Study of Anti-PD-L1 in Combination With Chemo(Radio)Therapy for Resectable Esophageal Squamous Cell Carcinoma
Primary Purpose
Esophageal Squamous Cell Carcinoma
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Durvalumab
Carboplatin
Paclitaxel
Radiotherapy 23 x 1.8 Gy
Sponsored by
About this trial
This is an interventional treatment trial for Esophageal Squamous Cell Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Histologically proven squamous cell carcinoma of the esophagus.
- Surgical resectable (T3 or T4b, N0 or N+, M0), as determined by Endoscopic Ultra Sound (EUS),PET/CT, Esophageal MRI and enhanced CT scan of neck, thorax and abdomen.
- Tumor length longitudinal ≤ 10 cm; if larger than 10 cm, inclusion should be discussed with the principal investigator.
- 18≤Age≤75.
- Tumor does not involve gastro-esophageal junction.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Adequate hematological, renal and hepatic functions defined as:
neutrophiles ≥ 1.5 x 109/L platelets ≥ 100 x 109/L alanine transaminase≤2 x upper normal limit hemoglobin ≥ 5.6 mmol total bilirubin ≤ 1.5 x upper normal limit creatinine clearance (Cockroft) ≥60 ml/min
- Written, voluntary informed consent.
Exclusion Criteria:
- Past or current history of malignancy other than entry diagnosis interfering with prognosis of esophageal cancer.
- T1, T2 tumors or in situ carcinoma.
- metastatic oesophageal cancer.
- Pregnancy (positive serum pregnancy test), planning to become pregnant, and lactation.
- Previous chemotherapy, radiotherapy, and/or treatment with checkpoint inhibitors.
- Clinically significant cardiovascular disease (including myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) precluding major surgery.
- Pulmonary fibrosis and/or severely impaired lung function precluding major surgery.
- Pre-existing motor or sensory neurotoxicity greater than WHO grade 1.
- Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy (>10 mg/day prednisone or equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment.
- Dementia or altered mental status that would prohibit the understanding and giving of informed consent
- Serious underlying medical condition which would impair the ability of the patient to receive the planned treatment, including prior allergic reactions to drugs containing Cremophor, such as teniposide or cyclosporine.
- Has an active infection requiring systemic therapy which has not resolved 3 days (simple infection such as cystitis) to 7 days (severe infection such as pyelonephritis) prior to the first dose of trial treatment.
- Has a diagnosis of acute or chronic hepatitis B, hepatitis C, known immunodeficiency or human immunodeficiency virus (HIV).
- Patients with prior allogeneic stem cell or solid organ transplantation.
Sites / Locations
- Peking Union Medical College HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
durvalumab and neoadjuvant therapy
normal saline and neoadjuvant therapy
Arm Description
durvalumab 1500mg i.v. day 1-22-43-64 Carboplatin AUC = 4-5 i.v day 1-22-43-64 Paclitaxel 75 mg/m2 i.v day 1-22-43-64 with/without Radiotherapy 23 x 1.8 Gy
normal saline 500ml i.v. day 1-22-43-64 Carboplatin AUC = 4-5 i.v day 1-22-43-64 Paclitaxel 75 mg/m2 i.v day 1-22-43-64 with/without Radiotherapy 23 x 1.8 Gy
Outcomes
Primary Outcome Measures
tumor response
assess the tumor response (by irRECIST) of preoperative treatment with durvalumab combined with neoadjuvant therapy
pathological response
assess the pathological response (by CAP classification) of preoperative treatment with durvalumab combined with neoadjuvant therapy
Secondary Outcome Measures
Percentage completion of treatment with durvalumab combined with chemotherapy with/without radiation treatment
Percentage completion of treatment with durvalumab combined with chemotherapy with/without radiation treatment
Incidence and severity of toxicity
Incidence and severity of toxicity defined to CTCAE v4.03 and Radiation Oncology Group (RTOG) criteria
Percentage completion of chemotherapy with/without radiation treatment
Percentage completion of chemotherapy with/without radiation treatment
Percentage withdrawal rate from surgery due to durvalumab related complications
Percentage withdrawal rate from surgery due to durvalumab related complications
