Clinical Trial

De-Escalation of Axillary Management in Advanced Nodal Disease

Study acronym: DEMAND
Not Yet Recruiting Phase 2
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Summary
This is a prospective, phase 2, single arm trial to evaluate whether Axillary Lymph Node Dissection (ALND) can be safely omitted for patients with cN2 and cN3 breast cancer who achieve a complete clinical response on exam with a complete or partial response by end-of-treatment (EOT) imaging and have either a partial or complete pathologic nodal response after neoadjuvant chemotherapy (NAC) by performing nodal assessment of sentinel lymph node surgery (with or without targeted axillary dissection (TAD) followed by Regional Nodal Irradiation (RNI). This study aims to demonstrate that performing only a sentinel node dissection, which includes the removal of palpably gross disease followed by radiation, will not impact distant disease and thus survival.
Trial Details
NCT Number NCT07643584
Lead Sponsor University of Kansas Medical Center
Conditions Breast Cancer
Enrollment 120 participants
Start Date 2026-07
Primary Completion 2031-07 (estimated)
Study Completion 2031-07 (estimated)
Updated on ClinicalTrials.gov 2026-06-11