Risk Reducing Salpingectomy With Delayed Oophorectomy as an Alternative to Risk- Reducing Salpingo-oophorectomy in High Risk-Women to Assess the Safety of Prevention - US Cohort Study

M.D. Anderson Cancer Center100 enrolled

Overview

This is a prospective preference study that will evaluate non-inferiority of the innovative treatment (RRS with delayed RRO) as compared to the standard treatment (RRSO) with respect to high grade serous (ovarian) cancer incidence

The aim of the project is to evaluate RRS with delayed RRO as an alternative for RRSO in BRCA1/2 gene germline mutation carriers with respect to ovarian cancer incidence. We hypothesize that postponement of oophorectomy and consequent menopause to the age of 40-45 (BRCA1) or 45-50 (BRCA2) compared to current standard RRSO at age 35-40 (BRCA1) or 40-45 (BRCA2) will not lead to a significant increase in ovarian cancer risk. PRIMARY OBJECTIVE: To evaluate non-inferiority of the innovative treatment (RRS with delayed RRO) as compared to the standard treatment (RRSO) with respect to high grade serous (ovarian) cancer incidence in BRCA1/2 gene germline mutation carriers. SECONDARY OBJECTIVE: Incidence of (pre)malignant findings in tubes/ovaries, perioperative morbidity and mortality, incidence of non-ovarian pelvic cancer, breast cancer, prophylactic breast surgery and uptake of risk reducing oophorectomy. EXPLORATORY OBJECTIVE: Estimate high grade serous (ovarian) cancer incidence for innovative and standard treatments in BRIP1, RAD51C, and RAD51D gene germline mutation carriers

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

100

Conditions

Ovarian Cancer Fallopian Tube Cancer

Interventions

RIsk-Reducing Salpingectomy (RRS)OTHER

complete questionnaires, standard-of-care laparoscopy to check the abdominal area before the assigned procedure

Risk-Reducing Oophorectomy-RROOTHER

complete questionnaires, standard-of-care laparoscopy to check the abdominal area before the assigned procedure

Risk-Reducing Salpingo-Oophorectomy-RRSOOTHER

complete questionnaires, standard-of-care laparoscopy to check the abdominal area before the assigned procedure

Eligibility

Sex: FEMALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: In order to be eligible to participate in this study, a subject must meet all of the following criteria: 1. Premenopausal women with a documented deleterious mutation in BRCA1, BRCA2, BRIP1, RAD51C, PALB2 and/or RAD51D gene germline mutation. 2. Age 25-40 years for BRCA1 mutation carriers, 25-45 years for BRCA2 and 30-50 years for BRIP1, RAD51C, RAD51D, and PALB2 3. No longer requires fallopian tubes for natural childbearing. Future plans for IVF are acceptable 4. Presence of at least one fallopian tube 5. Participants may have a personal history of non-ovarian malignancy 6. Informed consent must be obtained and documented. Exclusion Criteria: A potential subject who meets any of the following criteria will be excluded from participation in this study: 1. Postmenopausal status (natural menopause or due to (cancer) treatment) 2. Wish for second stage RRO within two years after RRS (if clear at enrollment) 3. Legally incapable 4. Prior bilateral salpingectomy 5. A personal history of ovarian, fallopian tube, or peritoneal cancer 6. Current clinicals signs, diagnosis, or treatment for malignant disease. Aromatase Inhibitors, Tamoxifen, and Selective Estrogen Receptor Modulators (SERM) are allowed.

Locations (9)

Dana Farber Cancer Institute

Boston, Massachusetts, United States

RECRUITING

Mayo Clinic

Rochester, Minnesota, United States

RECRUITING

WU St Louis

Outcomes

Primary Outcomes

To evaluate the non-inferiority of the innovative treatment (RRS with delayed RRO) as compared to the standard treatment (RRSO) with respect to high grade serous (ovarian) cancer incidence in BRCA1/2 gene germline mutation carriers.

Time frame: through study completion, an average of 15 years

Central Contacts

Roni Wilke, MD

CONTACT

(713) 822-4502 rnitecki@mdanderson.org

Data from ClinicalTrials.gov

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