DCIS: RECAST Trial Ductal Carcinoma In Situ: Re-Evaluating Conditions for Active Surveillance Suitability as Treatment

Last updated: March 10, 2026
Sponsor: QuantumLeap Healthcare Collaborative
Overall Status: Active - Recruiting

Phase

2

Condition

Breast Cancer

Carcinoma

Genitourinary Cancer

Treatment

T+Ai

TBD2

Elacestrant

Clinical Study ID

NCT06075953
RECAST-DCIS
  • Ages > 18
  • Female

Study Summary

The goal of this trial is to see if active surveillance monitoring and hormonal therapy in patients diagnosed with ductal cell carcinoma in situ (DCIS), an early stage of breast cancer, can be an effective management of the disease.

Participants will be asked to receive control hormonal therapy or an investigational hormonal therapy treatment. Participants will be asked to return for evaluation with MRI at three months and six months. Depending on the evaluation participants will have the option to continue on the treatment. If the evaluation suggests surgery is recommended, the participant will discontinue the study treatment and will undergo surgery. In addition to the treatment and MRI evaluation, participants will be asked to provide blood sample to understand their immune status, provide saliva sample for genetic testing, provide the study with a portion of the tissue or slides generated from tissue removed during surgery performed as part of their standard of care.

Eligibility Criteria

Inclusion

Inclusion Criteria:

A. Female, at least 18 years old

B. Previous diagnosis of HR+ DCIS (at least 50% ER or PR; biopsy will have been performed previously at diagnosis) with or without microinvasion

C. Patients who have previously received endocrine therapy should have a washout period of 4-6 weeks prior to the screening MRI on the RECAST-DCIS trial

D. Bilateral mammogram performed within up to 4 months (120 days) of the start of trial treatment may be used for screening evaluation

E. MRI performed within up to 2 months (60 days) of the start of trial treatment for lesion evaluation

F. CBC w/ diff, CMP, and Lipid Panel within normal limits within a year of the start of trial treatment. Abnormal labs to be repeated within 60 days prior to the start of trial treatment. Patients will be considered eligible for screening labs that are abnormal or out-of-range if the investigator has deemed the lab results not-clinically significant

G. Negative urine or serum pregnancy test within 1 month of the start of trial treatment

H. Controlled HIV positive patients are allowed as long as their current medication does not contraindicate the study's investigational agent

I. Willingness and ability to provide tumor samples for research

Exclusion

Exclusion Criteria:

A. Pregnant or actively breastfeeding women

B. History of allergic reactions attributed to compounds of similar chemical or biologic composition to study agent based on review of the medical record and patient history

C. Invasive carcinoma or identification of a mass on MRI that is subsequently biopsied and found to be invasive cancer

D. Co-enrollment in clinical trials of pharmacologic agents requiring an IND

E. Ongoing treatment for DCIS other than what is specified in this protocol

F. Uncontrolled intercurrent illness, including psychiatric conditions, that would limit compliance with study requirements

G. Medical history or ongoing gastrointestinal disorders potentially affecting the absorption of investigational agent and/or tamoxifen. Active inflammatory bowel disease or chronic diarrhea, known active hepatitis A/B/C*, hepatic cirrhosis, short bowel syndrome, or any upper gastrointestinal surgery including gastric resection or banding procedures

*Active hepatitis, defined as: A (positive HA antigen or positive IgM); B (either positive HBs antigen or positive hepatitis B viral DNA test above the lower limit of detection of the assay); C (positive hepatitis C antibody result, and quantitative hepatitis C (HCV) ribonucleic acid (RNA) results greater than the lower limits of detection of the assay)

H. Participants who are unable to swallow normally or unable to take tablets and capsules. Predictable poor compliance with oral treatment

Study Design

Total Participants: 400
Treatment Group(s): 10
Primary Treatment: T+Ai
Phase: 2
Study Start date:
February 17, 2024
Estimated Completion Date:
November 30, 2033

Study Description

The goal of this trial is to see if active surveillance monitoring and hormonal therapy in patients diagnosed with Ductal cell Carcinoma In Situ (DCIS), an early stage of breast cancer, can be an effective management of the disease. The current management of most patients with DCIS involves surgical intervention with or without radiation, similar to more aggressive breast cancers. These treatments can come with some significant health effects.The main question this study aims to answer is: to determine whether novel endocrine therapy increases the fraction of patients who will be suitable for long-term active surveillance.

Participants will be asked to take one of three investigational study medication (z-Elacestrant, Testosterone + Anastrazole, or Endoxifen) or receive control hormonal therapy (Tamoxifen or an aromatase inhibitor), depending on the treatment to which they have been randomized. Participants will be asked to return for evaluation with MRI at three months and six months. Depending on the evaluation, participants will have the option to continue on the treatment, with follow up evaluations of Mammogram and MRI at 6 month intervals. If the evaluation suggests surgery is recommended, the participant will discontinue the study treatment and will undergo surgery. In addition to the treatment and MRI evaluation, participants will be asked to:

  • Provide blood sample to understand their immune status

  • Provide saliva sample for genetic testing

  • Provide the study with a portion of the tissue or slides generated from tissue removed during surgery performed as part of their standard of care.

Participants will be followed annually for 10 years.

