CRYoablation for Small Tumors As Local Treatment - SIX Trial

Trial statusRecruiting
Trial phasePhase 3
Trial typeInterventional
Biological sexAll
Age18+
SponsorHospital do Coracao

About this trial

To demonstrate the non-inferiority of cryoablation compared to breast surgery for the local treatment of early-stage breast cancer and to conduct a cost-minimization analysis comparing direct costs between treatments.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Unifocal primary invasive breast carcinoma

Tumor size ≤ 2.0 cm (T1)

Complete pathological report (including results for ER, PR, HER2, Ki-67, and FISH report for the ERBB2 gene, if necessary)

Lesion visible on ultrasound

Disqualifiers

Multifocal or multicentric invasive breast carcinoma

Ductal carcinoma in situ

Breast cancer with skin involvement

Clinically positive axilla (N1, N2 or N3)

Trial design

Design model

Parallel

Treatments tested in this trial

  • cryoablation

    Procedure/Surgery

    Two devices can be used to perform cryoablation: Cryocare® and ProSense IceCure®: * Cryocare® - This procedure utilizes two types of gases: argon gas for freezing and helium gas for thawing. * ProSense IceCure® - This procedure uses extremely low temperatures generated by liquid nitrogen (LN2) to freeze and destroy the target tissue, without the need for an additional gas.

  • Breast Surgery (Lumpectomy or Mastectomy)

    Procedure/Surgery

    Surgery can be performed as lumpectomy or mastectomy and axillary surgery, preferably sentinel lymph node biopsy.

Treatment groups

750 Participants
are divided into 2 treatment groups
Group A: CryoablationExperimental treatment 0 interventions
Group B: Breast Surgery (Lumpectomy or Mastectomy)Active comparator 1 intervention

Trial outcomes

Primary outcomes

1

Locoregional recurrence (LRR)

LRR was defined as recurrence in the ipsilateral breast or chest wall, as well as in the ipsilateral axillary, supraclavicular/infraclavicular region, or internal mammary lymph nodes detected during follow-up, regardless of whether distant metastasis occurred before, after, or simultaneously.

Time frame
5 years
2

Cost-minimization

A cost-minimization analysis is an economic technique used to compare the costs of different interventions or treatments that produce equivalent outcomes in terms of efficacy and clinical effects. In other words, this analysis is applied when treatments are assumed to have the same clinical effectiveness, and the goal is to determine which one has the lowest cost. It is a type of cost-effectiveness analysis that compares only the costs of two or more technologies, as the health effects resulting from the compared technologies are considered similar. Clinical outcomes will not be taken into account. We will calculate the costs by collecting data on both direct and indirect expenses associated with the treatments. Direct costs will include procedure-related expenses such as equipment, supplies, medical fees, associated tests and consultations, hospitalization costs if applicable, and medication use. Indirect costs, if a societal perspective is considered, will include factors such as ti

Time frame
1 year

Secondary outcomes

1

Locoregional recurrence (LRR)

LRR was defined as recurrence in the ipsilateral breast or chest wall, as well as in the ipsilateral axillary, supraclavicular/infraclavicular region, or internal mammary lymph nodes detected during follow-up, regardless of whether distant metastasis occurred before, after, or simultaneously.

Time frame
1 year
2

Disease-free survival (DFS)

DFS is defined as the time from procedure to time of ipsilateral recurrence, contralateral recurrence, regional recurrence or distant metastasis, or date of last follow-up if none of the recurrence events occur.

Time frame
5 years
3

Overall Survival (OS)

OS is defined as the time from the date of first dose to the date of death due to any cause.

Time frame
5 years
4

Circulating tumor cells (CTCs)

CTCs are tumor cells that have sloughed off the primary tumor and extravasate into and circulate in the blood. Blood samples will be collected from participants included in the study at the time of the procedure, at 6 months, and at 1 year. A total of 10 mL of blood will be drawn via peripheral venipuncture into EDTA tubes (BD Vacutainer®), which will be maintained under homogenization for up to 6 hours at room temperature until filtration is performed (ISET®; Rarecells Diagnostics, Paris, France). CTCs will be identified through cytopathological analysis. After filtration, membranes washed with PBS and air-dried will be stored at -20°C until analysis. Blood samples for CTC research will preferably be sent within 48 hours and no later than 72 hours to the coordinating center.

Time frame
1 year

Other outcomes

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