Neoadjuvant Therapy With Nab-paclitaxel and Cisplatin for Locally Advanced Esophageal Squamous Cell Carcinoma (NTNC)
Primary Purpose
Esophageal Squamous Cell Carcinoma
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Nab-paclitaxel and Cisplatin
surgery
Sponsored by
About this trial
This is an interventional treatment trial for Esophageal Squamous Cell Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Age ranges from 18 to 75 years
- Radiographically, histologically or/and cytologically diagnosed resectable locally advanced middle-lower esophageal squamous cell carcinoma without distant metastasis,cT1N1M0 or T2-3N0-1M0(according to UICC esophageal cancer TNM staging system 8th edition)
- Enhanced CT showed the presence of potentially resectable lesions. Resectability features included no evidence of mediastinal infiltration, No evidence of tracheobronchial fistula or tumor entry into the airway
- Have not previously received systemic antitumor therapy for esophageal squamous cell carcinoma (Including radiotherapy, chemotherapy, targeted therapy, immunotherapy)
- ECOG performance status 0-1
- Expected survival more than 6 months
- No contraindications in the organ function tests before surgery
- The laboratory test meet the following requirements:
Bone marrow function: neutrophils ≥ 1.5×10(9)/L, platelets ≥ 100×10(9)/L, hemoglobin ≥ 90 g/L Liver function:Total bilirubin ≤ 1.5x ULN;AST and ALT) ≤ 2.5x ULN Renal function:Cr ≤ 1.5x ULN,Ccr ≥ 55 ml/min Coagulation function:INR≤1.5×ULN, PT≤1.5ULN, APTT within the normal range
- Female patients of child-bearing age agree to take effective contraceptive measures during the study period and 6 months after reseach completion;Pregnancy tests in serum or urine must be negative 7 days prior to study enrollment;Non-lactating patients;male patients agree to take effective contraceptive measures during the study period and 6 months after reseach completion
- Not concomitant with other uncontrollable benign disease before the recruitment(e.g. the infection in the kidney, lung and liver)
- Not participating in other clinical trials 4 weeks before the treatment
- The patient has good compliance with the planned treatment, understands the research process of the study and signs a written informed consent form.
Exclusion Criteria:
- Histological confirmation of esophageal adenocarcinoma
- with distant metastasis, without radical resection (stage IV)
- Ever administrated with other drugs(including TCM drugs) before the recruitment, or no guarantee of progress according to the study requirement after recruitment
- Grade 2 or above peripheral neuropathy or hemorrhage according to NCI CTCAE 4.03
- Combined with severe cardiovascular disease, including hypertension that cannot be controlled by medical treatment(BP≥160/95mmHg), unstable angina, a history of myocardial infarction in the past 6 months,Congestive heart failure>NYHA grade II, severe arrhythmia, pericardial effusion, etc.
