AzTrials
AzTrials

Breast CarcinomaPERICAFSNCT06666517

The Relationship Between the Density of Cancer-Associated Fibroblasts in the Peritumoral Stroma and Clinicopathological Data in Breast Cancer Patients

A study testing surgery (any volume) and / or pharmaceuticals treatment initiated or planned or only dynamic observation, in accordance with current clinical guidelines, Immunohistochemistry Analysis and Second Biopsy in people with Breast Carcinoma, run by Haydarpasa Numune Training and Research Hospital at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Research Question: Is there a relationship between the clinical prognosis and pathological data of breast cancer patients and the density of cancer-associated fibroblasts in the peritumoral stroma? Objectives of the Study: 1. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Carcinoma
What is being tested?
surgery (any volume) and / or pharmaceuticals treatment initiated or planned or only dynamic observation, in accordance with current clinical guidelines, Immunohistochemistry Analysis and Second Biopsy
Type of treatment
Surgery or procedure
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
69 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 Apr 2021to 27 Feb 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
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients diagnosed with histopathologically confirmed Luminal B, HER2-positive, or triple-negative breast cancer subtypes.
  • Patients who have not previously received any neoadjuvant chemoradiotherapy.
  • Patients over 18 years of age.
  • Adequate cellularity in biopsies obtained via core needle biopsy.

Who cannot join

  • Patients diagnosed with histopathologically confirmed Luminal A breast cancer subtype.
  • Patients who have previously received any neoadjuvant chemoradiotherapy.
  • Patients under 18 years of age.
  • Inadequate cellularity in biopsies obtained via core needle biopsy.

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Haydarpasa Numune Training and Research Hospital

    Istanbul, Uskudar, 34668

Other trials in Turkey (Türkiye)

About this study

Research Question:

Is there a relationship between the clinical prognosis and pathological data of breast cancer patients and the density of cancer-associated fibroblasts in the peritumoral stroma?

Objectives of the Study:

  1. Detection of cancer-associated fibroblasts in the tumor microenvironment across different breast cancer subtypes.
  2. Examination of the correlation between the clinical prognosis and pathological data of patients with different breast cancer subtypes and cancer-associated fibroblast subtypes.

The goal of this study based on the correlation obtained, the aim is to propose cancer-associated fibroblasts as a more effective marker for breast cancer classification and prognosis.

Read the detailed description

During the routine marking before neoadjuvant chemotherapy of breast cancer patients with triple-negative, HER2-positive, or Luminal B molecular subtypes, the correlation between the density of cancer-associated fibroblasts in the samples taken from the center of the tumor and the peritumoral stroma of the same mass with the patient's clinical prognosis and pathological data will be examined.

Approach and Methods:

Collection of Tissue Samples via Core Needle Biopsy from Breast Cancer Patients (Luminal B, HER2 Group, and Triple-Negative Group):

Breast masses will be examined supine using an ultrasound machine with a 14 MHz linear transducer. The tumor and peritumoral parenchyma will be evaluated using a 1.5 T MRI machine with a 16-channel breast coil, in the prone position, under dynamic contrast-enhanced and diffusion-weighted imaging guidance. Under sonographic guidance and local anesthesia, one tissue sample will be taken from the center of the mass using a 14G/10 cm core needle immediately before marking for neoadjuvant chemotherapy. One tissue sample will be taken from the peritumoral stroma where diffusion restriction is shown in diffusion-weighted MRI from patients diagnosed with Luminal B, HER2, or triple-negative malignancy.

Identification of Cancer-Associated Fibroblasts via Immunohistochemical Analysis:

For immunohistochemical analysis, 3 µm thick sections will be taken from paraffin blocks prepared from the core needle biopsy tissues from the periphery of the tumor, and the blocks will be deparaffinized in an incubator at 60 °C. The prepared slides will be stained using the LEICA Bond III fully automated IHC system, with the FAPα antibody, SMA antibody, and PDGFR-β antibody. Diaminobenzidine (DAB) will be used as the chromogen. Positive control tissues will include Fibroblast Activation Protein, alpha [SP325] Conc. 0.1mL (1:100) colon adenocarcinoma, Actin Smooth Muscle [1A4] Conc. 0.1mL (1:100-500) appendix, and PDGFR-B [D-6] C.Liq.1ml (1:50-500) kidney.

