Efficacy and Safety of OncoGel™ Added to Chemotherapy and Radiation Before Surgery in Subjects With Esophageal Cancer
Primary Purpose
Esophageal Cancer, Adenocarcinoma of the Esophagus, Squamous Cell Carcinoma
Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
OncoGel (Paclitaxel gel)
cisplatin
5-FU
radiation therapy
esophageal resection
Sponsored by
About this trial
This is an interventional treatment trial for Esophageal Cancer focused on measuring Esophageal cancer, Localized esophageal cancer, Operable esophageal cancer, Loco-regional esophageal cancer, Esophagectomy, Phase 2, Paclitaxel, Tumor, Local, Chemotherapy, radiation therapy, surgery, OncoGel, Squamous cell carcinoma of the esophagus
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed squamous cell carcinoma or adenocarcinoma of the esophagus. Stage T2-T3, N any, M0 (no evidence of disseminated cancer except regional involvement which may be designated as "M1a"). No evidence of metastatic disease
- Medically able to tolerate major abdominal and/or thoracic surgery
- Able to undergo EUS procedure and pass EUS probe through esophageal lumen
- Able to receive concurrent systemic chemotherapy (cisplatin and 5-FU) and RT
- Clinical management plan includes esophagectomy after completion of two courses of chemoradiation therapy
- Karnofsky Performance Status of ≥ 60
- Minimum life expectancy of 4 months
Hematologic function
- Absolute neutrophil count (ANC) ≥ 1500/mm3
- Platelet count ≥ 100,000/mm3
- Hemoglobin ≥ 9 g/dL
Hepatic function:
- Total bilirubin < 1.5 X upper limit of normal (ULN)
- AST and ALT < 3 X ULN
- Albumin ≥ 3.0 g/dL or ≥ 2.0 g/dL if the lower level is considered by the investigator to be due to nutritional depletion
- Serum creatinine < 1.5 mg/dL and/or creatinine clearance ≥ 65 mL/min
- ≥ 18 years old
- If female, must be non-pregnant, nonlactating, of non-childbearing potential, or using adequate birth control
- Capable of understanding and agreeing to fulfill the requirements of the protocol
- Sign the IRB/EC approved consent form
Exclusion Criteria:
- History of anaphylaxis to planned CT contrast agent
- Prior esophageal stent insertion, laser, or photodynamic therapy
- Prior chest RT or major esophageal surgery
- Any prior receipt of cytotoxic chemotherapeutic agents
- Prior receipt of other cancer treatments (ie, Chelation therapy), vaccines, or biological response modifiers/growth factors (ie, GM-CSF, IL-2) within the past 4 weeks.
- Prior malignancy unless disease free for ≥ 3 years. Note: basal cell/squamous carcinoma of the skin, in situ cervical or breast carcinoma, or superficial transitional cell bladder carcinoma will be allowed. Subjects with a history of low risk prostatic carcinoma (ie, clinical stage 1 or 2a, Gleason score < or = 6 and PSA <10 ng/mL at diagnosis) will be allowed
- Significant currently active systemic diseases including uncontrolled diabetes, severe heart disease (New York Heart Association Class III or IV), uncontrolled hypertension, myocardial infarction within 3 months, severe bronchial obstruction, uncontrolled seizure disorder, or peripheral neuropathy greater than CTCAE grade 1
- Allergies to any of the active or inactive components of OncoGel (ie, allergies to degradable PLGA [poly(lactide-co-glycolide) sutures])
- Receipt of an investigational drug or device within 30 days prior to signing informed consent
- Any medical condition or other circumstance that, in the Investigator's opinion, would prevent completion of the study, interfere with analysis of the study results, or potentially adversely affect subject safety
- Known esophageal varices
Sites / Locations
- University of California San Diego
- Rush University Medical Center
- University of Chicago Medical Center
- Indiana University Medical Center
- University of Kansas Medical Center
- Thomas Jefferson University
- Baylor University Medical Center
- Digestive Health Specialists of Tyler, Texas
- University Hospital Brno
- Hospital Jablonec nad Nisou
- University Hospital Olomouc
- University Hospital Motol
- Massaryk's Hospital in Usti nad Labem
- Kidwai Memorial Institute of Oncology
- Amrita Institute of Medical Sciences
- Bombay Hospital & Medical Research Centre
- Deenanath Mangeshkar Hospital
- Meenakshi Mission Hospital and Research Centre
- Samodzielny Publiczny Szpital Kliniczny
- Samodzielnego Publicznego Szpitala Klinicznego
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Group 1
Group 2
Arm Description
OncoGel, radiation therapy and systemic chemotherapy (cisplatin plus 5-FU) prior to surgical resection.