Percentage delay of surgery due to durvalumab related complications
Percentage delay of surgery due to durvalumab related complications
R0 resection rate
R0 resection rate
Incidence and severity of post-operative complications to the Dindo classification
Incidence and severity of post-operative complications to the Dindo classification
Progression free survival
Progression free survival
Overall survival
Overall survival
Full Information
NCT ID
NCT04568200
First Posted
September 15, 2020
Last Updated
March 12, 2022
Sponsor
Peking Union Medical College Hospital
1. Study Identification
Unique Protocol Identification Number
NCT04568200
Brief Title
Study of Anti-PD-L1 in Combination With Chemo(Radio)Therapy for Resectable Esophageal Squamous Cell Carcinoma
Official Title
A Prospective, Randomized Controlled Study to Evaluate the Efficacy and Safety of Durvalumab Combined With Neoadjuvant Therapy in Patients With Local Advanced Esophageal Squamous Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
March 2022
Overall Recruitment Status
Recruiting
Study Start Date
June 19, 2020 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Peking Union Medical College 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
This is a study to evaluate the efficacy and safety of preoperative treatment with durvalumab combined with neoajuvant therapy (carboplatin, paclitaxel with/without radiation) in locally advanced resectable oesophageal squamous carcinoma.
Detailed Description
The primary objective of the study is to assess the tumor response (by irRECIST) and pathological response of preoperative treatment with durvalumab combined with neoadjuvant therapy (carboplatin, paclitaxel with/without radiation).
Secondary objectives are:
To assess completion of treatment with durvalumab combined with chemotherapy with/without radiation treatment.
To assess toxicities of durvalumab in combination with chemoradiation. [Time Frame: up to 1 year] To assess completion of chemotherapy with/without radiation treatment. To assess withdrawal rate from surgery. To assess delay rate from surgery. To assess R0 resection rate. To assess post-operative complications. Progression Free Survival. [ Time Frame: up to 24 months ] Overall Survival. [ Time Frame: up to 24 months ]
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
Investigator
Allocation
Randomized
Enrollment
60 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
durvalumab and neoadjuvant therapy
Arm Type
Experimental
Arm Description
durvalumab 1500mg i.v. day 1-22-43-64 Carboplatin AUC = 4-5 i.v day 1-22-43-64 Paclitaxel 75 mg/m2 i.v day 1-22-43-64 with/without Radiotherapy 23 x 1.8 Gy
Arm Title
normal saline and neoadjuvant therapy
Arm Type
Placebo Comparator
Arm Description
normal saline 500ml i.v. day 1-22-43-64 Carboplatin AUC = 4-5 i.v day 1-22-43-64 Paclitaxel 75 mg/m2 i.v day 1-22-43-64 with/without Radiotherapy 23 x 1.8 Gy
Intervention Type
Drug
Intervention Name(s)
Durvalumab
Intervention Description
Durvalumab 1500mg i.v. day 1-22-43-64
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Other Intervention Name(s)
Chemotherapy
Intervention Description
Chemotherapy
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Other Intervention Name(s)
Chemotherapy
Intervention Description
Chemotherapy
Intervention Type
Radiation
Intervention Name(s)
Radiotherapy 23 x 1.8 Gy
Other Intervention Name(s)
Radiotherapy
Intervention Description
Radiotherapy 23 x 1.8 Gy
Primary Outcome Measure Information:
Title
tumor response
Description
assess the tumor response (by irRECIST) of preoperative treatment with durvalumab combined with neoadjuvant therapy
Time Frame
up to 12 months
Title
pathological response
Description
assess the pathological response (by CAP classification) of preoperative treatment with durvalumab combined with neoadjuvant therapy
Time Frame
up to 12 months
Secondary Outcome Measure Information:
Title
Percentage completion of treatment with durvalumab combined with chemotherapy with/without radiation treatment
Description
Percentage completion of treatment with durvalumab combined with chemotherapy with/without radiation treatment
Time Frame
up to 3 months
Title
Incidence and severity of toxicity
Description
Incidence and severity of toxicity defined to CTCAE v4.03 and Radiation Oncology Group (RTOG) criteria
Time Frame
