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Sintilimab in Combination With Chemotherapy in Neoadjuvant Treatment of Potentially Resectable Esophageal Cancer

Primary Purpose

Esophageal Squamous Cell Carcinoma

Status
Active
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Sintilimab
Liposomal Paclitaxel + Cisplatin + S-1
Sponsored by
The First Affiliated Hospital with Nanjing Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Esophageal Squamous Cell Carcinoma focused on measuring Neoadjuvant, Esophageal Cancer, PD-1

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Histologically or cytologically confirmed esophageal squamous cell carcinoma.

The tumor is located in the middle or lower third of the esophagus ( more than 18cm below incisor), potentially resectable and requiring neoadjuvant therapy (T1b-3, Nany, M0 or T4a, N0-1, M0).

No prior treatment for this disease.

Eastern cooperative oncology group (ECOG) performance status of 0 to 1.

Adequate bone marrow, liver, cardiac and renal function as assessed by the laboratory required by protocol.

Understand and voluntarily sign the informed consent(s).

Patients who are able to complete the treatment and follow-up according to the study plan.

Patients who have sufficient tissue samples and agree to provide their tissue samples and blood samples for detailed analysis.

Female patients in child bearing period must have evidence of negative pregnancy test and agree to take effective contraceptive measures during the study.

Exclusion Criteria:

Patients who may develop tracheoesophageal fistula or aortoesophageal fistula.

Patients suffering from severe malnutrition or needing tube feeding.

Uncured patients with other malignancies within 2 years.

Patients who have active autoimmune diseases or patients who are undergoing treatment of autoimmune diseases.

Patients who need systemic glucocorticosteroid treatment (more than 10mg prednisone daily or other equivalent drugs) within 7 days before the neoadjuvant therapy or other immunosuppressive drugs.

Patients who have immune deficiency.

Patients with active viral or bacterial infection who need systemic treatment within 7 days before the neoadjuvant therapy.

Patients with uncontrolled diabetes mellitus.

Patients with interstitial pulmonary disease, noninfectious pneumonia, or pulmonary fibrosis.

Patients with preexisting symptoms of sensory or motor nerve damage (greater than Grade 1, WHO) .

Patients who have received allogeneic organ or stem cell transplants.

Patients who are allergic to drugs or related ingredients in this study.

Patients who take part in clinical trials of other drugs or biological therapy at present.

Patients with any serious or unstable medical condition or mental illness.

Patients who are dependent on or addicted to alcohol or drugs.

Sites / Locations

  • The First Affiliated Hospital with Nanjing Medical University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sintilimab + Liposomal Paclitaxel + Cisplatin + S-1

Arm Description

Sintilimab will be administered prior to the chemotherapy in an interval of half an hour.

Outcomes

Primary Outcome Measures

Safety and feasibility
Safety is defined as the incidence of Grade 3-4 Treatment-Related Adverse Events (TRAEs) from the day of neoadjuvant therapy to 30 days after surgery or within 90 days after last neoadjuvant treatment. Feasibility of surgery is defined as the incidence of TRAEs causing surgery delay of ≥30 days and/or inoperable patients.

Secondary Outcome Measures

MPR rate
Major Pathological Response (MPR) is defined as the presence of 10% or fewer viable cancer cells in the hematoxylin and eosin (H&E)-stained slides from the resected tumor following neoadjuvant treatment.
R0 resection rate
R0 resection is defined as no cancer cells are seen microscopically at the resection margin following surgery.
Recurrence-Free Survival (RFS)
Recurrence-Free Survival (RFS) is calculated from surgery to the date of recurrence or death.
Overall Survival (OS)
Overall Survival (OS) is calculated from the beginning of neoadjuvant treatment to the date of death from any cause.