Radiation therapy and systemic chemotherapy (cisplatin plus 5-FU) prior to surgical resection.
Outcomes
Primary Outcome Measures
Overall Tumor Response at the Primary Tumor Site Based on Measurement of Primary Tumor Volume (Excluding Involved Lymph Nodes) by Spiral CT
Per the Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and by Spiral CT assessment:
Complete Response (CR) is the disappearance of all target lesions; Partial Response (PR) is a >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR
Secondary Outcome Measures
Full Information
NCT ID
NCT00573131
First Posted
December 11, 2007
Last Updated
June 2, 2022
Sponsor
Boston Scientific Corporation
1. Study Identification
Unique Protocol Identification Number
NCT00573131
Brief Title
Efficacy and Safety of OncoGel™ Added to Chemotherapy and Radiation Before Surgery in Subjects With Esophageal Cancer
Official Title
A Randomized Study of the Efficacy and Safety of OncoGel™ Treatment as an Adjunctive Therapy to Systemic Chemotherapy and Concurrent External Beam Radiation Prior to Surgery in Subjects With Localized or Loco-regional Esophageal Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
June 2022
Overall Recruitment Status
Terminated
Why Stopped
OncoGel did not show any impact on overall tumor response
Study Start Date
January 2008 (undefined)
Primary Completion Date
November 2010 (Actual)
Study Completion Date
November 2010 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boston Scientific Corporation
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
OncoGel is a new experimental drug delivery system that allows the slow continuous release of paclitaxel (an approved intravenous anticancer drug), from a gel (ReGel) over a long period of time. The gel will disappear in 4 to 6 weeks as it releases the paclitaxel.
The protocol is directed towards evaluating the efficacy and safety of paclitaxel delivered as a local, intralesional treatment when used in combination with chemotherapy (cisplatin and 5-FU) and radiation therapy before surgery.
Detailed Description
The primary objective of this study is to evaluate the efficacy of OncoGel given in combination with standard chemotherapy (cisplatin and 5-FU) and radiation therapy in patients with previously untreated, resectable, local or local-regional adenosarcoma or squamous cell carcinoma.
All patients will receive IV cisplatin on Day 1 and Day 29 and IV 5-FU given continuously for 96 hours starting on Day 1 and Day 29. All patients will also receive out-patient radiation therapy for 28 treatments once per day for 5 1/2 weeks starting on Day 1.
Patients randomized to the OncoGel treatment group will have the OncoGel dose injected into their esophageal tumors during an endoscopic procedure just before starting systemic chemotherapy and radiation therapy.
All patients will have CT scans for tumor measurements before starting chemotherapy and 12 weeks later after completion of the radiation therapy and both cycles of chemotherapy.
During the chemotherapy and radiation therapy, physical exams, vital signs, routine blood tests will be performed. Patients will also be asked about their quality of life and ability to swallow.
In-patient surgery will be scheduled 4 to 6 weeks after completion of chemotherapy and radiation therapy. The resected esophagus and lymph nodes will be evaluated for the presence of residual tumor.
