NCT05241119 Axillary Lymph Node Treatment Guided by Naocarbon Tracing After Neoadjuvant Chemotherapy
| NCT ID | NCT05241119 |
| Status | Recruiting |
| Phase | — |
| Sponsor | Shengjing Hospital |
| Condition | Breast Cancer |
| Study Type | INTERVENTIONAL |
| Enrollment | 100 participants |
| Start Date | 2021-11-01 |
| Primary Completion | 2023-10-31 |
Eligibility & Interventions
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What to Expect as a Participant
You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.
This trial targets 100 participants in total. It began in 2021-11-01 with a primary completion date of 2023-10-31.
⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.
Brief Summary
For patients with early breast cancer with negative axillary lymph nodes, sentinel lymph node biopsy (SLNB) can largely avoid complications such as upper limb lymphoedema caused by axillary lymph node dissection (ALND). Locally advanced breast cancer requires neoadjuvant chemotherapy (NAC), based on the breast cancer treatment guidelines. In addition to shrinking the primary breast lesion, NAC can reduce the stage for axillary positive lymph nodes. Therefore, in recent years clinicians have been considering SLNB for patients whose axillary lymph nodes have turned negative after NAC. After verification by the clinical trials, the current NCCN guidelines recommend that patients with T1-3N0-1 undergo SLNB after NAC, however, the false negative rate (FNR) of conventional SLNB after NAC is as high as 14%, which potentially leads to underestimation of the risk for recurrence and metastasis, insufficient adjuvant therapy, eventually affects long-term survival. Thus, how to accurately assess and treat axillary lymph nodes after NAC remains an urgent clinical question to be answered. In recent years, a method using a metal clip to label positive lymph node before NAC has emerged in order to reduce the FNR of SLNB after NAC. Its principle is to trace the metastasized lymph node, so that the lymph node can be accurately found in the surgery, even if the lymph node is not blue-stained at the time. Apparently, this method is more suitable for small number of nodes, and inappropriate for more than two metastasized nodes. The diameter of manocarbon particles (150nm) is between that of lymphatic capillaries (120-500nm) and capillaries (20-50 nm). With the unique macrophage phagocytosis, nanocarbon particles can remain in the lymphatic system for a long time. Using nanocarbon to label positive lymph nodes before NAC, our pilot study explored the regression of axillary lymph nodes after NAC. We found that, except for a small number of drug-resistant patients, the regression of positive lymph nodes after NAC followed a pattern of from the superior to the inferior, and from the medial to the lateral. We also found that, the worse the efficacy of NAC, the fewer black-stained nodes after NAC, suggesting long-term tracing of positive axillary lymph nodes by nanocarbon particles can guide precise treatment of axillary lymph nodes after NAC. These findings are integrated with our previous research project which investigated the spatial distribution of positive axillary lymph nodes with the intercostals brachial nerve (ICBN) as the boundary. It is proposed that low lymph node dissection below ICBN (pALND) may be a safe and efficient method reducing lymphoedema in patients with negative nodes after NAC. Prone position CT scan combined with clinical palpation of axillary lymph nodes can comprehensively evaluate axillary conditions in patients with breast cancer before surgery, and determine node metastasis accurately, and make correct clinical plans.
Eligibility Criteria
Inclusion Criteria: * invasive breast cancer confirmed by biopsy and histology; * based on prone CT scan and Doppler ultrasound, axillary stage cN2-3; * agree and meet the requirements for NAC; * meet surgical requirements and agree to undergo surgery after NAC; * the regime of NAC follows the NCCN recommendations. Exclusion Criteria: • previous history of breast cancer or other malignant tumors.
Contact & Investigator
Jianyi Jianyi, Master
PRINCIPAL INVESTIGATOR
Cancer Hospital of China Medical University, Liaoning Cancer Hospital
Frequently Asked Questions
Who can join the NCT05241119 clinical trial?
This trial is open to female participants only, aged 18 Years or older, up to 70 Years, studying Breast Cancer. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.
Is NCT05241119 currently recruiting?
Yes, NCT05241119 is actively recruiting participants. Contact the research team at sjbreast@yeah.net for enrollment information.
Where is the NCT05241119 trial being conducted?
This trial is being conducted at Shenyang, China, Shenyang, China.
Who is sponsoring the NCT05241119 clinical trial?
NCT05241119 is sponsored by Shengjing Hospital. The principal investigator is Jianyi Jianyi, Master at Cancer Hospital of China Medical University, Liaoning Cancer Hospital. The trial plans to enroll 100 participants.
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