Comparing two surgical procedures to lower ovarian cancer risk in women with BRCA1 mutations
A Non-Randomized Prospective Clinical Trial Comparing the Non-Inferiority of Salpingectomy to Salpingo-oophorectomy to Reduce the Risk of Ovarian Cancer Among BRCA1 Carriers [SOROCk]
This study is testing if a less invasive surgery can lower the risk of ovarian cancer just as well as a more extensive surgery for women with BRCA1 mutations.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 1956 (estimated) |
| Ages | 35 Years to 50 Years |
| Sex | Female |
| Sponsor | NRG Oncology Academic / other |
| Drugs / interventions | chemotherapy |
| Locations | 549 sites (Birmingham, Alabama and 548 other locations) |
| Trial ID | NCT04251052 on ClinicalTrials.gov |
What this trial studies
This clinical trial evaluates the effectiveness of two surgical procedures, bilateral salpingectomy (BLS) and bilateral salpingo-oophorectomy (BSO), in reducing the risk of ovarian cancer for individuals with BRCA1 mutations. The primary objective is to determine if BLS is non-inferior to BSO in terms of cancer risk reduction. Secondary objectives include assessing the impact of these procedures on quality of life, menopausal symptoms, and decision-making processes. The study involves patients aged 35-50 who are undergoing these surgical interventions and includes various assessments to evaluate outcomes.
Who should consider this trial
Good fit: Ideal candidates are women aged 35-50 with pathogenic BRCA1 mutations who are considering risk-reducing surgery.
Not a fit: Patients who have already undergone a hysterectomy that included bilateral salpingectomy or those without intact ovaries and fallopian tubes may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could provide a less invasive surgical option for women with BRCA1 mutations while effectively reducing their risk of ovarian cancer.
How similar studies have performed: Other studies have explored similar surgical approaches, but this specific comparison of BLS and BSO in BRCA1 mutation carriers is novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Individuals 35-50 years of age, inclusive * Patients who will undergo risk-reducing salpingo-oophorectomy (RRSO) (for the BSO arm) and patients who have declined or elected to defer BSO after proper counselling to clearly explain the standard of care for BRCA1 mutation carriers and are undergoing salpingectomy (for the BLS arm with delayed oophorectomy arm). Concurrently planned hysterectomy with either arm is permitted * At least one intact ovary and fallopian tube is in situ at the time of counseling, consent, and registration. Prior hysterectomy is allowed provided it did not include bilateral salpingectomy. Prior tubal ligation is allowed if one ovary and fallopian tube (with fimbria not removed) are present * Positive Clinical Laboratory Improvement Act (CLIA)-approved test results for pathogenic or likely pathogenic germline BRCA1 mutation in the patient. Documentation of the result is required * Patients may be premenopausal or menopausal * Pelvic ultrasound (transvaginal imaging preferred, but transabdominal imaging is acceptable) or pelvic MRI and CA-125 within 180 days of registration * The patient or a legally authorized representative must provide study-specific informed consent prior to study entry * Individuals who are currently pregnant or plan to become pregnant in the future through assisted reproductive technologies and who have received proper counseling are eligible. Individuals who are currently pregnant and plan bilateral salpingectomy at the time of a planned cesarean section are eligible. Patients must understand that they will not be able to become pregnant naturally in the future Exclusion Criteria: * Individuals with a history of any prior cancer who have received cytotoxic chemotherapy within the past 30 days or radiotherapy to abdomen or pelvis at any prior time. Endocrine therapy or maintenance ERBB2/HER2 targeted therapy is allowed. Maintenance immune checkpoint inhibitor therapy is allowed. Maintenance therapy with PARP in inhibitor is allowed. * Prior history of ovarian cancer, including low malignant potential neoplasms (LMP), primary peritoneal carcinoma, or fallopian tube carcinoma * Patients medically unfit for the planned surgical procedure * Patients with abnormal screening tests (pelvic ultrasound, pelvic MRI, CA-125) suspicious for occult or gross pelvic malignancy within the past 180 days * An abnormal pelvic ultrasound (or pelvic MRI) is defined as morphologic or structural variations suspicious for ovarian malignancy. Complex cystic lesions felt to represent a benign lesion are not exclusionary. Simple cysts of any size are not exclusionary * An abnormal CA-125 is defined as a level \> 50U/ml in premenopausal individuals if they are not current users of oral contraceptives; an abnormal CA-125 is defined as a level \> 40U/ml for premenopausal individuals who are current users of oral contraceptives (Skates 2011). An abnormal CA-125 is defined as a level \> 35 U/ml in postmenopausal individuals