Patients will be followed at months 4, 5, 6, and then every 3 Months thereafter for survival and esophageal cancer status and treatment until the last patient enrolled has completed their Month 12 visit.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophageal Cancer, Adenocarcinoma of the Esophagus, Squamous Cell Carcinoma
Keywords
Esophageal cancer, Localized esophageal cancer, Operable esophageal cancer, Loco-regional esophageal cancer, Esophagectomy, Phase 2, Paclitaxel, Tumor, Local, Chemotherapy, radiation therapy, surgery, OncoGel, Squamous cell carcinoma of the esophagus
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
137 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Group 1
Arm Type
Experimental
Arm Description
OncoGel, radiation therapy and systemic chemotherapy (cisplatin plus 5-FU) prior to surgical resection.
Arm Title
Group 2
Arm Type
Active Comparator
Arm Description
Radiation therapy and systemic chemotherapy (cisplatin plus 5-FU) prior to surgical resection.
Intervention Type
Drug
Intervention Name(s)
OncoGel (Paclitaxel gel)
Intervention Description
6.3 mg/mL tumor volume, injected into the esophagus during endoscopy, once, before starting chemoradiotherapy
Intervention Type
Drug
Intervention Name(s)
cisplatin
Intervention Description
75 mg/m2 IV (in the vein) once on Day 1 and Day 29
Intervention Type
Drug
Intervention Name(s)
5-FU
Intervention Description
1000 mg/m2/day, IV (in the vein) for 4 days (96 hours) for two cycles starting on Day 1 and Day 29
Intervention Type
Radiation
Intervention Name(s)
radiation therapy
Intervention Description
50.4 Gy, given in 28 treatments, once per day for 5 1/2 weeks
Intervention Type
Procedure
Intervention Name(s)
esophageal resection
Intervention Description
Removal of esophagus after completion of chemotherapy and radiation therapy
Primary Outcome Measure Information:
Title
Overall Tumor Response at the Primary Tumor Site Based on Measurement of Primary Tumor Volume (Excluding Involved Lymph Nodes) by Spiral CT
Description
Per the Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and by Spiral CT assessment:
Complete Response (CR) is the disappearance of all target lesions; Partial Response (PR) is a >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR
Time Frame
Screening and Week 12
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically or cytologically confirmed squamous cell carcinoma or adenocarcinoma of the esophagus. Stage T2-T3, N any, M0 (no evidence of disseminated cancer except regional involvement which may be designated as "M1a"). No evidence of metastatic disease
Medically able to tolerate major abdominal and/or thoracic surgery
Able to undergo EUS procedure and pass EUS probe through esophageal lumen
Able to receive concurrent systemic chemotherapy (cisplatin and 5-FU) and RT
Clinical management plan includes esophagectomy after completion of two courses of chemoradiation therapy
Karnofsky Performance Status of ≥ 60
Minimum life expectancy of 4 months
Hematologic function
Absolute neutrophil count (ANC) ≥ 1500/mm3
Platelet count ≥ 100,000/mm3
Hemoglobin ≥ 9 g/dL
Hepatic function:
Total bilirubin < 1.5 X upper limit of normal (ULN)
AST and ALT < 3 X ULN
Albumin ≥ 3.0 g/dL or ≥ 2.0 g/dL if the lower level is considered by the investigator to be due to nutritional depletion
Serum creatinine < 1.5 mg/dL and/or creatinine clearance ≥ 65 mL/min
≥ 18 years old
If female, must be non-pregnant, nonlactating, of non-childbearing potential, or using adequate birth control
Capable of understanding and agreeing to fulfill the requirements of the protocol
Sign the IRB/EC approved consent form
Exclusion Criteria:
History of anaphylaxis to planned CT contrast agent
Prior esophageal stent insertion, laser, or photodynamic therapy
Prior chest RT or major esophageal surgery
Any prior receipt of cytotoxic chemotherapeutic agents
Prior receipt of other cancer treatments (ie, Chelation therapy), vaccines, or biological response modifiers/growth factors (ie, GM-CSF, IL-2) within the past 4 weeks.
