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Neoadjuvant Immunochemotherapy in Locally Advanced Esophagogastric Junction Adenocarcinoma

Primary Purpose

Esophagogastric Junction Adenocarcinoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Sintilimab
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Esophagogastric Junction Adenocarcinoma focused on measuring Esophagogastric Junction Adenocarcinoma, neoadjuvant, chemo-immunotherapy, Sintilimab

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically confirmed locally advanced esophagogastric junction Adenocarcinoma cT3-4aN0 or T1-4aN1-3M0
  • No previous anti-tumor treatment
  • ECOG PS: 0-1
  • The functions of important organs meet the following requirements (excluding the use of any blood components and cell growth factors during the screening period):Absolute neutrophil count ≥ 1.5 × 109/L; Platelet ≥ 90 × 109/L; Hemoglobin ≥ 9g / dl; Serum albumin ≥ 3G / dl; Thyroid stimulating hormone (TSH) ≤ ULN (if abnormal, the levels of T3 and T4 should be investigated at the same time. If the levels of T3 and T4 are normal, they can be included in the group); Bilirubin ≤ ULN; ALT and AST ≤ 1.5 times ULN; AKP ≤ 2.5 times ULN; Serum creatinine ≤ 1.5 times ULN or creatinine clearance ≥ 60ml / min.
  • Women of childbearing age must have taken reliable contraceptive measures or conducted pregnancy test (serum or urine) within 7 days before enrollment, and the result is negative, and are willing to use appropriate contraceptive methods during the test and 8 weeks after the last administration of test drugs. For men, they must agree to use appropriate methods of contraception or surgical sterilization during the trial and 8 weeks after the last administration of the trial drug.
  • The patients voluntarily joined the study and signed the informed consent form. They had good compliance and cooperated with the follow-up.

Exclusion Criteria:

  • Known Her-2 positive
  • Any active autoimmune disease or history of autoimmunity (as follows, but not limited to: autoimmune hepatitis, interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism and hypothyroidism; Subjects with vitiligo or asthma in childhood have been completely relieved and do not need any intervention after adulthood can be included; Asthma in which subjects need bronchodilators for medical intervention cannot be included).
  • Severe allergic reaction to monoclonal antibody.
  • The number of neutrophils in peripheral blood was less than 1500 / mm3.
  • There are cardiac clinical symptoms or diseases that are not well controlled.
  • Previously received radiotherapy, chemotherapy, hormone therapy, surgery or molecular targeted therapy.
  • The subjects were innate or acquired immunodeficiency (such as HIV), or active hepatitis (hepatitis B reference: HBsAg) positive, HBVDNA > 2000IU/ml or copy number > 104/ml; Hepatitis C reference: HCV antibody positive.
  • According to the judgment of the researcher, the subject has other factors that may lead to the forced midway termination of this study, such as other serious diseases (including mental diseases) requiring combined treatment, serious laboratory abnormalities, accompanied by family or social factors, which will affect the safety of the subject, or the collection of data and samples.
  • The researchers judged the patients with high risk of esophageal perforation or no potential possibility of surgery through endoscopic ultrasonography or imaging.

Sites / Locations

  • Sun Yat-sen University Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Neoadjuvant chemo-immunotherapy

Arm Description

Neoadjuvant Immunotherapy (Sintilimab, PD-1 inhibitor) Combined With Chemotherapy (Tegafur+Oxaliplatin) Each patient will complete 3 cycles of neoadjuvant therapy. After evaluating the radiographical response, operation with curative extent (Ivor-lewis or Mckeown procedure with two-field lymph node dissection) will be performed after 6 to 8 weeks from the last cycle of neoadjuvant treatment. Patients with and without surgery enter the survival follow-up period.

Outcomes

Primary Outcome Measures

Pathologic Complete Response
No malignant tumor cells were detected in the removed specimens including primary tumor and lymph nodes

Secondary Outcome Measures

Overall survival
The time from randomization to death from any cause.
Disease-Free-Survival
The time between the beginning of treatment and the observation of disease progression or death from any cause.
R0 resection rate
The percentage of patients who undergo complete resection

Full Information

First Posted
December 24, 2021
Last Updated
December 29, 2021
Sponsor
Sun Yat-sen University
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1. Study Identification

Unique Protocol Identification Number
NCT05170503
Brief Title
Neoadjuvant Immunochemotherapy in Locally Advanced Esophagogastric Junction Adenocarcinoma
Official Title
Neoadjuvant Sintilimab Plus SOX in the Locally Advanced Esophagogastric Junction Adenocarcinoma: a Prospective, Single Arm Phase II Trial
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Recruiting
Study Start Date
December 29, 2021 (Actual)
Primary Completion Date
January 1, 2024 (Anticipated)
Study Completion Date
January 1, 2029 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to access the safety and efficacy of neoadjuvant Immunotherapy (Sintilimab, PD-1 inhibitor) combined with chemotherapy (Tegafur+Oxaliplatin) for locally advanced esophagogastric junction adenocarcinoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophagogastric Junction Adenocarcinoma
Keywords
Esophagogastric Junction Adenocarcinoma, neoadjuvant, chemo-immunotherapy, Sintilimab