Where this trial is running
Birmingham, Alabama and 548 other locations
- University of Alabama at Birmingham Cancer Center — Birmingham, Alabama, United States (Recruiting)
- Anchorage Associates in Radiation Medicine — Anchorage, Alaska, United States (Recruiting)
- Anchorage Radiation Therapy Center — Anchorage, Alaska, United States (Suspended)
- Alaska Breast Care and Surgery LLC — Anchorage, Alaska, United States (Recruiting)
- Alaska Oncology and Hematology LLC — Anchorage, Alaska, United States (Recruiting)
- Alaska Women's Cancer Care — Anchorage, Alaska, United States (Recruiting)
- Katmai Oncology Group — Anchorage, Alaska, United States (Recruiting)
- Providence Alaska Medical Center — Anchorage, Alaska, United States (Recruiting)
- CTCA at Western Regional Medical Center — Goodyear, Arizona, United States (Active_not_recruiting)
- Banner University Medical Center - Tucson — Tucson, Arizona, United States (Recruiting)
- University of Arizona Cancer Center-North Campus — Tucson, Arizona, United States (Recruiting)
- University of Arkansas for Medical Sciences — Little Rock, Arkansas, United States (Recruiting)
- Kaiser Permanente-Deer Valley Medical Center — Antioch, California, United States (Recruiting)
- Tower Cancer Research Foundation — Beverly Hills, California, United States (Suspended)
- Keck Medicine of USC Buena Park — Buena Park, California, United States (Recruiting)
- Providence Saint Joseph Medical Center/Disney Family Cancer Center — Burbank, California, United States (Recruiting)
- Mercy Cancer Center - Carmichael — Carmichael, California, United States (Recruiting)
- Mercy San Juan Medical Center — Carmichael, California, United States (Recruiting)
- City of Hope Comprehensive Cancer Center — Duarte, California, United States (Recruiting)
- Kaiser Permanente Dublin — Dublin, California, United States (Recruiting)
- Mercy Cancer Center - Elk Grove — Elk Grove, California, United States (Recruiting)
- Kaiser Permanente-Fremont — Fremont, California, United States (Recruiting)
- Fresno Cancer Center — Fresno, California, United States (Suspended)
- Kaiser Permanente Fresno Orchard Plaza — Fresno, California, United States (Recruiting)
- Kaiser Permanente-Fresno — Fresno, California, United States (Recruiting)
- City of Hope Seacliff — Huntington Beach, California, United States (Recruiting)
- Keck Medicine of USC Huntington Beach — Huntington Beach, California, United States (Recruiting)
- City of Hope at Irvine Lennar — Irvine, California, United States (Recruiting)
- Kaiser Permanente-Irvine — Irvine, California, United States (Recruiting)
- City of Hope Antelope Valley — Lancaster, California, United States (Recruiting)
- Keck Medicine of USC Koreatown — Los Angeles, California, United States (Recruiting)
- Kaiser Permanente Los Angeles Medical Center — Los Angeles, California, United States (Recruiting)
- Los Angeles General Medical Center — Los Angeles, California, United States (Recruiting)
- USC / Norris Comprehensive Cancer Center — Los Angeles, California, United States (Recruiting)
- Cedars Sinai Medical Center — Los Angeles, California, United States (Recruiting)
- UCLA / Jonsson Comprehensive Cancer Center — Los Angeles, California, United States (Recruiting)
- Kaiser Permanente- Modesto MOB II — Modesto, California, United States (Recruiting)
- Kaiser Permanente-Modesto — Modesto, California, United States (Recruiting)
- Providence Queen of The Valley — Napa, California, United States (Recruiting)
- USC Norris Oncology/Hematology-Newport Beach — Newport Beach, California, United States (Recruiting)
- Kaiser Permanente Oakland-Broadway — Oakland, California, United States (Suspended)
- Kaiser Permanente-Oakland — Oakland, California, United States (Recruiting)
- Kaiser Permanente - Panorama City — Panorama City, California, United States (Recruiting)
- Huntington Memorial Hospital — Pasadena, California, United States (Recruiting)
- Keck Medical Center of USC Pasadena — Pasadena, California, United States (Recruiting)
- Kaiser Permanente-Rancho Cordova Cancer Center — Rancho Cordova, California, United States (Suspended)
- Kaiser Permanente- Marshall Medical Offices — Redwood City, California, United States (Recruiting)
- Kaiser Permanente-Redwood City — Redwood City, California, United States (Recruiting)
- Kaiser Permanente-Richmond — Richmond, California, United States (Recruiting)
- Kaiser Permanente-Riverside — Riverside, California, United States (Recruiting)
+499 more sites — see ClinicalTrials.gov for the full list.
Study contacts
- Principal investigator: Kathryn P Pennington — NRG Oncology
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.