Prior malignancy unless disease free for ≥ 3 years. Note: basal cell/squamous carcinoma of the skin, in situ cervical or breast carcinoma, or superficial transitional cell bladder carcinoma will be allowed. Subjects with a history of low risk prostatic carcinoma (ie, clinical stage 1 or 2a, Gleason score < or = 6 and PSA <10 ng/mL at diagnosis) will be allowed
Significant currently active systemic diseases including uncontrolled diabetes, severe heart disease (New York Heart Association Class III or IV), uncontrolled hypertension, myocardial infarction within 3 months, severe bronchial obstruction, uncontrolled seizure disorder, or peripheral neuropathy greater than CTCAE grade 1
Allergies to any of the active or inactive components of OncoGel (ie, allergies to degradable PLGA [poly(lactide-co-glycolide) sutures])
Receipt of an investigational drug or device within 30 days prior to signing informed consent
Any medical condition or other circumstance that, in the Investigator's opinion, would prevent completion of the study, interfere with analysis of the study results, or potentially adversely affect subject safety
Known esophageal varices
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kirk D Fowers, PhD
Organizational Affiliation
Boston Scientific Corporation
Official's Role
Study Director
Facility Information:
Facility Name
University of California San Diego
City
San Diego
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
University of Chicago Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Indiana University Medical Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Thomas Jefferson University
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Baylor University Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
Digestive Health Specialists of Tyler, Texas
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States
Facility Name
University Hospital Brno
City
Brno
ZIP/Postal Code
62500
Country
Czechia
Facility Name
Hospital Jablonec nad Nisou
City
Jablonec nad Nisou
ZIP/Postal Code
466 60
Country
Czechia
Facility Name
University Hospital Olomouc
City
Olomouc
ZIP/Postal Code
775 20
Country
Czechia
Facility Name
University Hospital Motol
City
Praha
ZIP/Postal Code
150 06
Country
Czechia
Facility Name
Massaryk's Hospital in Usti nad Labem
City
Usti nad Labem
ZIP/Postal Code
401 13
Country
Czechia
Facility Name
Kidwai Memorial Institute of Oncology
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560029
Country
India
Facility Name
Amrita Institute of Medical Sciences
City
Kochi
State/Province
Kerala
ZIP/Postal Code
682026
Country
India
Facility Name
Bombay Hospital & Medical Research Centre
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400020
Country
India
Facility Name
Deenanath Mangeshkar Hospital
City
Erandwane
State/Province
Pune
ZIP/Postal Code
411004
Country
India
Facility Name
Meenakshi Mission Hospital and Research Centre
City
Madurai
State/Province
Tamil Nadu
ZIP/Postal Code
625107
Country
India
Facility Name
Samodzielny Publiczny Szpital Kliniczny
City
Lublin
ZIP/Postal Code
20-081
Country
Poland
Facility Name
Samodzielnego Publicznego Szpitala Klinicznego
City
Szczecin
ZIP/Postal Code
70-111
Country
Poland
12. IPD Sharing Statement
Citations:
PubMed Identifier
27890801
Citation
DeWitt JM, Murthy SK, Ardhanari R, DuVall GA, Wallner G, Litka P, Daugherty C, Fowers K. EUS-guided paclitaxel injection as an adjunctive therapy to systemic chemotherapy and concurrent external beam radiation before surgery for localized or locoregional esophageal cancer: a multicenter prospective randomized trial. Gastrointest Endosc. 2017 Jul;86(1):140-149. doi: 10.1016/j.gie.2016.11.017. Epub 2016 Nov 24.
Results Reference
derived
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Efficacy and Safety of OncoGel™ Added to Chemotherapy and Radiation Before Surgery in Subjects With Esophageal Cancer
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