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PD-L1 PET Imaging During Neoadjuvant (Chemo)Radiotherapy in Esophageal and Rectal Cancer (PETNEC)

Primary Purpose

Rectal Cancer Stage, Oesophageal Cancer

Status
Recruiting
Phase
Not Applicable
Locations
Austria
Study Type
Interventional
Intervention
CRT
SCPRT
CROSS Protocol
PD-L1 PET
Sponsored by
Johannes Laengle, MD, PhD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Rectal Cancer Stage focused on measuring Rectal Cancer, Oesophageal Cancer, Chemoradiotherapy, Short-course preoperative radiotherapy, PD-L1 PET, 89Zr-atezolizumab

Eligibility Criteria

18 Years - 100 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • 18 years of age and older
  • All sexes
  • Histologically confirmed carcinoma of the rectum or oesophagus (squamous cell carcinoma and adenocarcinoma, including oesophago-gastric junction cancers)
  • Medical need for a neoadjuvant CRT/SCPRT
  • Suitable to withstand the course of neoadjuvant CRT/SCPRT
  • Written informed consent form (ICF) for participation in the study

Exclusion Criteria:

  • Metastatic disease, which is considered incurable by local therapies (expect for oligometastatic disease with a curative intend)
  • Previous surgery of the tumor other than biopsy
  • Pregnancy, breastfeeding or expectancy to conceive
  • Prior therapy with anti-CTLA-4, anti-PD-1, anti-PD-L1, anti-PD-L2 or any other agent directed against co-inhibitory T cell receptors or has previously participated in clinical studies with immunotherapy
  • Disagreement of participants with reproductive potential to use contraception throughout the study period and for up to 180 days after the last dose of study therapy
  • Hepatitis B or C
  • Human immunodeficiency virus (HIV)
  • Immunodeficiency
  • Allogeneic tissue or solid organ transplantation
  • Autoimmune disease that has required systemic therapy in the past 2 years with modifying agents, steroids or immunosuppressive drugs
  • Active non-infectious pneumonitis
  • Active infection requiring systemic therapy
  • Systemic steroids or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment
  • Diagnosed and/or treated additional malignancy within 5 years of randomization, with the exception of curatively-treated basal cell or squamous cell carcinoma of the skin and/or curatively-resected in situ cervical and/or breast cancers
  • Treatment with botanical preparations (i.e. herbal supplements or traditional Chinese medicines) intended for general health support or to treat the disease under study within 2 weeks prior to randomization/treatment
  • Participants with serious or uncontrolled medical disorders
  • Uncontrolled or significant cardiovascular disease (myocardial infarction, uncontrolled angina, any history of clinically significant arrhythmias, QTc prolongation in males > 450 ms and > 470 ms in females, participants with history of myocarditis)
  • Allergies and adverse drug reaction (history of allergy or hypersensitivity to study drug components, contraindications to any of the study drugs of the chemotherapy regimen)
  • Other exclusion criteria: Prisoners or participants who are involuntarily incarcerated, participants who are compulsorily detained for treatment of either a psychiatric or physical (i.e. infectious disease) illness

Sites / Locations

  • Medical University of ViennaRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Other

Other

Other

Arm Label

Neoadjuvant Chemoradiotherapy (CRT)

Short-course preoperative radiotherapy (SCPRT)

Neoadjuvant Chemoradiotherapy (CROSS protocol)

Arm Description

Outcomes

Primary Outcome Measures

Intratumoral changes of PD-L1 expression during neoadjuvant CRT/SCPRT
Intratumoral PD-L1 expression dynamics induced by neoadjuvant CRT/SCPRT will be assessed by 89Zr-atezolizumab PET imaging (day 0 and between day 10-14).

Secondary Outcome Measures

Radiographic therapy response
Radiographic therapy response will be determined by magnetic resonance imaging-assessed tumor regression grade (mrTRG) for rectal cancer and PET response criteria in solid tumors (PERCIST) for esophageal cancer.
Pathological therapy response
Pathological therapy response will be determined according to the latest American Joint Committee on Cancer/International Union Against Cancer-Tumor Node Metastasis (AJCC/UICC-TNM) staging and tumor regression grade (TRG).

Full Information

First Posted
September 15, 2020
Last Updated
November 1, 2022
Sponsor
Johannes Laengle, MD, PhD
Collaborators
Christian Doppler Laboratory Applied Metabolomics
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1. Study Identification

Unique Protocol Identification Number
NCT04564482
Brief Title
PD-L1 PET Imaging During Neoadjuvant (Chemo)Radiotherapy in Esophageal and Rectal Cancer
Acronym
PETNEC
Official Title
Programmed Death-ligand 1 Positron Emission Tomography Imaging During Neoadjuvant (Chemo)radiothErapy in Esophageal and Rectal Cancer (PETNEC): a Prospective Non-randomized Open-label Single-center Pilot Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Recruiting
Study Start Date
November 1, 2022 (Actual)
Primary Completion Date
December 1, 2023 (Anticipated)
Study Completion Date
June 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Johannes Laengle, MD, PhD
Collaborators
Christian Doppler Laboratory Applied Metabolomics

4. Oversight

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

5. Study Description

Brief Summary
The overall aim of this pilot study is to prospectively monitor programmed death-ligand 1 (PD-L1) expression dynamics in vivo, during neoadjuvant chemoradiotherapy (CRT) or short-course preoperative radiotherapy (SCPRT) in rectal and esophageal cancer by a positron emission tomography (PET) imaging approach.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rectal Cancer Stage, Oesophageal Cancer
Keywords
Rectal Cancer, Oesophageal Cancer, Chemoradiotherapy, Short-course preoperative radiotherapy, PD-L1 PET, 89Zr-atezolizumab

