develop Evidence-based Guidelines.
Today, the majority of clinically node positive (cN+) breast cancer patients is treated with neoadjuvant systemic therapy (NST). Axillary staging and treatment after NST in cN+ patients are areas of controversy. Patients with a pathological complete response (pCR) of the axillary lymph nodes are not expected to benefit from axillary lymph node dissection (ALND). Hence, less invasive axillary staging procedures are being introduced to avoid unnecessary ALND. However, evidence supporting the safety of replacing ALND by less invasive techniques in terms of oncologic safety and impact on quality of life (QoL) is lacking.
Read the detailed description
The MINIMAX is a multicenter registry study that includes node positive breast cancer patients, who are treated with NST (chemotherapy and ± immunotherapy), in order to gain insight in the oncologic safety and impact on QoL of less and more invasive axillary staging and treatment strategies.
Patients who are included in this study will complete Patient Reported Outcome Measures (PROMs) at baseline (time of diagnosis), and 1 and 5 years after diagnosis to assess impact on QoL.
A database will be built by the Netherlands Cancer Registry. Data on patient-, tumor-, pre-NST staging-, post-NST staging- and treatment-characteristics will be retrieved from patients' records by trained data registrars of the Netherlands Comprehensive Cancer Organisation (IKNL) using electronic case report forms (eCRFs). Five-year survival and recurrence will be evaluated to determine oncologic safety.
The results will be incorporated in the national guidelines. In case of an equilibrium between less and more invasive strategies, the data of this study will at least be extremely suitable to be used in the shared decision making process.
- Conditions
- Breast Cancer, Neoadjuvant Therapy, Lymph Node Metastases
- Medical subject headings
- Breast Neoplasms, Lymphatic Metastasis
What is being measured
The primary outcome is the main question the study is designed to answer.
Disease free survival (DFS)
DFS is defined as the time interval between the date of diagnosis until the date that a patient survives without any signs or symptoms of the disease.
Measured: 5 years
Breast cancer specific survival (BCSS)
BCSS is defined as the time interval between the date of diagnosis until death from the disease.
Measured: 5 years
Overall survival (OS)
OS is defined as the time interval between the date of diagnosis until death from any cause.
Measured: 5 years
Axillary recurrence rate (ARR)
ARR is defined as tumor recurrence and as residual tumor that became clinically apparent in the ipsilateral axillary lymph nodes (pathologically proven).
Measured: 5 years
Quality of life, as measured by EQ-5D-5L
The EQ-5D-5L comprises a descriptive system questionnaire and a visual analogue scale (VAS). The descriptive system consists of five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. For each dimension, participants choose one of 5 levels that best describes their health on that day (from 'no problem'= 1 to 'unable/extreme'= 5). The numbers chosen for the five dimensions are combined to give a 5 digit score (minimum score = 11111 maximum score = 55555). The VAS provides participant's rating of their health on a scale from 0 ('the worst health you can imagine') to 100 ('the best health you can imagine').
Measured: Baseline, and 1 and 5 years after baseline
Quality of life, as measured by Quality of Life Questionnaire Core 30 Items (QLQ-C30) and QLQ-BR23
These questionnaires contain functional domains, global health status, and symptom scales. For functional domains and global health status, scores range from 0 to 100 with higher scores representing a better level of functioning. For symptoms scales, scores range from 0 to 100 with higher scores representing a greater degree of symptoms.
Measured: Baseline, and 1 and 5 years after baseline
Quality of life, as measured by BREAST-Q, which includes the following domains: satisfaction with breasts, psychosocial well being, physical well being, sexual well being.
All domains are scored 0 to 100 points. Higher points represent a better outcome.
Measured: Baseline, and 1 and 5 years after baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jul 2020
- Study start16 Jul 2020
- Primary completion1 Jul 2027 (estimated)
- Study completion1 Jul 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- More trials run by Maastricht University Medical CenterThe sponsor's other registered studies.
- 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
- Cohort
- Time perspective
- Prospective
- Enrolment
- 549 participants (estimated)
- Target duration
- 5 Years
Sponsor and investigators
- Lead sponsor
- Maastricht University Medical Center
- Sponsor type
- University, hospital or other
- Collaborators
- Erasmus Medical Center, The Netherlands Cancer Institute
- Responsible party
- Sponsor
- Investigators
- Marjolein Smidt, MD, PhD, Principal investigator, Maastricht University Medical CenterMarie-Jeanne Vrancken Peeters, MD, PhD, Principal investigator, The Netherlands Cancer InstituteLinetta Koppert, MD, PhD, Principal investigator, Erasmus Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04486495
- Sponsor's protocol ID
- 2020-12518
- Acronym
- MINIMAX
- Status last verified
- Aug 2022
- First submitted
- 7 Jul 2020
- Last updated
- 24 Aug 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 24 Aug 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Minimal Invasive Axillary Staging and Treatment After Neoadjuvant Systemic Therapy in Node Positive Breast Cancer (MINIMAX): a Dutch Multicenter Observational Study to Gain Insight in Less and More Invasive Axillary Staging and Treatment in Relation to Oncologic Safety and Quality of Life to Develop Evidence-based Guidelines.
