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| Name | Class |
|---|---|
| National University of Singapore | OTHER |
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To assess the safety and tolerability of combined PEMFs and anthracycline-based chemotherapy in subjects who are undergoing neoadjuvant chemotherapy for breast cancer treatment.
This was a single-center, open-label, Phase Ib study utilizing a 3+3 dose-escalation design. Patients with histologically confirmed ductal carcinoma were enrolled into three sequential cohorts. Dose Level 1 (DL1) enrolled patients with metastatic disease (Grade 3, Stage III/IV, ER-/HER2+) for a single 30-minute PEMF session to assess local toxicity. Dose Level 2 (DL2) enrolled patients were planned for upfront surgical resection (Grade 1-2, ER+/PR+) to assess wound-healing safety; PEMF was administered 30 minutes pre-surgery. Dose Level 3 (DL3) enrolled patients undergoing neoadjuvant chemotherapy (Grade 3, Stage I-III) to receive PEMF 30 minutes prior to their final cycle (4th cycle) of either Anthracycline (DL3a) or Taxane (DL3b) therapy. The primary endpoints were safety and incidence of device-related adverse events. The trial ended at Dose Level 3 and demonstrates that a 30-minute PEMF application is safe and well-tolerated in breast cancer patients across metastatic, pre-surgical, and neoadjuvant chemotherapy settings. The intervention had no adverse effect on surgical wound healing or on chemotherapy administration. These findings support the closure of the Phase I safety evaluation and justify progression to a Phase II trial to evaluate the efficacy of PEMF in enhancing chemotherapeutic response.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dose Level 1 (Metastatic Disease) | Experimental | Patients with metastatic disease (Grade 3, Stage III/IV, ER-/HER2+) receive a single PEMF session. |
|
| Dose Level 2 (Pre-Surgical) | Experimental | Patients planned for upfront surgical resection receive a single PEMF session prior to surgery. |
|
| Dose Level 3 (Neoadjuvant Chemotherapy | Experimental | Patients undergoing neoadjuvant chemotherapy receive a single PEMF session prior to their final chemotherapy cycle. This cohort is subdivided into those receiving Anthracycline (DL3a) and those receiving Taxane (DL3b). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pulsed electromagnetic fields (PEMFs) | Device | A single 30-minute PEMF session to assess local toxicity. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Treatment-Emergent Adverse Events as assessed by CTCAE 5.0 | Toxicity to treatment as assessed by Common Terminology Criteria for Adverse Events 5.0. Grade 1-5 refer to the severity of the adverse event with higher grade indicating greater severity. Grade 3 and above will be considered severe. A dose limiting toxicity will be defined as Grade 3 or above toxicity of the following: a) pain in breast where PEMF was applied
| up to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Treatment response as assessed by clinical measurement of tumor size using calipers | Subjects should have documented the size of the tumor through clinical measurement using calipers at each assessment visit. Wherever possible, documentation of radiological size based on mammogram, ultrasound or magnetic resonance imaging should also be recorded. | up to 6 months |
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Inclusion Criteria:
Histologically confirmed breast carcinoma of any subtype (any estrogen receptor, progesterone receptor and HER2 receptor status)
ECOG 0-1.
Non-metastatic disease for which surgery of curative intent is planned upfront or after completion of neoadjuvant chemotherapy
Adequate organ function including the following:
Bone marrow:
Hepatic:
Renal:
Signed informed consent from subject or legal representative.
Able to comply with study-related procedures.
Exclusion Criteria:
Breast cancer study - 99.9% breast cancer subjects are female. Male breast cancer is extremely rare and thus males will not be recruited
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| Name | Affiliation | Role |
|---|---|---|
| Rachel Wong, Medical Degree | National University Hospital, Singapore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National University Hospital | Singapore | Singapore | 119074 | Singapore |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35141145 | Background | Tai YK, Chan KKW, Fong CHH, Ramanan S, Yap JLY, Yin JN, Yip YS, Tan WR, Koh APF, Tan NS, Chan CW, Huang RYJ, Li JZ, Frohlich J, Franco-Obregon A. Modulated TRPC1 Expression Predicts Sensitivity of Breast Cancer to Doxorubicin and Magnetic Field Therapy: Segue Towards a Precision Medicine Approach. Front Oncol. 2022 Jan 24;11:783803. doi: 10.3389/fonc.2021.783803. eCollection 2021. | |
| 31798383 |
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| Pulsed electromagnetic fields (PEMFs) | Device | A single 30-minute PEMF session administered 30 minutes pre-surgery to assess wound-healing safety. |
|
| Device: Pulsed electromagnetic fields (PEMFs); Drug: Anthracycline OR Taxane | Combination Product | A single 30-minute PEMF session administered 30 minutes prior to the final cycle (4th cycle) of either Anthracycline (DL3a) or Taxane (DL3b) therapy. |
|
| Background |
| Haidinger R, Bauerfeind I. Long-Term Side Effects of Adjuvant Therapy in Primary Breast Cancer Patients: Results of a Web-Based Survey. Breast Care (Basel). 2019 Apr;14(2):111-116. doi: 10.1159/000497233. Epub 2019 Feb 15. |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| D018943 | Anthracyclines |
| C080625 | taxane |
| ID | Term |
|---|---|
| D009279 | Naphthacenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D011083 | Polycyclic Compounds |
| D000617 | Aminoglycosides |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
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