- Combined with severe ADH abnormal secretion syndrome, poorly controlled diabetes: more than 40 units of insulin per day need to be continuously administered; or 40 units of insulin per day for continuous use or not used, but fasting blood glucose is still above 14mmol / L, HbA1c above 9.0
- Long-term use of anticoagulants or vitamin K antagonists such as warfarin, heparin or its analogues for more than 6 months,small doses of warfarin (≤1mg / day) or aspirin (≤100mg / day) for prevention purposes are not included
- Major surgery within 4 weeks prior to enrollment, or surgical wounds have not fully healed
- Operation can not use the stomach instead of esophageal cancer to reconstruct the digestive tract due to previous operation
- Severe infection within 1 week prior to the start of study, requiring intravenous antibiotics, antifungal or antiviral therapy
- Known to be allergic, highly sensitive or intolerable to research-related drugs or excipient
- In the past 5 years, there were other malignant tumors, melanoma skin cancer or ervical carcinoma in situ were excepted
- Any indicator shows chemotherapy and surgery contraindications
- Women who are pregnant or lactating
- The investigator determined that unable to complete the study due to medical, social, or psychological reasons or were unable to sign valid informed consent
Sites / Locations
- Jun Feng LiuRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Neo-adjuvant chemotherapy group
Surgery alone
Arm Description
cisplatin and nab-paclitaxel: Nab-paclitaxel, 125mg/m(2), d1,d8, Cisplatin, 75mg/m(2), d1, 3 week, 2 cycles. Surgery: 4-6weeks after Neo-adjuvant chemotherapy
Surgery alone
Outcomes
Primary Outcome Measures
OS
Overall survival,From date of randomization until death due to any cause
Secondary Outcome Measures
OS rate
Overall survival rate
DFS rate
Disease free survival rate
R0 resection rate
R0 resection rate
Down-staging rate
Down-staging rate
Rate of Operative Complications
Rate of Adverse Event
Incidence of adverse events according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03
Full Information
NCT ID
NCT03964753
First Posted
May 18, 2019
Last Updated
October 6, 2023
Sponsor
Hebei Medical University Fourth Hospital
1. Study Identification
Unique Protocol Identification Number
NCT03964753
Brief Title
Neoadjuvant Therapy With Nab-paclitaxel and Cisplatin for Locally Advanced Esophageal Squamous Cell Carcinoma
Acronym
NTNC
Official Title
The Effectiveness and Safety of Neoadjuvant Therapy With Nab-paclitaxel and Cisplatin Followed by Surgery Versus Surgery Alone for Locally Advanced Esophageal Squamous Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 24, 2019 (Actual)
Primary Completion Date
June 24, 2026 (Anticipated)
Study Completion Date
December 24, 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Hebei Medical University Fourth Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
To verify the role of nab-paclitaxel in neoadjuvant therapy for esophageal squamous cell carcinoma, the investigators designed a prospective, randomized, controlled , multicente phase II trial, to investigate the efficacy and safety of nab-paclitaxel combined with cisplatin as neoadjuvant therapy followed by surgery versus surgery alone for esophageal squamous cell carcinoma.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophageal Squamous Cell Carcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
202 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Neo-adjuvant chemotherapy group
Arm Type
Experimental
Arm Description
cisplatin and nab-paclitaxel: Nab-paclitaxel, 125mg/m(2), d1,d8, Cisplatin, 75mg/m(2), d1, 3 week, 2 cycles.
Surgery:
4-6weeks after Neo-adjuvant chemotherapy
Arm Title
Surgery alone
Arm Type
Active Comparator
Arm Description
Surgery alone
Intervention Type
Drug
Intervention Name(s)
Nab-paclitaxel and Cisplatin
Intervention Description
Nab-paclitaxel,125mg/m(2), d1,d8, Cisplatin,75mg/m(2), d1, 3 week, 2 cycles.
