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HINTS AND TIPS
DEFINITIONS
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Trial registered on ANZCTR
Registration number
ACTRN12623000470695
Ethics application status
Approved
Date submitted
21/04/2023
Date registered
8/05/2023
Date last updated
28/04/2024
Date data sharing statement initially provided
8/05/2023
Date results provided
28/04/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
Contouring Conformance comparing Barrigel® with Surgical Clips for Post-Lumpectomy Cavity Delineation in Breast Cancer
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Scientific title
Contouring Conformance comparing Barrigel® with Surgical Clips for Post-Lumpectomy Cavity Delineation in Breast Cancer
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Secondary ID [1]
309503
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
breast cancer
329782
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Condition category
Condition code
Cancer
326679
326679
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0
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Breast
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants with newly diagnosed early breast cancers planned for breast conserving surgery attend the hospital for surgery.
In the operating theatre, following wide local excision of the breast cancer, the breast surgeon injects Barrigel (Non-animal stabilised hyaluronic acid gel) in the form of drops, with the goal to mark the deep and radial margins of the excision cavity. This involves drops (approximately 0.3 – 0.5 millilitres) injected using a sterile 21-23 gauge needle, starting at the base, injected just under the pectoral fascia at 4 points of the compass, indicating the deep margin. Further 4 drops are injected approximately 1cm interval above the base plane, also at 4 points of the compass, but at 1cm into the cavity wall, into the adjacent breast tissue. This is repeated at further 1cm intervals above the previous injection plane until the skin was reached. Standard surgical clips are also placed as markers at the same time to indicate the deep, radial and superficial margins of the excision cavity (approximately 4 to 6 clips are used).
Following surgery and adequate recovery (approximately 1 to 2 months, or later if the participants undergo adjuvant chemotherapy), participants attend the radiation oncology outpatient department for CT and MRI simulation planning scans, in preparation for their adjuvant radiotherapy treatment.
For the study, the scan images are de-identified and provided to radiation oncologists and radiologist to delineate the tumour bed aided by clips on CT, and gel on MRI.
These are then further evaluated for consistency and other characteristics.
The study participants' future surveillance breast imaging is then monitored for presence of the gel and its characteristics.
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Intervention code [1]
325932
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Treatment: Devices
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Intervention code [2]
326036
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Treatment: Other
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Comparator / control treatment
The tumour bed delineated on CT aided by surgical clips
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Control group
Active
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Outcomes
Primary outcome [1]
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Inter-observer variability of the delineated tumour bed using the overlap difference of contours using clips and CT versus gel and MRI.
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Assessment method [1]
334547
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Timepoint [1]
334547
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Within approximately 6 months after the final participant has undergone their CT and MRI scans.
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Secondary outcome [1]
421059
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Composite outcome of the presence or absence of the gel and its characteristics on routine surveillance breast imaging.
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Assessment method [1]
421059
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Timepoint [1]
421059
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At each annual post-op visit timepoints or when surveillance imaging are performed, for up to 2 years.
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Secondary outcome [2]
421368
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Adverse events following insertion of gel drops (eg. allergic reaction, infection, pain, bleed) graded using common terminology criteria for adverse events (CTCAE) version 5.
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Assessment method [2]
421368
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Timepoint [2]
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Immediately after insertion, on the day of CT / MRI scan, and up until the start of radiotherapy treatment (up to approximately 3 months post intervention, or 7 months if having chemotherapy before radiotherapy)
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Secondary outcome [3]
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Observer rating of the visibility and usefulness of gel drops on the MRI scans, using a 10-point Likert scale.
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Assessment method [3]
421385
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Timepoint [3]
421385
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At the time of tumour bed delineation, within approximately 6 months after the final participant has undergone their CT and MRI scans.
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Eligibility
Key inclusion criteria
Female patients with clinically node negative, unifocal early breast cancer, measuring a maximum diameter of 3 centimetre (cm), planned for wide local excision (WLE) and sentinel lymph node biopsy (SLNB) were eligible for the study. The breast carcinoma could be of any grade, oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2) status.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with allergy to hyaluronic acid, contraindication to magnetic resonance imaging (MRI), or who are unsuitable for RT (eg. active pregnancy, previous ipsilateral breast RT).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
All participants receive both clips and gel, and therefore act as their own control.