Connect with a study center

  • Berkeley Outpatient Center

    Berkeley, California 94158
    United States

    Active - Recruiting

  • City of Hope -Duarte Cancer Center

    Duarte, California 91010
    United States

    Active - Recruiting

  • City of Hope - Lennar Foundation Cancer Center

    Irvine, California 92618
    United States

    Active - Recruiting

  • UCLA

    Los Angeles, California 90095
    United States

    Active - Recruiting

  • UCSF

    San Francisco, California 94158
    United States

    Active - Recruiting

  • City of Hope

    South Pasadena, California 91030
    United States

    Active - Recruiting

  • John Muir Health

    Walnut Creek, California 94598
    United States

    Active - Recruiting

  • Berkeley Outpatient Center

    Berkeley 5327684, California 5332921 94158
    United States

    Site Not Available

  • City of Hope -Duarte Cancer Center

    Duarte 5344147, California 5332921 91010
    United States

    Site Not Available

  • City of Hope - Lennar Foundation Cancer Center

    Irvine 5359777, California 5332921 92618
    United States

    Site Not Available

  • UCLA

    Los Angeles 5368361, California 5332921 90095
    United States

    Site Not Available

  • UCSF

    San Francisco 5391959, California 5332921 94158
    United States

    Site Not Available

  • City of Hope

    South Pasadena 5397717, California 5332921 91030
    United States

    Site Not Available

  • John Muir Health

    Walnut Creek 5406990, California 5332921 94598
    United States

    Site Not Available

  • Moffitt Cancer Center

    Tampa, Florida 33612
    United States

    Active - Recruiting

  • Moffitt Cancer Center

    Tampa 4174757, Florida 4155751 33612
    United States

    Site Not Available

  • Winship Cancer Institute, Emory University

    Atlanta, Georgia 30322
    United States

    Active - Recruiting

  • Winship Cancer Institute, Emory University

    Atlanta 4180439, Georgia 4197000 30322
    United States

    Site Not Available

  • University of Chicago Medical Center

    Chicago, Illinois 60637
    United States

    Active - Recruiting

  • University of Chicago Medical Center

    Chicago 4887398, Illinois 4896861 60637
    United States

    Site Not Available

  • Maple Grove Cancer Center

    Maple Grove, Minnesota 55369
    United States

    Active - Recruiting

  • Hennepin Healthcare -Minneapolis

    Minneapolis, Minnesota 55404
    United States

    Active - Recruiting

  • University of Minnesota

    Minneapolis, Minnesota 55455
    United States

    Active - Recruiting

  • Health Partners - Frauenshuh Cancer Center

    Saint Louis Park, Minnesota 55426
    United States

    Active - Recruiting

  • Health Partners - Regions Hospital

    Saint Paul, Minnesota 55101
    United States

    Active - Recruiting

  • Maple Grove Cancer Center

    Maple Grove 5036493, Minnesota 5037779 55369
    United States

    Site Not Available

  • Hennepin Healthcare -Minneapolis

    Minneapolis 5037649, Minnesota 5037779 55404
    United States

    Active - Recruiting

  • University of Minnesota

    Minneapolis 5037649, Minnesota 5037779 55455
    United States

    Site Not Available

  • Health Partners - Frauenshuh Cancer Center

    Saint Louis Park 5045021, Minnesota 5037779 55426
    United States

    Site Not Available

  • Health Partners - Regions Hospital

    Saint Paul 5045360, Minnesota 5037779 55101
    United States

    Site Not Available

  • Englewood Hospital and Medical Center

    Englewood, New Jersey 07631
    United States

    Active - Recruiting

  • Englewood Hospital and Medical Center

    Englewood 5097672, New Jersey 5101760 07631
    United States

    Site Not Available

  • Icahn School of Medicine at Mount Sinai

    New York, New York 10029
    United States

    Active - Recruiting

  • Mount Sinai Chelsea

    New York, New York 10011
    United States

    Active - Recruiting

  • Mount Sinai Union Square

    New York, New York 10003
    United States

    Active - Recruiting

  • Mount Sinai West

    New York, New York 10019
    United States

    Active - Recruiting

  • Icahn School of Medicine at Mount Sinai

    New York 5128581, New York 5128638 10029
    United States

    Active - Recruiting

  • Mount Sinai Chelsea

    New York 5128581, New York 5128638 10011
    United States

    Active - Recruiting

  • Mount Sinai Union Square

    New York 5128581, New York 5128638 10003
    United States

    Active - Recruiting

  • Mount Sinai West

    New York 5128581, New York 5128638 10019
    United States

    Site Not Available

  • Duke Cancer Institute

    Durham, North Carolina 27710
    United States

    Active - Recruiting

  • Atrium Health Wake Forest Baptist Comprehensive Cancer Center

    Winston-Salem, North Carolina 27157
    United States

    Active - Recruiting

  • Atrium Health Wake Forest Baptist Comprehensive Cancer Center

    Winston-Salem 4499612, North Carolina 4482348 27157
    United States

    Site Not Available

  • Bryn Mawr Hospital

    Bryn Mawr, Pennsylvania 19010
    United States

    Active - Recruiting

  • Riddle Hospital

    Media, Pennsylvania 19063
    United States

    Site Not Available

  • Paoli Hospital

    Paoli, Pennsylvania 19301
    United States

    Active - Recruiting

  • Lankenau Medical Center

    Wynnewood, Pennsylvania 19096
    United States

    Active - Recruiting

  • Bryn Mawr Hospital

    Bryn Mawr 5182063, Pennsylvania 6254927 19010
    United States

    Site Not Available

  • Paoli Hospital

    Paoli 5205037, Pennsylvania 6254927 19301
    United States

    Site Not Available

  • Lankenau Medical Center

    Wynnewood 5220230, Pennsylvania 6254927 19096
    United States

    Site Not Available

  • Vanderbilt University Medical Center

    Nashville, Tennessee 37232
    United States

    Active - Recruiting

  • Vanderbilt University Medical Center

    Nashville 4644585, Tennessee 4662168 37232
    United States

    Site Not Available

  • Huntsman Cancer Institute

    Salt Lake City, Utah 84112
    United States

    Active - Recruiting

  • Huntsman Cancer Institute

    Salt Lake City 5780993, Utah 5549030 84112
    United States

    Site Not Available

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