256 Participants Needed

Cryoablation vs Lumpectomy for Early Stage Breast Cancer

(COOL-IT Trial)

HG
Overseen ByHeather Garrett, M.D.
Age: 18+
Sex: Female
Trial Phase: Academic
Sponsor: Washington University School of Medicine
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial studies the safety and effectiveness of cryoablation, a method that freezes and kills cancer cells, in patients with low risk, early stage breast cancer. It aims to see if cryoablation can be a better alternative to the usual surgery. Cryoablation has been successfully used to treat various types of solid tumors, including breast carcinomas, and is considered a less invasive alternative to surgical treatment.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is cryoablation safe for treating breast cancer?

Research shows that cryoablation is generally safe for treating breast cancer, with no major complications reported and only minor issues observed. Improvements in techniques and equipment have enhanced its safety profile.12345

How does cryoablation differ from lumpectomy for early-stage breast cancer?

Cryoablation is a minimally invasive treatment that uses extreme cold to destroy cancer cells, often performed with local anesthesia and guided by imaging, making it potentially more patient-friendly and cost-effective compared to traditional surgery like lumpectomy, which involves removing the tumor surgically.14567

What data supports the effectiveness of the treatment Cryoablation vs Lumpectomy for Early Stage Breast Cancer?

Research shows that cryoablation, a treatment that uses extreme cold to destroy cancer cells, is safe and effective for small breast tumors, with studies noting complete local tumor control in 73% of patients. It is also considered more patient-friendly due to its natural pain-relieving effects and satisfactory cosmetic outcomes.14678

Who Is on the Research Team?

HG

Heather Garrett, M.D.

Principal Investigator

Washington University School of Medicine

Are You a Good Fit for This Trial?

This trial is for women over 50 with early-stage, low-risk breast cancer (T1N0M0, Luminal A type, ER/PR positive, Her-2 negative) that's visible on ultrasound and not too close to the skin or chest muscles. Participants must have a specific Oncotype score if applicable and can't be pregnant or breastfeeding. They should not have had breast cancer before, no BRCA mutations, no electrical implants incompatible with MRI, and no allergy to local anesthetics.

Inclusion Criteria

My breast cancer has an Oncotype score below 26.
My breast cancer is early stage, hormone receptor positive, HER2 negative, and not aggressive.
My tumor can be seen on an ultrasound and is not too close to my skin or chest muscles.
See 2 more

Exclusion Criteria

My cancer has spread to the lymph nodes in my armpit.
I have a BRCA 1 or BRCA 2 gene mutation.
I have had breast cancer before.
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Safety Lead-In

Initial safety assessment of cryoablation procedure

31 days
1 visit (in-person)

Treatment

Participants receive either cryoablation or lumpectomy

Varies based on procedure
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

5 years
6 month MRI and yearly MRI/mammography

What Are the Treatments Tested in This Trial?

Interventions

  • Endocare SlimLine Cryoprobe
  • Lumpectomy
Trial Overview The study compares cryoablation—a technique of freezing tumors—with lumpectomy—the standard surgical removal of tumors—in treating T1 stage breast cancer. It aims to assess which method offers better disease control and quality of life while monitoring safety and complication rates.
How Is the Trial Designed?
4Treatment groups
Experimental Treatment
Active Control
Group I: Rescue Arm: LumpectomyExperimental Treatment1 Intervention
If there is evidence of residual or recurrent tumor on follow-up imaging evaluation (6 month MRI (if can tolerate) and yearly MRI/mammography), patients in the cryoablation safety lead-in and who were randomized to receive cryoablation only will be crossed over to receive a rescue lumpectomy followed by adjuvant treatment based on standard of care.
Group II: Cryoablation - Safety Lead InExperimental Treatment1 Intervention
Patients will be treated with cryoablation (Day 1) using the Endocare SlimLine Cyroprobe followed by adjuvant treatment.
Group III: CryoablationExperimental Treatment1 Intervention
Patients will be treated with cryoablation using the Endocare SlimLine Cyroprobe under real time ultrasound guidance and local anesthesia. The cryoablation consists of a 10 minute freeze phase followed by a 10 minute passive thaw, and ends with a second 10 minute freeze cycle. The freeze-thaw-freeze times may be adjusted at the physician's discretion depending on tumor size.
Group IV: LumpectomyActive Control1 Intervention
Lumpectomy will be performed under general anesthesia as per standard operative procedures at Washington University and Siteman Cancer Center.