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Neoadjuvant Chemoradiotherapy (CRT)
Arm Type
Other
Arm Title
Short-course preoperative radiotherapy (SCPRT)
Arm Type
Other
Arm Title
Neoadjuvant Chemoradiotherapy (CROSS protocol)
Arm Type
Other
Intervention Type
Radiation
Intervention Name(s)
CRT
Intervention Description
50 Gy in 2 Gy fractions over 25 working days + capecitabine 1650 mg/m2/d PO
Intervention Type
Radiation
Intervention Name(s)
SCPRT
Intervention Description
25 Gy in 5 Gy fractions over 5 working days
Intervention Type
Radiation
Intervention Name(s)
CROSS Protocol
Intervention Description
41.4 Gy in 1.8 Gy fractions over 23 working days + carboplatin AUC of 2 mg/ml/min + paclitaxel 50 mg/m2 IV Q1W
Intervention Type
Diagnostic Test
Intervention Name(s)
PD-L1 PET
Intervention Description
10 mg atezolizumab IV followed by 37 MBq 89Zr-atezolizumab IV. PET imaging will be done before neoadjuvant CRT/SCPRT (day 0) and between day 10-14 during CRT/SCPRT.
Primary Outcome Measure Information:
Title
Intratumoral changes of PD-L1 expression during neoadjuvant CRT/SCPRT
Description
Intratumoral PD-L1 expression dynamics induced by neoadjuvant CRT/SCPRT will be assessed by 89Zr-atezolizumab PET imaging (day 0 and between day 10-14).
Time Frame
3 weeks
Secondary Outcome Measure Information:
Title
Radiographic therapy response
Description
Radiographic therapy response will be determined by magnetic resonance imaging-assessed tumor regression grade (mrTRG) for rectal cancer and PET response criteria in solid tumors (PERCIST) for esophageal cancer.
Time Frame
12 weeks
Title
Pathological therapy response
Description
Pathological therapy response will be determined according to the latest American Joint Committee on Cancer/International Union Against Cancer-Tumor Node Metastasis (AJCC/UICC-TNM) staging and tumor regression grade (TRG).
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 years of age and older All sexes Histologically confirmed carcinoma of the rectum or oesophagus (squamous cell carcinoma and adenocarcinoma, including oesophago-gastric junction cancers) Medical need for a neoadjuvant CRT/SCPRT Suitable to withstand the course of neoadjuvant CRT/SCPRT Written informed consent form (ICF) for participation in the study Exclusion Criteria: Metastatic disease, which is considered incurable by local therapies (expect for oligometastatic disease with a curative intend) Previous surgery of the tumor other than biopsy Pregnancy, breastfeeding or expectancy to conceive Prior therapy with anti-CTLA-4, anti-PD-1, anti-PD-L1, anti-PD-L2 or any other agent directed against co-inhibitory T cell receptors or has previously participated in clinical studies with immunotherapy Disagreement of participants with reproductive potential to use contraception throughout the study period and for up to 180 days after the last dose of study therapy Hepatitis B or C Human immunodeficiency virus (HIV) Immunodeficiency Allogeneic tissue or solid organ transplantation Autoimmune disease that has required systemic therapy in the past 2 years with modifying agents, steroids or immunosuppressive drugs Active non-infectious pneumonitis Active infection requiring systemic therapy Systemic steroids or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment Diagnosed and/or treated additional malignancy within 5 years of randomization, with the exception of curatively-treated basal cell or squamous cell carcinoma of the skin and/or curatively-resected in situ cervical and/or breast cancers Treatment with botanical preparations (i.e. herbal supplements or traditional Chinese medicines) intended for general health support or to treat the disease under study within 2 weeks prior to randomization/treatment Participants with serious or uncontrolled medical disorders Uncontrolled or significant cardiovascular disease (myocardial infarction, uncontrolled angina, any history of clinically significant arrhythmias, QTc prolongation in males > 450 ms and > 470 ms in females, participants with history of myocarditis) Allergies and adverse drug reaction (history of allergy or hypersensitivity to study drug components, contraindications to any of the study drugs of the chemotherapy regimen) Other exclusion criteria: Prisoners or participants who are involuntarily incarcerated, participants who are compulsorily detained for treatment of either a psychiatric or physical (i.e. infectious disease) illness
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Johannes Laengle, MD, PhD
Phone
+43140400 69260
Email
johannes.laengle@meduniwien.ac.at
First Name & Middle Initial & Last Name or Official Title & Degree
Michael Bergmann, MD
Phone
+43140400 69260
Email
michael.bergmann@meduniwien.ac.at
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alexander Haug, MD
Organizational Affiliation
Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medical University of Vienna
City
Vienna
ZIP/Postal Code
1090
Country
Austria
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Johannes Laengle, MD, PhD
Phone
+43 1 40400 69260
Email
johannes.laengle@meduniwien.ac.at
First Name & Middle Initial & Last Name & Degree
Michale Bergmann, MD
Phone
+43 1 40400 69260
Email
michael.bergmann@meduniwien.ac.at
First Name & Middle Initial & Last Name & Degree
Alexander Haug, MD
First Name & Middle Initial & Last Name & Degree
Johannes Laengle, MD, PhD
First Name & Middle Initial & Last Name & Degree
Michael Bergmann, MD
First Name & Middle Initial & Last Name & Degree
Dietmar Tamandl, MD
First Name & Middle Initial & Last Name & Degree
Rainer Schmid, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

PD-L1 PET Imaging During Neoadjuvant (Chemo)Radiotherapy in Esophageal and Rectal Cancer

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