This randomized research trial studies how well serum tumor marker directed disease monitoring works in monitoring patients with hormone receptor positive Her2 negative breast cancer that has spread to other places in the body. Using markers to prompt when scans should be ordered may be as good as the usual approach to monitoring disease.
STEP 1 REGISTRATION
Patients must have a diagnosis of hormone receptor positive (estrogen receptor positive [ER+] and/or progesterone receptor positive [PR+]), HER-2 negative, metastatic (M1) breast cancer and must be receiving or plan to receive first-line systemic treatment for metastatic disease. (Systemic treatment is any treatment meant to treat the whole body such as endocrine therapy +/- targeted therapy +/- chemotherapy).
NOTE: Participants are eligible if they have either de-novo metastatic breast cancer and/or recurrent breast cancer from an earlier stage that is now metastatic
Patients must be registered to step 1 between 14 days prior to and 60 days after start of first-line systemic treatment for metastatic disease
None
Parallel
Usual care disease monitoring
Other interventionImaging and serum tumor markers are at the discretion of the treating physician (however imaging must be performed at least every 12 weeks).
Serum Tumor Marker directed disease monitoring
Other interventionSerum tumor markers every 4-8 weeks without imaging
Quality-of-Life Assessment
Other interventionAncillary studies
Anxiety Questionnaire Administration
Other interventionAncillary studies
Assessment of whether patients monitored with STMDDM have non-inferior overall survival compared with patients monitored with usual care
The assessment of whether patients monitored with STMDDM have non-inferior overall survival compared with patients monitored with usual care will be based on multivariable Cox regression, adjusting for intervention assignment (intention-to-treat) and the stratification factor (bone only versus visceral disease). If at the time of final analysis the study shows notably fewer events than anticipated, extended follow-up will be examined for its potential to allow examination of the primary endpoint with full power.
Cumulative direct healthcare costs (in the United States) of patients monitored with STMDDM versus usual care
The comparison of direct healthcare costs (in the US) by arm will be based on a multivariable linear regression, adjusting for patient and tumor characteristics.
Assessment of anxiety of patients monitored with STMDDM compared to patients monitored with usual care
Patient anxiety will be measured at baseline and at 12, 24, 36, 48, and 102 after randomization using the State-Trait Anxiety inventory Scale (STAI-S). Differences in anxiety by arm will be evaluated using a mixed-effects model for repeated measures controlling for the baseline score and stratification factor as covariates. No direction of effect will be assumed, implying two-sided testing.
Assessment of quality of life of patients monitored with STMDDM versus patients monitored with usual care
Patient quality of life (QOL) will be measured at baseline and at weeks 12, 24, 36, 48, and 102 after randomization using the PROMIS-29. Differences in QOL by arm will be evaluated using a mixed-effects model for repeated measures, controlling for the baseline score and stratification factor as covariates. No direction of effect will be assumed, implying two-sided testing.
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SWOG Cancer Research Network
Lead sponsor
National Cancer Institute (NCI)
Collaborator