The immunohistochemical analysis of the patient under clinical follow-up will be compared with the type of surgery performed, the pathological data, and the clinical prognosis.

Being tested
surgery (any volume) and / or pharmaceuticals treatment initiated or planned or only dynamic observation, in accordance with current clinical guidelines, Immunohistochemistry Analysis, Second Biopsy
Keywords
cancer associated fibroblast, breast cancer, tumor microenvironment
Medical subject headings
Breast Neoplasms

What participants receive

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

  • surgery (any volume) and / or pharmaceuticals treatment initiated or planned or only dynamic observation, in accordance with current clinical guidelinesProcedure or surgery

    Routine surgery after neoadjuvant chemotherapy for breast cancer according to current guidelines.

  • Immunohistochemistry AnalysisOther

    Determination of breast cancer subtypes through immunohistochemical analysis, and selection of Luminal B, HER2-positive, and triple-negative groups.

  • Second BiopsyProcedure or surgery

    Taking biopsies from the center of the tumor and the peritumoral stroma of the same mass during marking of the mass before neoadjuvant chemotherapy

Study groups in NCT06666517
Study groupRoleWhat they receive
1- Subtyping of Breast Cancer Patients.Sham comparatorBiopsy collection from patients who were diagnosed with breast cancer, subtyping of biopsy materials, and identification of patients with Luminal A, Luminal B, HER2 positive group, and triple-negative types.
Receives: Other: Immunohistochemistry Analysis
5- Surgery PhaseSham comparatorSurgery after neoadjuvant chemotherapy
Receives: Procedure: surgery (any volume) and / or pharmaceuticals treatment initiated or planned or only dynamic observation, in accordance with current clinical guidelines
2- Identification of patients to be included in the study.No interventionIdentification of patients diagnosed with breast cancer who meet the study's eligibility criteria.
3- Second BiopsyExperimentalTaking biopsies from the center of the tumor and the peritumoral stroma of the same mass during marking of the mass before neoadjuvant chemotherapy
Receives: Procedure: Second Biopsy
4- Detection of cancer-associated fibroblastsNo interventionAnalysis of cancer-associated fibroblasts using immunohistochemical methods on materials taken from the periphery and center of patients' tumors during the second biopsy.
6- Statistically AnalyzeNo interventionThe investigators compare cancer-associated fibroblast densities by analyzing monitored patients' clinical and pathological data and statistically analyze and interpret the results.

What is being measured

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

  1. Detection of Cancer-Associated Fibroblasts via Immunohistochemical Analysis

    The detection of cancer-associated fibroblasts will be conducted separately using each immunohistochemical stain, and after the density(percentage) and intensity(will be scored 1 to 4) are assessed, the H-score(percentage X intensity score) will be determined by an expert pathologist, followed by grouping.

    Measured: Within 4 weeks after immunohistochemical staining.

Secondary outcomes (1)
  1. Collecting Patient Information From The Hospital System

    Patients who underwent surgery after neoadjuvant chemotherapy will be monitored based on the following parameters in the pathology specimen: estrogen receptor(positive or negative), progesterone receptor(positive or negative), HER2 receptor(positive or negative), percentage of Ki67, nuclear grade(1,2 or 3), tumor diameter in centimeters, percentage of tumor-infiltrating lymphocytes, presence of in situ carcinoma, presence of multifocality, presence of lymphovascular invasion, residual cancer burden score(MD Anderson RCB Score) and clinically performed axillary and breast surgeries(breast sparing mastectomy, skin sparing mastectomy, nipple sparing mastectomy, modified radical mastectomy, axillary dissection or sentinel lymph node dissection), presence of recurrence and metastasis, whether they underwent reoperation, overall and disease-free survival in days and presence of mortality.

