Neoadjuvant Immunotherapy to ESCC
Primary Purpose
Esophagus SCC
Status
Withdrawn
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Sintilimab Injection plus Paclitaxel and Cisplatin
Paclitaxel and Cisplatin
Sponsored by
About this trial
This is an interventional treatment trial for Esophagus SCC focused on measuring ESCC, PD-1/PD-L1, Randomized controlled clinical trial, neoadjuvant
Eligibility Criteria
Inclusion Criteria:
- Volunteer to participated and sign information consent;
- Age 18-70, male or female;
- Locally advanced esophageal cancer diagnosed by pathology, Clinical tumor stage should be II-IVa; tumor located at the lower middle segment;
- No previous chemoradiotherapy or immunotherapy;
- PD-L1 expression >=10%;
- Have a performance status of 0 or 1 on the ECOG Performance Scale;
- Demonstrate adequate organ function as defined below (excluding the use of any blood components and cytokines during the screening period): Absolute neutrophil count (ANC) ≥1.5*109 /L; Platelet ≥100*109/L; Hemoglobin ≥ 9 g/dL; Serum albumin≥3g/dL; Bilirubin≤1.5 x ULN; ALT and AST≤2.5 ULN; Serum creatinine ≤1.5 x ULN or creatinine clearance ≥40mL/min; LVEF>=50%; Urine protein<++; INR<1.5 and APTT<1.5;
- Female subject must have taken reliable contraceptive measures of childbearing potential should have a negative urine or serum pregnancy within 7 days prior to receiving the first dose of study medication. and be willing to use an appropriate method of contraception during the trial and 8 weeks after the last administration of the test drug. Male subject should agree to use appropriate contraceptive methods or to have been surgically sterilized during the trial and 8 weeks after the last administration of the test drug.
Exclusion Criteria:
- Any active autoimmune disease or history of autoimmune disease (as follows, but not limited to: autoimmune hepatitis, interstitial pneumonia, uveitis, enteritis, hepatitis, pituitritis, vasculitis, nephritis, hyperthyroidism, thyroid dysfunction);
- Asthma requiring medical intervention with bronchodilators was not included.
- Subjects with history of severe allergy;
- There are clinical symptoms or diseases of the heart that are not well controlled, such as: heart failure above grade 2 by the Criteria of NYHA; unstable angina pectoris; myocardial infarction occurred within 1 year; Clinically meaningful supraventricular or ventricular arrhythmias require treatment or intervention;
- Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies), or has known active Hepatitis B (e.g. HBV DNA≥ 2000IU/ml or copy number ≥104/ml;) or Hepatitis C (e.g. HCV antibody positive);
- Systematic glucocorticoid therapy is administered one week prior to neoadjuvant therapy;
- Subjects who are participating other drug clinical trials.
Sites / Locations
- Qilu Hospital of Shandong University
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
intervention group
controll group
Arm Description
Neoadjuvant immunotherapy (PD-1) plus concurrent chemotherapy (paclitaxel + Cisplatin) will be applied to patients with locally advanced esophageal squamous cell carcinoma with PD-L1>=10% before surgery.
Neoadjuvant chemotherapy (paclitaxel + Cisplatin) will be applied to patients with locally advanced esophageal squamous cell carcinoma with PD-L1>=10% before surgery.
Outcomes
Primary Outcome Measures
Major Pathological Response (MPR) rate
MPR is defined as 10% or fewer viable cancer cells in the hematoxylin and eosin (H&E)-stained slides from the resected tumor following neoadjuvant treatment.
Secondary Outcome Measures
Objective Response Rate (ORR)
ORR determines the tumor shrinkage rate, tumor boundary and the adhesion of tumor
2-year progression-free survival (PFS)
From date of surgery until the date of first documented progression or date of death from any cause
The incidence of adverse events
Safety will be evaluated for all treated patients using CTCAE V 5.0.
Full Information
NCT ID
NCT04625543
First Posted
November 6, 2020
Last Updated
April 19, 2022
Sponsor
Qilu Hospital of Shandong University
1. Study Identification
Unique Protocol Identification Number
NCT04625543
Brief Title
Neoadjuvant Immunotherapy to ESCC
Official Title
Neoadjuvant Immunotherapy Combined With Neoadjuvant Chemotherapy for Locally Advanced Esophageal Cancer: an Open Label, Randomized Control, Phase II Trial
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Withdrawn
Why Stopped
insufficient money
Study Start Date
December 2020 (Anticipated)
Primary Completion Date
June 2023 (Anticipated)
Study Completion Date
September 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Qilu Hospital of Shandong University
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
Currently, surgery after neoadjuvant chemoradiotherapy is the standard treatment for patients with locally advanced esophageal cancer, but the recurrence rate is high and the 5-year survival rate is low. Immunotherapy shows a potential treatment for esophageal cancer. Immunocheckpoint (PD-1/PD-L1) inhibitors can activate tumor immunity. The guidelines have recommended it as a sencond-line therapy. However, there is still lack of the evidence for its efficacy as a neoadjuvant therapy. This study is to conduct a randomized controlled, open label, phase II clinical trial to evaluate the efficacy and safety of neoadjuvant immnotherapy combined with neoadjuvant chemotherapy for locally advanced esophageal squamous cell carcinoma (ESCC) patient with PD-L1 (CPS>=10%) positive.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophagus SCC
Keywords
ESCC, PD-1/PD-L1, Randomized controlled clinical trial, neoadjuvant
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
intervention group
Arm Type
Experimental
Arm Description
Neoadjuvant immunotherapy (PD-1) plus concurrent chemotherapy (paclitaxel + Cisplatin) will be applied to patients with locally advanced esophageal squamous cell carcinoma with PD-L1>=10% before surgery.