Full Information

First Posted
May 9, 2019
Last Updated
July 16, 2022
Sponsor
The First Affiliated Hospital with Nanjing Medical University
Collaborators
Innovent Biologics (Suzhou) Co. Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03946969
Brief Title
Sintilimab in Combination With Chemotherapy in Neoadjuvant Treatment of Potentially Resectable Esophageal Cancer
Official Title
Safety and Efficacy of Combination of Sintilimab and Platinum-based Chemotherapy in Neoadjuvant Treatment of Potentially Resectable Esophageal Cancer: An Open-lable, Single-arm, Exploratory Clinical Study
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 9, 2019 (Actual)
Primary Completion Date
November 9, 2021 (Actual)
Study Completion Date
October 31, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The First Affiliated Hospital with Nanjing Medical University
Collaborators
Innovent Biologics (Suzhou) Co. Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study aims to investigate the safety and efficacy of sintilimab combined with platinum-based chemotherapy in neoadjuvant treatment of potentially resectable esophageal cancer.
Detailed Description
This study was designed as an open-lable, single-arm, exploratory clinical study. Sintilimab in combination with liposomal paclitaxel, cisplatin and S-1 will be given every 3 weeks to our patients for 2 cycles as neoadjuvant therapy. A radical dissection is scheduled within 6 weeks after last neoadjuvant treatment. This study will be devided for 3 phases: safety run-in, efficacy pilot and efficacy confirmation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophageal Squamous Cell Carcinoma
Keywords
Neoadjuvant, Esophageal Cancer, PD-1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sintilimab + Liposomal Paclitaxel + Cisplatin + S-1
Arm Type
Experimental
Arm Description
Sintilimab will be administered prior to the chemotherapy in an interval of half an hour.
Intervention Type
Drug
Intervention Name(s)
Sintilimab
Other Intervention Name(s)
IBI308
Intervention Description
Sintilimab (200mg) will be given intravenously on day 1 in 3-week cycles for two cycles.
Intervention Type
Drug
Intervention Name(s)
Liposomal Paclitaxel + Cisplatin + S-1
Other Intervention Name(s)
PFC
Intervention Description
Liposomal Paclitaxel (135mg/m2), ivd, d1 + Cisplatin (25mg/m2), ivd, d1-3 + S-1 capsule (40mg), po, d1-14, repeated every 3 weeks for two cycles.
Primary Outcome Measure Information:
Title
Safety and feasibility
Description
Safety is defined as the incidence of Grade 3-4 Treatment-Related Adverse Events (TRAEs) from the day of neoadjuvant therapy to 30 days after surgery or within 90 days after last neoadjuvant treatment. Feasibility of surgery is defined as the incidence of TRAEs causing surgery delay of ≥30 days and/or inoperable patients.
Time Frame
20 months
Secondary Outcome Measure Information:
Title
MPR rate
Description
Major Pathological Response (MPR) is defined as the presence of 10% or fewer viable cancer cells in the hematoxylin and eosin (H&E)-stained slides from the resected tumor following neoadjuvant treatment.
Time Frame
20 months
Title
R0 resection rate
Description
R0 resection is defined as no cancer cells are seen microscopically at the resection margin following surgery.
Time Frame
20 months
Title
Recurrence-Free Survival (RFS)
Description
Recurrence-Free Survival (RFS) is calculated from surgery to the date of recurrence or death.
Time Frame
5 years
Title
Overall Survival (OS)
Description
Overall Survival (OS) is calculated from the beginning of neoadjuvant treatment to the date of death from any cause.
Time Frame
5 years
Other Pre-specified Outcome Measures:
Title
Exploratory Outcomes
Description
Correlation between biomarkers, including tumor mutational burden (TMB), clonal mutations, genetic alterations, and circulating tumor DNA (ctDNA), and therapeutic response to neoadjuvant therapy will be explored.
Time Frame
20 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed esophageal squamous cell carcinoma. The tumor is located in the middle or lower third of the esophagus ( more than 18cm below incisor), potentially resectable and requiring neoadjuvant therapy (T1b-3, Nany, M0 or T4a, N0-1, M0). No prior treatment for this disease. Eastern cooperative oncology group (ECOG) performance status of 0 to 1. Adequate bone marrow, liver, cardiac and renal function as assessed by the laboratory required by protocol. Understand and voluntarily sign the informed consent(s). Patients who are able to complete the treatment and follow-up according to the study plan. Patients who have sufficient tissue samples and agree to provide their tissue samples and blood samples for detailed analysis. Female patients in child bearing period must have evidence of negative pregnancy test and agree to take effective contraceptive measures during the study. Exclusion Criteria: Patients who may develop tracheoesophageal fistula or aortoesophageal fistula. Patients suffering from severe malnutrition or needing tube feeding. Uncured patients with other malignancies within 2 years. Patients who have active autoimmune diseases or patients who are undergoing treatment of autoimmune diseases. Patients who need systemic glucocorticosteroid treatment (more than 10mg prednisone daily or other equivalent drugs) within 7 days before the neoadjuvant therapy or other immunosuppressive drugs. Patients who have immune deficiency. Patients with active viral or bacterial infection who need systemic treatment within 7 days before the neoadjuvant therapy. Patients with uncontrolled diabetes mellitus. Patients with interstitial pulmonary disease, noninfectious pneumonia, or pulmonary fibrosis. Patients with preexisting symptoms of sensory or motor nerve damage (greater than Grade 1, WHO) . Patients who have received allogeneic organ or stem cell transplants. Patients who are allergic to drugs or related ingredients in this study. Patients who take part in clinical trials of other drugs or biological therapy at present. Patients with any serious or unstable medical condition or mental illness. Patients who are dependent on or addicted to alcohol or drugs.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yanhong Gu
Organizational Affiliation
The First Affiliated Hospital with Nanjing Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The First Affiliated Hospital with Nanjing Medical University
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210029
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Sintilimab in Combination With Chemotherapy in Neoadjuvant Treatment of Potentially Resectable Esophageal Cancer

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