Endocare SlimLine Cryoprobe is already approved in European Union, United States for the following indications:

🇪🇺
Approved in European Union as Cryoablation Therapy for:
  • Early-stage breast cancer
  • Benign breast tumors (fibroadenomas)
🇺🇸
Approved in United States as Cryoablation Therapy for:
  • Fibroadenoma (benign breast tumors)
  • Investigational for breast cancer

Find a Clinic Near You

Who Is Running the Clinical Trial?

Washington University School of Medicine

Lead Sponsor

Trials
2,027
Recruited
2,353,000+

The Foundation for Barnes-Jewish Hospital

Collaborator

Trials
43
Recruited
6,600+

Varian Medical Systems

Industry Sponsor

Trials
63
Recruited
3,700+

Dow R. Wilson

Varian Medical Systems

Chief Executive Officer since 2012

MBA from Dartmouth's Amos Tuck School of Business, BA from Brigham Young University

Dr. Deepak Khuntia

Varian Medical Systems

Chief Medical Officer since 2020

MD from the University of Cambridge, PhD from the University of Leicester

Published Research Related to This Trial

Cryoablation is a safe and effective treatment for early-stage breast cancer, particularly for tumors smaller than 1.5 cm, with successful destruction rates for cancers under 1.0 cm.
The presence of noncalcified ductal carcinoma-in-situ (DCIS) can lead to treatment failures, so cryoablation is recommended only for invasive ductal carcinoma with less than 25% DCIS in the biopsy.
Cryosurgery of breast cancer.Niu, L., Zhou, L., Xu, K.[2022]
Percutaneous breast cancer cryoablation demonstrated a complete local tumor control rate of 73% over an average follow-up period of 8 months, indicating its efficacy, especially for small ductal tumors under 15 mm.
The procedure was found to be safe, with no major complications reported and satisfactory cosmetic outcomes, suggesting it is a viable option for breast cancer treatment.
Percutaneous Image-Guided Cryoablation of Breast Cancer: A Systematic Review.Lanza, E., Palussiere, J., Buy, X., et al.[2022]
Cryoablation is a safe and effective primary therapy for breast fibroadenoma, providing durable results that can be replicated in community practices, making it a patient-friendly alternative to traditional heat-based treatments.
Cryolocalization, a new application of cryotechnology, helps create a clear frozen boundary around tumors, which may reduce the chances of leaving cancerous tissue behind during lumpectomy procedures.
Cryoablation and cryolocalization in the management of breast disease.Whitworth, PW., Rewcastle, JC.[2007]

Citations

1.China (Republic : 1949- )pubmed.ncbi.nlm.nih.gov
Cryosurgery of breast cancer. [2022]
Percutaneous Image-Guided Cryoablation of Breast Cancer: A Systematic Review. [2022]
Cryoablation and cryolocalization in the management of breast disease. [2007]
Unresected Breast Cancer: Evolution of Imaging Findings Following Cryoablation. [2020]
A Phase II Trial Exploring the Success of Cryoablation Therapy in the Treatment of Invasive Breast Carcinoma: Results from ACOSOG (Alliance) Z1072. [2022]
Cryoablation of benign breast tumors: evolution of technique and technology. [2006]
Percutaneous cryoablation of breast tumours in patients with stable metastatic breast cancer: safety, feasibility and efficacy. [2019]
CT-guided cryoablation of both breast cancer and lymph node axillary metastasis. [2020]
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