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
28/05/2021
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Date of last participant enrolment
Anticipated
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Actual
17/08/2022
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Date of last data collection
Anticipated
31/12/2024
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Actual
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Sample size
Target
36
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Accrual to date
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Final
35
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
24581
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Austin Health - Austin Hospital - Heidelberg
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Recruitment postcode(s) [1]
40177
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3084 - Heidelberg
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Funding & Sponsors
Funding source category [1]
313694
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Hospital
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Name [1]
313694
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Austin Health
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Address [1]
313694
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145 Studley Road, Heidelberg, VIC 3084
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Country [1]
313694
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Australia
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Funding source category [2]
313697
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Commercial sector/Industry
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Name [2]
313697
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Palette Life Sciences
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Address [2]
313697
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27 E Cota Street
4th Floor
Santa Barbara, California 93101
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Country [2]
313697
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United States of America
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Primary sponsor type
Hospital
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Name
Austin Health
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Address
145 Studley Road, Heidelberg, VIC 3084
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Country
Australia
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Secondary sponsor category [1]
315501
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None
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Name [1]
315501
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Address [1]
315501
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Country [1]
315501
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
312861
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Austin Health human research ethics committee
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Ethics committee address [1]
312861
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145 Studley Road PO Box 5555 Heidelberg Victoria Australia 3084
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Ethics committee country [1]
312861
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Australia
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Date submitted for ethics approval [1]
312861
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Approval date [1]
312861
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30/04/2021
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Ethics approval number [1]
312861
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HREC/68327/Austin-2020
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Summary
Brief summary
This study aims to determine whether Barrigel (hyaluronic acid gel) can delineate the tumour bed after breast cancer surgery Who is it for? You may be eligible to join this study if you have been diagnosed with early breast cancer and planned for wide local excision (WLE) and sentinel lymph node biopsy (SLNB) Study details All participants in this study will have both Barrigel and standard surgical clips applied following wide local incision of the breast cancer. Approximately 4-6 weeks after surgery (or after chemotherapy if needed), participants will undergo computed tomography (CT) scans and magnetic resonance imaging (MRI) scans to visualise the gel and clip placements. A group of doctors will then independently contour out where they think the tumour bed is, and the degree of overlap of each contour will help determine its efficacy. Participants will then be assessed annually for up to 2 years using routine surveillance breast mammography and ultrasound to determine gel presence and characteristics over the long-term. It is hoped that this research project will provide us more information about alternative ways to improve the accuracy of post-operative radiotherapy planning and treatment in early breast cancer, especially as MRI guided planning and treatment becomes more prevalent.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
126162
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Prof Michael Chao
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Address
126162
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Department of Radiation Oncology, Austin Health, 145 Studley Road, Heidelberg, VIC 3084
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Country
126162
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Australia
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Phone
126162
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+61 3 9496 9803
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Fax
126162
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Email
126162
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[email protected]
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Contact person for public queries
Name
126163
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Michael Chao
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Address
126163
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Department of Radiation Oncology, Austin Health, 145 Studley Road, Heidelberg, VIC 3084
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Country
126163
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Australia
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Phone
126163
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+61 3 9496 9803
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Fax
126163
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Email
126163
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[email protected]
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Contact person for scientific queries
Name
126164
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Michael Chao
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Address
126164
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Department of Radiation Oncology, Austin Health, 145 Studley Road, Heidelberg, VIC 3084
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Country
126164
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Australia
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Phone
126164
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+61 3 9496 9803
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Fax
126164
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Email
126164
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Individual participant data underlying published results only
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When will data be available (start and end dates)?
Beginning 3 months and ending 3 years following main results publication.
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Available to whom?
Researchers who provide a methodologically sound proposal, and at the discretion of the Primary Investigator.
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Available for what types of analyses?
Only to achieve the aims in the approved proposal
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How or where can data be obtained?
Access subject to approvals by Principal Investigator (
[email protected]
)
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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