    Measured: Within 1 year after surgery

Timeline

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

  1. First posted30 Oct 2024
  2. Study start1 Apr 2021
  3. Primary completion15 Dec 2024
  4. Study completion27 Feb 2025

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
Basic science
Allocation
Non-randomised
Intervention model
Sequential
Masking
Single blind
Who is masked
Participant
Enrolment
69 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06666517
Sponsor's protocol ID
HNEAH-GAEK 2024/149
Other IDs
Unit of Scientific Research
Acronym
PERICAFS
Status last verified
Mar 2025
First submitted
8 Oct 2024
Last updated
13 Mar 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Everything can be accessible.

Publications

  • Giorello MB, Borzone FR, Labovsky V, Piccioni FV, Chasseing NA. Cancer-Associated Fibroblasts in the Breast Tumor Microenvironment. J Mammary Gland Biol Neoplasia. 2021 Jun;26(2):135-155. doi: 10.1007/s10911-020-09475-y. Epub 2021 Jan 4.

    PubMed 33398516
  • Barriga V, Kuol N, Nurgali K, Apostolopoulos V. The Complex Interaction between the Tumor Micro-Environment and Immune Checkpoints in Breast Cancer. Cancers (Basel). 2019 Aug 19;11(8):1205. doi: 10.3390/cancers11081205.

    PubMed 31430935
  • Wall SW, Echeverria GV. Avoiding Extinction: Cancer-Associated Fibroblasts Help Triple-Negative Breast Cancer Outrun Chemotherapy. Cancer Res. 2023 Nov 15;83(22):3667-3669. doi: 10.1158/0008-5472.CAN-23-2770.

    PubMed 37964615
  • Benyahia Z, Dussault N, Cayol M, Sigaud R, Berenguer-Daize C, Delfino C, Tounsi A, Garcia S, Martin PM, Mabrouk K, Ouafik L. Stromal fibroblasts present in breast carcinomas promote tumor growth and angiogenesis through adrenomedullin secretion. Oncotarget. 2017 Feb 28;8(9):15744-15762. doi: 10.18632/oncotarget.14999.

    PubMed 28178651
  • Eiro N, Gonzalez LO, Fraile M, Cid S, Schneider J, Vizoso FJ. Breast Cancer Tumor Stroma: Cellular Components, Phenotypic Heterogeneity, Intercellular Communication, Prognostic Implications and Therapeutic Opportunities. Cancers (Basel). 2019 May 13;11(5):664. doi: 10.3390/cancers11050664.

    PubMed 31086100
  • Salimifard S, Masjedi A, Hojjat-Farsangi M, Ghalamfarsa G, Irandoust M, Azizi G, Mohammadi H, Keramati MR, Jadidi-Niaragh F. Cancer associated fibroblasts as novel promising therapeutic targets in breast cancer. Pathol Res Pract. 2020 May;216(5):152915. doi: 10.1016/j.prp.2020.152915. Epub 2020 Mar 2.

    PubMed 32146002
  • Pelon F, Bourachot B, Kieffer Y, Magagna I, Mermet-Meillon F, Bonnet I, Costa A, Givel AM, Attieh Y, Barbazan J, Bonneau C, Fuhrmann L, Descroix S, Vignjevic D, Silberzan P, Parrini MC, Vincent-Salomon A, Mechta-Grigoriou F. Cancer-associated fibroblast heterogeneity in axillary lymph nodes drives metastases in breast cancer through complementary mechanisms. Nat Commun. 2020 Jan 21;11(1):404. doi: 10.1038/s41467-019-14134-w.

    PubMed 31964880

Questions about this trial

What is this clinical trial studying?

A study testing surgery (any volume) and / or pharmaceuticals treatment initiated or planned or only dynamic observation, in accordance with current clinical guidelines, Immunohistochemistry Analysis and Second Biopsy in people with Breast Carcinoma, run by Haydarpasa Numune Training and Research Hospital at 1 site in Turkey (Türkiye).

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 4 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: finished, as of the sponsor's last update on 13 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). 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. Some participants in this study may receive a placebo. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Detection of Cancer-Associated Fibroblasts via Immunohistochemical Analysis (time frame: Within 4 weeks after immunohistochemical staining.). 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 NCT06666517, which also lists 7 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 Mar 2025.

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