LYMPHA Procedure for the Prevention of Lymphedema After Axillary Lymphadenectomy

Stanford University

Status: Enrolling

Conditions: Lymphedema, Breast Cancer; Lymphedema

Treatments: Procedure: axillary lymphadenectomy with immediate lymphatic reconstruction (LYMPHA); Procedure: axillary lymphadenectomy with soft tissue reinforcement; Procedure: Axillary lymphadenetomy alone

Study type: Interventional

Funder types: Other

Identifiers

NCT05366699

NCI-2022-05172 (Other Identifier)

BRS0127 (Other Identifier)

IRB-53132

Details and patient eligibility

About

Lymphedema is a chronic, progressive, and debilitating condition that occurs with disruption or obstruction of the lymphatic system, which commonly occurs a result of breast cancer therapy. The purpose of this study is to determine if the use of a low risk lymphatic reconstruction procedure at the time of axillary lymph node dissection will reduce the risk of developing lymphedema.

Additionally, to determine if this procedure improves objective outcomes of lymphedema and patient quality of life

Enrollment: 80 estimated patients

Sex: Female

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Ages 18 to 75 years (inclusive)
• Patients undergoing unilateral or bilateral breast cancer related axillary lymphadenectomy
• Free of distant metastasis in preoperative screening
• Histology results of axillary lymph nodes could be either Negative or Positive
• Patients who undergo preoperative chemotherapy can be included
• Willingness and ability to provide written informed consent
• Willingness and ability to comply with all study procedures

Exclusion criteria

• Primary lymphedema of the affected upper limb
• Secondary lymphedema of the affected limb prior to the lymphadenectomy
• Radiotherapy at the axilla before the study / surgery
• Allergic reaction to porcine collagen or ICG
• Receiving radiation therapy to the involved nodal basin in a period less than 4 weeks after the surgery
• Concurrent participation in a clinical trial of any other investigational drug or therapy, regardless of indication, within 1 month before screening
• Other medical condition that could lead to limb edema, such as (but not limited to primary lymphedema or acute venous thrombosis
• Other medical condition that could result in symptoms overlapping those of lymphedema in the affected limb (e.g., pain, swelling, decreased range of motion)
• Either of the following, at the time of baseline evaluation: ipsilateral:contralateral limb volume ratio>1.1 or R0 bioimpedance ratio > 1.106 when the nondominant limb is at risk, and 1.134 when the dominant limb is at risk.
• Life expectancy < 2 years for any reason
• Pregnancy or nursing
• Substance abuse (such as alcohol or drug abuse) within 6 months prior to screening
• Severe psychiatric disease
• Significant or chronic renal insufficiency (defined as serum creatinine > 2.5 mg/dL or an estimated glomerular filtration rate [eGFR] < 30 mL/min at screening) or requires dialytic support
• Hepatic dysfunction, defined as alanine transaminase (ALT) or aspartate transaminase (AST) levels > 3 × upper limit of the normal range (ULN) and/or bilirubin level > 2 × ULN at screening
• Absolute neutrophil count < 1500 mm3 at screening
• Hemoglobin concentration < 9 g/dL at screening
• Any reason (in addition to those listed above) that, in the opinion of the investigator, precludes full participation in the study

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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80 participants in 3 patient groups

Group A

Other group

Description:

Group A will under axillary lymphadenectomy alone

Treatment:

Procedure: Axillary lymphadenetomy alone

Group B

Active Comparator group

Description:

Group B will undergo axillary lymphadenectomy with soft tissue reinforcement(STR)

Treatment:

Procedure: axillary lymphadenectomy with soft tissue reinforcement

Group C

Experimental group

Description:

Group B will undergo axillary lymphadenectomy with immediate lymphatic reconstruction (LYMPHA) using reverse mapping using the SPY System.

Treatment:

Procedure: axillary lymphadenectomy with immediate lymphatic reconstruction (LYMPHA)