TARGIT

Targit trial – Targeted Intraoperative Radiotherapy for Breast Cancer

The TARGIT trial

[please scroll down to see the trial design and past literature]

15 March 2012 Audience poll at the Miami Breast Cancer Conference, USA. CLICK the see the video

7 Nov 2011- TARGIT trial plenary lecture at the BASO-ACS Annual meeting, Royal College of Surgeons of England, London, UK: CLICK to see the presentation

29 April 2011- TARGIT trial plenary lecture gets strong support at American Society of Breast Surgeons meeting, Washington DC, USA

19 March 2011

At the 12th International St.Gallen Breast Cancer Conference
16-19 March 2011 / St.Gallen, Switzerland, the delegates (n~4200) at the Consensus session on the last day of the conference voted in favour of using intraoperative radiotherapy.

Voting results for the following questions were as follows:

In association with breast conserving surgery,

partial breast irradiation (intraoperative) is acceptable

- As definitive radiation, without any external beam therapy?

Yes= 48.9%, No=35.6%, Don’t know= 15.6%

In association with breast conserving surgery,

partial breast irradiation (intraoperative) is acceptable

- Instead of external beam boost to tumour bed?

Yes= 60.9%, No=17.4%, Don’t know= 21.7%

Should partial breast radiotherapy be applied

in selected patients (including intraoperative)

- Elderly (> age 70) ?

Yes = 86.7%, No=6.7%, Don’t know=6.7%

Should partial breast radiotherapy be applied

in selected patients (including intraoperative)

- Lymphoma survivors after mantle field RT?

Yes= 37.2%, No=25.6%, Don’t know=37.2%

2010 NEWS FLASH: TARGIT-A trial results at ASCO and in the Lancet

5 June 2010

The results of the TARGIT-A trial published in The Lancet Online first

6 June 2010

Oral presentation at the TARGIT Symposium, ASCO, Chicago, USA

7 June 2010

Poster Discussion, ASCO, Chicago, USA

Click here to read a brief description of the TARGIT-A trial and its results

A description of the TARGIT-A trial in an interview with eCancer TV at the ESSO meeting Bordeaux, Sep 2010

In the randomised TARGIT trial, two policies of local radiation treatment are being compared:

Breast cancer patient (>=45 years) suitable for breast conserving surgery

RANDOMISE

TARGIT group (A)

Individualised-Risk-Adjusted Radiotherapy

A single dose of TARGIT with Intrabeam (in ~85%)

if high risk*

add EBRT (45-50Gy, no boost)

*prespeficied criteria e.g., unsuspected lobular carcinoma, lymphovascular invasion, etc.

EBRT group (B)

One-size-fits-all Radiotherapy

Standard 4-6 week course of external beam radiotherapy (EBRT)

40-56Gy in 15-25 fractions

+/-

Tumour bed boost

10-16 G y in 5-8 fractions

Eligible patients can be recruited at two stages of their treatment in the pragmatic Targit trial:

Before the primary surgery

If a patient is to have her primary breast cancer operation at a hospital where intraoperative radiotherapy ( radiation treatment ) can be given, then randomisation in the Targit trial can be done before surgery and intraoperative radiation treatment can be given at the same time as the lumpectomy for breast cancer, if they draw the arm (B). If at the postoperative pathology review, it is felt that they have a particularly high risk of local recurrence especially in other quadrants (e.g., EIC, extensive LVI or nodal metastases, etc) then external beam radiotherapy can be added and the patient will remain in the trial.

After the primary surgery

If primary surgery is performed elsewhere, randomisation in the Targit trial can be performed after the primary surgery (lumpectomy or wide local excision) and they can have a single session intraoperative radiotherapy as a day-case operation . If a patient draws arm a) external beam radiotherapy can be administered at their usual hospital (we will have recorded the exact schedule).

The TARGIT technique uses the Intrabeam device for delivering precise and timely dose of intraoperative radiotherapy accurately to the tumour bed. This device was developed by an collaborative effort between University College London and the industry. It has had extensive experience since its first use in July 1998.

Targit-A trial is active in 28 international centres from 9 countries (UK, USA, Germany, Italy, Poland , Switzerland, Denmark, Canada and Australia) and 2232 patients have already been randomised since the trial started on 24 March 2000.

Visit: The TARGIT trial Blog

Targeted intraoperative radiotherapy Literature

[NOTE: these papers can be downloaded strictly for personal use only. This site is maintained by Dr Jayant S Vaidya ]

Pathological and biological rationale of

partial breast irradiation (PBI) and the basis of the Targit Trial

1995 Hongkong International Cancer Congress

1996 British Journal of Cancer

1997 The Lancet

Could MRI be useful to select patients for breast conserving surgery?

1998 The Lancet (1)

1998 The Lancet (2)