Breast cancer PAINT: a first-in-human, dose-escalation study to determine the safety of Plasma Adjuvant INtra-operative Treatment in breast cancer patients

Abstract Background Non-thermal plasma (NTP) refers to an ionized gas composed of ions, electrons and other reactive agents. The anticancer properties of NTP have been proven in vitro and in vivo. The 10-year local recurrence risk (LRR) in breast cancer patients after breast conservation therapy (i....

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Main Authors: Audrey Glory, Erica Patocskai, Philip Wong
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14153-5
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author Audrey Glory
Erica Patocskai
Philip Wong
author_facet Audrey Glory
Erica Patocskai
Philip Wong
author_sort Audrey Glory
collection DOAJ
description Abstract Background Non-thermal plasma (NTP) refers to an ionized gas composed of ions, electrons and other reactive agents. The anticancer properties of NTP have been proven in vitro and in vivo. The 10-year local recurrence risk (LRR) in breast cancer patients after breast conservation therapy (i.e., lumpectomy, typically followed by radiation therapy) is still as high as 15–20%. NTP could be used to further treat the tumor bed to reduce the LRR. Methods Our primary objective is to determine the safe and tolerable dose of NTP treatment following breast cancer lumpectomy. Our secondary objectives are to assess the safety and tolerability of NTP and to assess the cosmetic effects of NTP treatment in patients with breast cancer. Our exploratory objective is to assess the impact of NTP treatment on cancerous and normal tissues. Patients are followed for up to 3 months after NTP treatment. The patients are divided into 3 groups: group A (n = 3): NTP treatment of part of the tumor bed ex vivo. Group B (n = 3): NTP treatment of part of the tumor bed in situ (all treated tissues are removed for analysis). Group C (n = 6–24): dose escalation per “3 + 3 Design” up to a maximum dose level of 3. NTP treatment of part of the tumor bed in situ (the treated parts of the tumor bed will not be excised, except for a small portion for analysis). Discussion The safety and tolerability of treatment will be evaluated by means of dose-limiting toxicity, adverse event (AE) and serious adverse event reports; physical examinations; and laboratory safety evaluations. AEs will be coded according to CTCAE v5.0. The results will be tabulated to examine their frequency, grade, and relationship to the study treatment. The results of laboratory assessments will be evaluated similarly. The number of patients with cosmetic alterations linked to NTP treatment and the type of alteration will be assessed through quality of life questionnaires (questions about breast appearance and texture) and through photo collection. This is the first clinical trial to study the safety and tolerability of NTP in an all-breast cancer patient cohort. Trial registration Name of the registry: ClinicalTrials.gov. Trial registration number: NCT06222788. Date of registration: 01/15/2024. URL of trial registry record: https://clinicaltrials.gov/study/NCT06222788 .
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spelling doaj-art-48ef498ba87d4563a20446b5632f2d592025-08-20T02:20:25ZengBMCBMC Cancer1471-24072025-04-0125111010.1186/s12885-025-14153-5Breast cancer PAINT: a first-in-human, dose-escalation study to determine the safety of Plasma Adjuvant INtra-operative Treatment in breast cancer patientsAudrey Glory0Erica Patocskai1Philip Wong2Centre de Recherche du Centre Hospitalier de l’Université de MontréalCentre de Recherche du Centre Hospitalier de l’Université de MontréalCentre de Recherche du Centre Hospitalier de l’Université de MontréalAbstract Background Non-thermal plasma (NTP) refers to an ionized gas composed of ions, electrons and other reactive agents. The anticancer properties of NTP have been proven in vitro and in vivo. The 10-year local recurrence risk (LRR) in breast cancer patients after breast conservation therapy (i.e., lumpectomy, typically followed by radiation therapy) is still as high as 15–20%. NTP could be used to further treat the tumor bed to reduce the LRR. Methods Our primary objective is to determine the safe and tolerable dose of NTP treatment following breast cancer lumpectomy. Our secondary objectives are to assess the safety and tolerability of NTP and to assess the cosmetic effects of NTP treatment in patients with breast cancer. Our exploratory objective is to assess the impact of NTP treatment on cancerous and normal tissues. Patients are followed for up to 3 months after NTP treatment. The patients are divided into 3 groups: group A (n = 3): NTP treatment of part of the tumor bed ex vivo. Group B (n = 3): NTP treatment of part of the tumor bed in situ (all treated tissues are removed for analysis). Group C (n = 6–24): dose escalation per “3 + 3 Design” up to a maximum dose level of 3. NTP treatment of part of the tumor bed in situ (the treated parts of the tumor bed will not be excised, except for a small portion for analysis). Discussion The safety and tolerability of treatment will be evaluated by means of dose-limiting toxicity, adverse event (AE) and serious adverse event reports; physical examinations; and laboratory safety evaluations. AEs will be coded according to CTCAE v5.0. The results will be tabulated to examine their frequency, grade, and relationship to the study treatment. The results of laboratory assessments will be evaluated similarly. The number of patients with cosmetic alterations linked to NTP treatment and the type of alteration will be assessed through quality of life questionnaires (questions about breast appearance and texture) and through photo collection. This is the first clinical trial to study the safety and tolerability of NTP in an all-breast cancer patient cohort. Trial registration Name of the registry: ClinicalTrials.gov. Trial registration number: NCT06222788. Date of registration: 01/15/2024. URL of trial registry record: https://clinicaltrials.gov/study/NCT06222788 .https://doi.org/10.1186/s12885-025-14153-5Non-thermal plasmaBreast cancerIntraoperative treatmentLocal recurrence risk
spellingShingle Audrey Glory
Erica Patocskai
Philip Wong
Breast cancer PAINT: a first-in-human, dose-escalation study to determine the safety of Plasma Adjuvant INtra-operative Treatment in breast cancer patients
BMC Cancer
Non-thermal plasma
Breast cancer
Intraoperative treatment
Local recurrence risk
title Breast cancer PAINT: a first-in-human, dose-escalation study to determine the safety of Plasma Adjuvant INtra-operative Treatment in breast cancer patients
title_full Breast cancer PAINT: a first-in-human, dose-escalation study to determine the safety of Plasma Adjuvant INtra-operative Treatment in breast cancer patients
title_fullStr Breast cancer PAINT: a first-in-human, dose-escalation study to determine the safety of Plasma Adjuvant INtra-operative Treatment in breast cancer patients
title_full_unstemmed Breast cancer PAINT: a first-in-human, dose-escalation study to determine the safety of Plasma Adjuvant INtra-operative Treatment in breast cancer patients
title_short Breast cancer PAINT: a first-in-human, dose-escalation study to determine the safety of Plasma Adjuvant INtra-operative Treatment in breast cancer patients
title_sort breast cancer paint a first in human dose escalation study to determine the safety of plasma adjuvant intra operative treatment in breast cancer patients
topic Non-thermal plasma
Breast cancer
Intraoperative treatment
Local recurrence risk
url https://doi.org/10.1186/s12885-025-14153-5
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