search
Back to results

Concurrent Chemoradiotherapy for Stage IVB Esophageal Squamous Cell Carcinoma(EC-CRT-003) (EC-CRT-003)

Primary Purpose

Metastatic Esophageal Squamous Cell Carcinoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Intensity-modulated radiotherapy concurrent with capecitabine
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Esophageal Squamous Cell Carcinoma focused on measuring metastatic esophageal squamous cell carcinoma, anti-PD-1, Capecitabine, chemoradiotherapy

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Eastern Cooperative Oncology Group performance status ≤ 2
  2. Histologically confirmed squamous cell carcinoma of the esophagus;
  3. Diagnosed with stage IVB disease (according to UICC TNM version 8);
  4. Received 4 to 6 cycles of standard chemotherapy (fluoropyrimidine or taxane-based platinum doublet chemotherapy) and anti-PD1 treatment, and no progression disease was confirmed;
  5. Estimated life expectancy >4 months;
  6. The function of important organs meet the following requirements: a. white blood cell count (WBC) ≥ 4.0×109/L, absolute neutrophil count (ANC) ≥ 1.5×109/L; b. platelets ≥ 100×109/L; c. hemoglobin ≥ 9g/dL; d. serum albumin ≥ 2.8g/dL; e. total bilirubin ≤ 1.5×ULN, ALT, AST and/or AKP ≤ 2.5×ULN; f. serum creatinine ≤ 1.5×ULN or creatinine clearance rate >60 mL/min;
  7. Ability to understand the study and sign informed consent.

Exclusion Criteria:

  1. Progression was confirmed after completion of 4 to 6 cycles of standard chemotherapy and anti-PD1 treatment;
  2. Patients with intracranial metastasis disease at diagnosis;
  3. History of thoracic irradiation;
  4. Known or suspected allergy or hypersensitivity to monoclonal antibodies and the chemotherapeutic drugs: Capecitabine, paclitaxel, or platinum;
  5. Patients who have a preexisting esophagomediastinal fistula and/or esophagotracheal fistula;
  6. A history of malignancies other than esophageal cancer before enrollment, excluding non-melanoma skin cancer, in situ cervical cancer, or cured early prostate cancer
  7. Patients who cannot tolerate chemoradiotherapy due to severe cardiac, lung, liver, or kidney dysfunction, or hematopoietic disease or cachexia.
  8. Inability to provide informed consent due to psychological, familial, social, and other factors;
  9. Female patients who are pregnant or during lactation;
  10. Active autoimmune diseases, a history of autoimmune diseases (including but not limited to these diseases or syndromes, such as colitis, hepatitis, hyperthyroidism), a history of immunodeficiency (including a positive HIV test result), or other acquired or congenital immunodeficiency diseases, a history of organ transplantation or allogeneic bone marrow transplantation;
  11. A history of interstitial lung disease or non-infectious pneumonia;
  12. Presence of active hepatitis B (HBV DNA ≥ 2000 IU/mL or 104 copies/mL), hepatitis C (positive for hepatitis C antibody, and HCV-RNA levels higher than the lower limit of the assay).

Sites / Locations

  • Sun yat-sen University Cancer centerRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Concurrent Chemoradiotherapy group

Control group

Arm Description

After completion of 4 to 6 cycles of standard chemotherapy and anti-PD1, all patients will receive thoracic radiation therapy (RT) in the following scheme: 45 to 50.4Gy in 25 to 28 fractions, concurrently with 2 cycles of capecitabine tablets (825mg/m2) for two weeks, and then followed by a maintenance treatment phase of anti-PD1 every 3 weeks.

After completion of 4 to 6 cycles of standard chemotherapy and anti-PD1, patients will receive the maintenance treatment with anti-PD1 every 3 weeks.

Outcomes

Primary Outcome Measures

1-year progression-free survival
The 1-year progression-free survival of each group

Secondary Outcome Measures

1-year overall survival
The 1-year overall survival of the each group
ORR
Overall response rate
Treatment-related adverse events
Toxicity of treatment was evaluated according to CTCAE 4.0

Full Information

First Posted
August 21, 2022
Last Updated
September 24, 2022
Sponsor
Sun Yat-sen University
search

1. Study Identification

Unique Protocol Identification Number
NCT05512520
Brief Title
Concurrent Chemoradiotherapy for Stage IVB Esophageal Squamous Cell Carcinoma(EC-CRT-003)
Acronym
EC-CRT-003
Official Title
Systemic Therapy Combined With Thoracic Concurrent Chemoradiotherapy Versus Systemic Therapy Alone in Stage IVB Esophageal Squamous Cell Carcinoma: A Prospective Randomized Phase II Study
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 20, 2022 (Actual)
Primary Completion Date
August 30, 2024 (Anticipated)
Study Completion Date
September 30, 2025 (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
No