- ClinicalTrials.gov ID
- NCT04486495
- Acronym / sponsor ID
- MINIMAX / 2020-12518
- Conditions
- Breast Cancer, Neoadjuvant Therapy, Lymph Node Metastases
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 549 participants (estimated)
- Lead sponsor
- Maastricht University Medical CenterUniversity, hospital or other
- Collaborators
- Erasmus Medical Center, The Netherlands Cancer Institute
- Study start
- 16 Jul 2020 (actual)
- Primary completion
- 1 Jul 2027 (estimated)
- Study completion
- 1 Jul 2027 (estimated)
- First posted
- 24 Jul 2020 (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.
Today, the majority of clinically node positive (cN+) breast cancer patients is treated with neoadjuvant systemic therapy (NST). Axillary staging and treatment after NST in cN+ patients are areas of controversy. Patients with a pathological complete response (pCR) of the axillary lymph nodes are not expected to benefit from axillary lymph node dissection (ALND). Hence, less invasive axillary staging procedures are being introduced to avoid unnecessary ALND. However, evidence supporting the safety of replacing ALND by less invasive techniques in terms of oncologic safety and impact on quality of life (QoL) is lacking.
Detailed description
The MINIMAX is a multicenter registry study that includes node positive breast cancer patients, who are treated with NST (chemotherapy and ± immunotherapy), in order to gain insight in the oncologic safety and impact on QoL of less and more invasive axillary staging and treatment strategies.
Patients who are included in this study will complete Patient Reported Outcome Measures (PROMs) at baseline (time of diagnosis), and 1 and 5 years after diagnosis to assess impact on QoL.
A database will be built by the Netherlands Cancer Registry. Data on patient-, tumor-, pre-NST staging-, post-NST staging- and treatment-characteristics will be retrieved from patients' records by trained data registrars of the Netherlands Comprehensive Cancer Organisation (IKNL) using electronic case report forms (eCRFs). Five-year survival and recurrence will be evaluated to determine oncologic safety.
The results will be incorporated in the national guidelines. In case of an equilibrium between less and more invasive strategies, the data of this study will at least be extremely suitable to be used in the shared decision making process.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Target follow-up
- 5 Years
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Female patients with unilateral invasive breast cancer and cN1-3, with a minimum of one pathologically proven positive axillary lymph node, treatment with neoadjuvant chemotherapy (± immunotherapy), followed by staging and treatment of the breast and axilla.
Key inclusion criteria (3 listed)
- Female patient with unilateral invasive breast cancer and cN1-3
- Pathologically proven positive axillary lymph node
- Planned to undergo neoadjuvant chemotherapy (± immunotherapy), followed by staging and treatment of the breast and axilla
Key exclusion criteria (7 listed)
- Clinically node negative breast cancer before NST
- Bilateral invasive breast cancer
- Neoadjuvant endocrine therapy
- Distant metastases (including oligometastatic disease)
- History of invasive breast cancer
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Disease free survival (DFS)
Time frame: 5 years
DFS is defined as the time interval between the date of diagnosis until the date that a patient survives without any signs or symptoms of the disease.
Breast cancer specific survival (BCSS)
Time frame: 5 years
BCSS is defined as the time interval between the date of diagnosis until death from the disease.
Overall survival (OS)
Time frame: 5 years
OS is defined as the time interval between the date of diagnosis until death from any cause.
Axillary recurrence rate (ARR)
Time frame: 5 years
ARR is defined as tumor recurrence and as residual tumor that became clinically apparent in the ipsilateral axillary lymph nodes (pathologically proven).
Quality of life, as measured by EQ-5D-5L
Time frame: Baseline, and 1 and 5 years after baseline
The EQ-5D-5L comprises a descriptive system questionnaire and a visual analogue scale (VAS). The descriptive system consists of five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. For each dimension, participants choose one of 5 levels that best describes their health on that day (from 'no problem'= 1 to 'unable/extreme'= 5). The numbers chosen for the five dimensions are combined to give a 5 digit score (minimum score = 11111 maximum score = 55555). The VAS provides participant's rating of their health on a scale from 0 ('the worst health you can imagine') to 100 ('the best health you can imagine').
Quality of life, as measured by Quality of Life Questionnaire Core 30 Items (QLQ-C30) and QLQ-BR23
Time frame: Baseline, and 1 and 5 years after baseline
These questionnaires contain functional domains, global health status, and symptom scales. For functional domains and global health status, scores range from 0 to 100 with higher scores representing a better level of functioning. For symptoms scales, scores range from 0 to 100 with higher scores representing a greater degree of symptoms.
Quality of life, as measured by BREAST-Q, which includes the following domains: satisfaction with breasts, psychosocial well being, physical well being, sexual well being.
Time frame: Baseline, and 1 and 5 years after baseline
All domains are scored 0 to 100 points. Higher points represent a better outcome.
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 24 Aug 2022.
- Individual participant dataSharing planned: No
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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.
Janine Simons, MD, PhD contact
Marjolein Smidt, MD, PhD principal investigator
Maastricht University Medical Center
Marie-Jeanne Vrancken Peeters, MD, PhD principal investigator
The Netherlands Cancer Institute
Linetta Koppert, MD, PhD principal investigator
Erasmus Medical Center
35 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Breast Cancer and Neoadjuvant Therapy, run by Maastricht University Medical Center at 35 sites in Netherlands.
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 3 inclusion and 7 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: looking for participants now, as of the sponsor's last update on 24 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 35 sites in Netherlands. 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?
Contact Sabine de Wild, MD (+31433881574, s.dewild@maastrichtuniversity.nl), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Disease free survival (DFS) (time frame: 5 years). The study lists 7 primary outcomes in all. 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 24 Aug 2022; AzTrials last refreshed its copy on 6 Nov 2026.