up to 12 months
Title
Percentage completion of chemotherapy with/without radiation treatment
Description
Percentage completion of chemotherapy with/without radiation treatment
Time Frame
up to 3 months
Title
Percentage withdrawal rate from surgery due to durvalumab related complications
Description
Percentage withdrawal rate from surgery due to durvalumab related complications
Time Frame
up to 3 months
Title
Percentage delay of surgery due to durvalumab related complications
Description
Percentage delay of surgery due to durvalumab related complications
Time Frame
up to 3 months
Title
R0 resection rate
Description
R0 resection rate
Time Frame
up to 3 months
Title
Incidence and severity of post-operative complications to the Dindo classification
Description
Incidence and severity of post-operative complications to the Dindo classification
Time Frame
up to 3 months
Title
Progression free survival
Description
Progression free survival
Time Frame
up to 24 months
Title
Overall survival
Description
Overall survival
Time Frame
up to 24 months
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:
Histologically proven squamous cell carcinoma of the esophagus.
Surgical resectable (T3 or T4b, N0 or N+, M0), as determined by Endoscopic Ultra Sound (EUS),PET/CT, Esophageal MRI and enhanced CT scan of neck, thorax and abdomen.
Tumor length longitudinal ≤ 10 cm; if larger than 10 cm, inclusion should be discussed with the principal investigator.
18≤Age≤75.
Tumor does not involve gastro-esophageal junction.
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
Adequate hematological, renal and hepatic functions defined as:
neutrophiles ≥ 1.5 x 109/L platelets ≥ 100 x 109/L alanine transaminase≤2 x upper normal limit hemoglobin ≥ 5.6 mmol total bilirubin ≤ 1.5 x upper normal limit creatinine clearance (Cockroft) ≥60 ml/min
Written, voluntary informed consent.
Exclusion Criteria:
Past or current history of malignancy other than entry diagnosis interfering with prognosis of esophageal cancer.
T1, T2 tumors or in situ carcinoma.
metastatic oesophageal cancer.
Pregnancy (positive serum pregnancy test), planning to become pregnant, and lactation.
Previous chemotherapy, radiotherapy, and/or treatment with checkpoint inhibitors.
Clinically significant cardiovascular disease (including myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) precluding major surgery.
Pulmonary fibrosis and/or severely impaired lung function precluding major surgery.
Pre-existing motor or sensory neurotoxicity greater than WHO grade 1.
Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy (>10 mg/day prednisone or equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment.
Dementia or altered mental status that would prohibit the understanding and giving of informed consent
Serious underlying medical condition which would impair the ability of the patient to receive the planned treatment, including prior allergic reactions to drugs containing Cremophor, such as teniposide or cyclosporine.
Has an active infection requiring systemic therapy which has not resolved 3 days (simple infection such as cystitis) to 7 days (severe infection such as pyelonephritis) prior to the first dose of trial treatment.
Has a diagnosis of acute or chronic hepatitis B, hepatitis C, known immunodeficiency or human immunodeficiency virus (HIV).
Patients with prior allogeneic stem cell or solid organ transplantation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jia He, MD
Phone
+86-13810096213
Email
hejia@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Luo Zhao, MD
Phone
+86-18519667758
Email
zhaoluo@pumch.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jia He, MD
Organizational Affiliation
Peking Union Medical College Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Peking Union Medical College Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100730
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jia He, MD
Phone
+86-13810096213
Email
hejia@126.com
First Name & Middle Initial & Last Name & Degree
Luo Zhao, MD
Phone
+86-18519667758
Email
Zhaoluo@pumch.cn
12. IPD Sharing Statement
Learn more about this trial
Study of Anti-PD-L1 in Combination With Chemo(Radio)Therapy for Resectable Esophageal Squamous Cell Carcinoma
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