Arm Title
controll group
Arm Type
Active Comparator
Arm Description
Neoadjuvant chemotherapy (paclitaxel + Cisplatin) will be applied to patients with locally advanced esophageal squamous cell carcinoma with PD-L1>=10% before surgery.
Intervention Type
Drug
Intervention Name(s)
Sintilimab Injection plus Paclitaxel and Cisplatin
Intervention Description
Paclitaxel 150mg/m2 on day 1, every 3 weeks, for two cycles; Cisplatin 70mg/m2 on day 1, every 3 weeks, for two cycles; Sintilimab Injection 200mg on day 22; 4-6 weeks after completion of preoperative therapy, Mckeown esophagectomy will be performed if there is no contraindication.
Intervention Type
Drug
Intervention Name(s)
Paclitaxel and Cisplatin
Intervention Description
Paclitaxel 150mg/m2 on day 1, every 3 weeks, for two cycles; Cisplatin 70mg/m2 on day 1, every 3 weeks, for two cycles; 4-6 weeks after completion of preoperative therapy, Mckeown esophagectomy will be performed if there is no contraindication.
Primary Outcome Measure Information:
Title
Major Pathological Response (MPR) rate
Description
MPR is defined as 10% or fewer viable cancer cells in the hematoxylin and eosin (H&E)-stained slides from the resected tumor following neoadjuvant treatment.
Time Frame
30 days after the second cycle of treatment(each cycle is 21 days)
Secondary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
ORR determines the tumor shrinkage rate, tumor boundary and the adhesion of tumor
Time Frame
at the end of the second cycle of treatment(each cycle is 21 days)
Title
2-year progression-free survival (PFS)
Description
From date of surgery until the date of first documented progression or date of death from any cause
Time Frame
every 3 months (up to 24 months)
Title
The incidence of adverse events
Description
Safety will be evaluated for all treated patients using CTCAE V 5.0.
Time Frame
the day from the first treatment cycle
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:
Volunteer to participated and sign information consent;
Age 18-70, male or female;
Locally advanced esophageal cancer diagnosed by pathology, Clinical tumor stage should be II-IVa; tumor located at the lower middle segment;
No previous chemoradiotherapy or immunotherapy;
PD-L1 expression >=10%;
Have a performance status of 0 or 1 on the ECOG Performance Scale;
Demonstrate adequate organ function as defined below (excluding the use of any blood components and cytokines during the screening period): Absolute neutrophil count (ANC) ≥1.5*109 /L; Platelet ≥100*109/L; Hemoglobin ≥ 9 g/dL; Serum albumin≥3g/dL; Bilirubin≤1.5 x ULN; ALT and AST≤2.5 ULN; Serum creatinine ≤1.5 x ULN or creatinine clearance ≥40mL/min; LVEF>=50%; Urine protein<++; INR<1.5 and APTT<1.5;
Female subject must have taken reliable contraceptive measures of childbearing potential should have a negative urine or serum pregnancy within 7 days prior to receiving the first dose of study medication. and be willing to use an appropriate method of contraception during the trial and 8 weeks after the last administration of the test drug. Male subject should agree to use appropriate contraceptive methods or to have been surgically sterilized during the trial and 8 weeks after the last administration of the test drug.
Exclusion Criteria:
Any active autoimmune disease or history of autoimmune disease (as follows, but not limited to: autoimmune hepatitis, interstitial pneumonia, uveitis, enteritis, hepatitis, pituitritis, vasculitis, nephritis, hyperthyroidism, thyroid dysfunction);
Asthma requiring medical intervention with bronchodilators was not included.
Subjects with history of severe allergy;
There are clinical symptoms or diseases of the heart that are not well controlled, such as: heart failure above grade 2 by the Criteria of NYHA; unstable angina pectoris; myocardial infarction occurred within 1 year; Clinically meaningful supraventricular or ventricular arrhythmias require treatment or intervention;
Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies), or has known active Hepatitis B (e.g. HBV DNA≥ 2000IU/ml or copy number ≥104/ml;) or Hepatitis C (e.g. HCV antibody positive);
Systematic glucocorticoid therapy is administered one week prior to neoadjuvant therapy;
Subjects who are participating other drug clinical trials.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shaowei Sang, Doctor
Organizational Affiliation
Qilu Hospital of Shandong University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Qilu Hospital of Shandong University
City
Jinan
State/Province
Shandong
ZIP/Postal Code
250012
Country
China
12. IPD Sharing Statement
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Neoadjuvant Immunotherapy to ESCC
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