Intervention Type
Procedure
Intervention Name(s)
surgery
Intervention Description
surgery
Primary Outcome Measure Information:
Title
OS
Description
Overall survival,From date of randomization until death due to any cause
Time Frame
up to 5 years
Secondary Outcome Measure Information:
Title
OS rate
Description
Overall survival rate
Time Frame
1 year,3years,5years
Title
DFS rate
Description
Disease free survival rate
Time Frame
1 year,3years,5years
Title
R0 resection rate
Description
R0 resection rate
Time Frame
within 4 weeks following the operation
Title
Down-staging rate
Description
Down-staging rate
Time Frame
within 6 weeks following the last dose of chemotherapy
Title
Rate of Operative Complications
Time Frame
within 4 weeks following the operation
Title
Rate of Adverse Event
Description
Incidence of adverse events according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03
Time Frame
up to 6 weeks after the last dose of chemotherapy
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ranges from 18 to 75 years
Radiographically, histologically or/and cytologically diagnosed resectable locally advanced middle-lower esophageal squamous cell carcinoma without distant metastasis,cT1N1M0 or T2-3N0-1M0(according to UICC esophageal cancer TNM staging system 8th edition)
Enhanced CT showed the presence of potentially resectable lesions. Resectability features included no evidence of mediastinal infiltration, No evidence of tracheobronchial fistula or tumor entry into the airway
Have not previously received systemic antitumor therapy for esophageal squamous cell carcinoma (Including radiotherapy, chemotherapy, targeted therapy, immunotherapy)
ECOG performance status 0-1
Expected survival more than 6 months
No contraindications in the organ function tests before surgery
The laboratory test meet the following requirements:
Bone marrow function: neutrophils ≥ 1.5×10(9)/L, platelets ≥ 100×10(9)/L, hemoglobin ≥ 90 g/L Liver function:Total bilirubin ≤ 1.5x ULN;AST and ALT) ≤ 2.5x ULN Renal function:Cr ≤ 1.5x ULN,Ccr ≥ 55 ml/min Coagulation function:INR≤1.5×ULN, PT≤1.5ULN, APTT within the normal range
Female patients of child-bearing age agree to take effective contraceptive measures during the study period and 6 months after reseach completion;Pregnancy tests in serum or urine must be negative 7 days prior to study enrollment;Non-lactating patients;male patients agree to take effective contraceptive measures during the study period and 6 months after reseach completion
Not concomitant with other uncontrollable benign disease before the recruitment(e.g. the infection in the kidney, lung and liver)
Not participating in other clinical trials 4 weeks before the treatment
The patient has good compliance with the planned treatment, understands the research process of the study and signs a written informed consent form.
Exclusion Criteria:
Histological confirmation of esophageal adenocarcinoma
with distant metastasis, without radical resection (stage IV)
Ever administrated with other drugs(including TCM drugs) before the recruitment, or no guarantee of progress according to the study requirement after recruitment
Grade 2 or above peripheral neuropathy or hemorrhage according to NCI CTCAE 4.03
Combined with severe cardiovascular disease, including hypertension that cannot be controlled by medical treatment(BP≥160/95mmHg), unstable angina, a history of myocardial infarction in the past 6 months,Congestive heart failure>NYHA grade II, severe arrhythmia, pericardial effusion, etc.
Combined with severe ADH abnormal secretion syndrome, poorly controlled diabetes: more than 40 units of insulin per day need to be continuously administered; or 40 units of insulin per day for continuous use or not used, but fasting blood glucose is still above 14mmol / L, HbA1c above 9.0
Long-term use of anticoagulants or vitamin K antagonists such as warfarin, heparin or its analogues for more than 6 months,small doses of warfarin (≤1mg / day) or aspirin (≤100mg / day) for prevention purposes are not included
Major surgery within 4 weeks prior to enrollment, or surgical wounds have not fully healed
Operation can not use the stomach instead of esophageal cancer to reconstruct the digestive tract due to previous operation
Severe infection within 1 week prior to the start of study, requiring intravenous antibiotics, antifungal or antiviral therapy
Known to be allergic, highly sensitive or intolerable to research-related drugs or excipient
In the past 5 years, there were other malignant tumors, melanoma skin cancer or ervical carcinoma in situ were excepted
Any indicator shows chemotherapy and surgery contraindications
Women who are pregnant or lactating
The investigator determined that unable to complete the study due to medical, social, or psychological reasons or were unable to sign valid informed consent
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Junfeng Liu, PhD
Phone
13931152296
Email
liujf@hbmu.edu
Facility Information:
Facility Name
Jun Feng Liu
City
Shijiazhuang
State/Province
Hebei
ZIP/Postal Code
050011
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jun Feng Liu, PhD
Phone
13931152296
12. IPD Sharing Statement
Learn more about this trial
Neoadjuvant Therapy With Nab-paclitaxel and Cisplatin for Locally Advanced Esophageal Squamous Cell Carcinoma
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