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Neoadjuvant chemo-immunotherapy
Arm Type
Experimental
Arm Description
Neoadjuvant Immunotherapy (Sintilimab, PD-1 inhibitor) Combined With Chemotherapy (Tegafur+Oxaliplatin) Each patient will complete 3 cycles of neoadjuvant therapy. After evaluating the radiographical response, operation with curative extent (Ivor-lewis or Mckeown procedure with two-field lymph node dissection) will be performed after 6 to 8 weeks from the last cycle of neoadjuvant treatment. Patients with and without surgery enter the survival follow-up period.
Intervention Type
Drug
Intervention Name(s)
Sintilimab
Intervention Description
Sintilimab 200mg iv drip. Qd D1 + Oxaliplatin 130/m2 iv drip. Qd D1 + Tegafur (Gimeracil and Oteracil Potassium Capsules) [40mg/m2 if BSA <1.25m2, 50mg/m2 if BSA ≥1.25m2 & <1.5m2, 60mg/m2 if BSA ≥1.5m2] po. Bid D1-14 for three cycles
Primary Outcome Measure Information:
Title
Pathologic Complete Response
Description
No malignant tumor cells were detected in the removed specimens including primary tumor and lymph nodes
Time Frame
From date of enrollment until one month after resection
Secondary Outcome Measure Information:
Title
Overall survival
Description
The time from randomization to death from any cause.
Time Frame
2-5 years
Title
Disease-Free-Survival
Description
The time between the beginning of treatment and the observation of disease progression or death from any cause.
Time Frame
2-5 years
Title
R0 resection rate
Description
The percentage of patients who undergo complete resection
Time Frame
From date of enrollment until one month after resection

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 confirmed locally advanced esophagogastric junction Adenocarcinoma cT3-4aN0 or T1-4aN1-3M0 No previous anti-tumor treatment ECOG PS: 0-1 The functions of important organs meet the following requirements (excluding the use of any blood components and cell growth factors during the screening period):Absolute neutrophil count ≥ 1.5 × 109/L; Platelet ≥ 90 × 109/L; Hemoglobin ≥ 9g / dl; Serum albumin ≥ 3G / dl; Thyroid stimulating hormone (TSH) ≤ ULN (if abnormal, the levels of T3 and T4 should be investigated at the same time. If the levels of T3 and T4 are normal, they can be included in the group); Bilirubin ≤ ULN; ALT and AST ≤ 1.5 times ULN; AKP ≤ 2.5 times ULN; Serum creatinine ≤ 1.5 times ULN or creatinine clearance ≥ 60ml / min. Women of childbearing age must have taken reliable contraceptive measures or conducted pregnancy test (serum or urine) within 7 days before enrollment, and the result is negative, and are willing to use appropriate contraceptive methods during the test and 8 weeks after the last administration of test drugs. For men, they must agree to use appropriate methods of contraception or surgical sterilization during the trial and 8 weeks after the last administration of the trial drug. The patients voluntarily joined the study and signed the informed consent form. They had good compliance and cooperated with the follow-up. Exclusion Criteria: Known Her-2 positive Any active autoimmune disease or history of autoimmunity (as follows, but not limited to: autoimmune hepatitis, interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism and hypothyroidism; Subjects with vitiligo or asthma in childhood have been completely relieved and do not need any intervention after adulthood can be included; Asthma in which subjects need bronchodilators for medical intervention cannot be included). Severe allergic reaction to monoclonal antibody. The number of neutrophils in peripheral blood was less than 1500 / mm3. There are cardiac clinical symptoms or diseases that are not well controlled. Previously received radiotherapy, chemotherapy, hormone therapy, surgery or molecular targeted therapy. The subjects were innate or acquired immunodeficiency (such as HIV), or active hepatitis (hepatitis B reference: HBsAg) positive, HBVDNA > 2000IU/ml or copy number > 104/ml; Hepatitis C reference: HCV antibody positive. According to the judgment of the researcher, the subject has other factors that may lead to the forced midway termination of this study, such as other serious diseases (including mental diseases) requiring combined treatment, serious laboratory abnormalities, accompanied by family or social factors, which will affect the safety of the subject, or the collection of data and samples. The researchers judged the patients with high risk of esophageal perforation or no potential possibility of surgery through endoscopic ultrasonography or imaging.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hong Yang, M.D. Ph.D.
Phone
+8613560405144
Ext
+8613560405144
Email
yanghong@sysucc.org.cn
Facility Information:
Facility Name
Sun Yat-sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hong Yang, Ph.D.,M.D.
Phone
008613560405144
Email
yanghong@sysucc.org.cn
First Name & Middle Initial & Last Name & Degree
Jiyang Chen
Phone
008618826238208
Email
chenjy1@sysucc.org.cn

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
upon reaseonable request with a plan

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Neoadjuvant Immunochemotherapy in Locally Advanced Esophagogastric Junction Adenocarcinoma

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