5. Study Description

Brief Summary
Retrospective studies suggested that the addition of thoracic concurrent chemoradiotherapy to systemic chemotherapy improved the survival and quality of life (QOL) of patients with metastatic esophageal squamous cell carcinoma (ESCC). However, no prospective study had been conducted to confirm these findings. Recently, immunotherapy targeting the PD-1/PD-L1 checkpoints combined with chemotherapy had been proved to significantly prolong the survival of those patients compared with chemotherapy alone. Moreover, anti-PD-1 combined with radiotherapy exerts a synergistic anti-tumor effect, which may further improve the combination efficacy. This randomized, phase II study aimed to evaluate the efficacy and safety of the chemotherapy and anti-PD-1 combined with concurrent chemoradiotherapy to primary tumor versus systemic therapy alone in stage IVB ESCC. Of note, non-regional lymph node metastasis only was the stratification factor in the random assignment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Esophageal Squamous Cell Carcinoma
Keywords
metastatic esophageal squamous cell carcinoma, anti-PD-1, Capecitabine, chemoradiotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
126 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Concurrent Chemoradiotherapy group
Arm Type
Experimental
Arm Description
After completion of 4 to 6 cycles of standard chemotherapy and anti-PD1, all patients will receive thoracic radiation therapy (RT) in the following scheme: 45 to 50.4Gy in 25 to 28 fractions, concurrently with 2 cycles of capecitabine tablets (825mg/m2) for two weeks, and then followed by a maintenance treatment phase of anti-PD1 every 3 weeks.
Arm Title
Control group
Arm Type
No Intervention
Arm Description
After completion of 4 to 6 cycles of standard chemotherapy and anti-PD1, patients will receive the maintenance treatment with anti-PD1 every 3 weeks.
Intervention Type
Combination Product
Intervention Name(s)
Intensity-modulated radiotherapy concurrent with capecitabine
Intervention Description
All patients received external-beam radiation using intensity-modulated radiotherapy. The prescribed dose is 45 to 50.4Gy in 25 to 28 fractions, concurrently with 2 cycles of capecitabine tablets (825mg/m2) for two weeks.
Primary Outcome Measure Information:
Title
1-year progression-free survival
Description
The 1-year progression-free survival of each group
Time Frame
From date of randomization until the date of death from any cause or the date of first documented disease progression whichever came first, assessed up to 12 months
Secondary Outcome Measure Information:
Title
1-year overall survival
Description
The 1-year overall survival of the each group
Time Frame
From date of randomization until the date of death from any cause or the date of last follow-up, whichever came first, assessed up to 12 months
Title
ORR
Description
Overall response rate
Time Frame
3 months after chemoradiotherapy (plus or minus 14 days)
Title
Treatment-related adverse events
Description
Toxicity of treatment was evaluated according to CTCAE 4.0
Time Frame
From the start of treatment to 2 year after the completion of treatment

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: Eastern Cooperative Oncology Group performance status ≤ 2 Histologically confirmed squamous cell carcinoma of the esophagus; Diagnosed with stage IVB disease (according to UICC TNM version 8); Received 4 to 6 cycles of standard chemotherapy (fluoropyrimidine or taxane-based platinum doublet chemotherapy) and anti-PD1 treatment, and no progression disease was confirmed; Estimated life expectancy >4 months; The function of important organs meet the following requirements: a. white blood cell count (WBC) ≥ 4.0×109/L, absolute neutrophil count (ANC) ≥ 1.5×109/L; b. platelets ≥ 100×109/L; c. hemoglobin ≥ 9g/dL; d. serum albumin ≥ 2.8g/dL; e. total bilirubin ≤ 1.5×ULN, ALT, AST and/or AKP ≤ 2.5×ULN; f. serum creatinine ≤ 1.5×ULN or creatinine clearance rate >60 mL/min; Ability to understand the study and sign informed consent. Exclusion Criteria: Progression was confirmed after completion of 4 to 6 cycles of standard chemotherapy and anti-PD1 treatment; Patients with intracranial metastasis disease at diagnosis; History of thoracic irradiation; Known or suspected allergy or hypersensitivity to monoclonal antibodies and the chemotherapeutic drugs: Capecitabine, paclitaxel, or platinum; Patients who have a preexisting esophagomediastinal fistula and/or esophagotracheal fistula; A history of malignancies other than esophageal cancer before enrollment, excluding non-melanoma skin cancer, in situ cervical cancer, or cured early prostate cancer Patients who cannot tolerate chemoradiotherapy due to severe cardiac, lung, liver, or kidney dysfunction, or hematopoietic disease or cachexia. Inability to provide informed consent due to psychological, familial, social, and other factors; Female patients who are pregnant or during lactation; Active autoimmune diseases, a history of autoimmune diseases (including but not limited to these diseases or syndromes, such as colitis, hepatitis, hyperthyroidism), a history of immunodeficiency (including a positive HIV test result), or other acquired or congenital immunodeficiency diseases, a history of organ transplantation or allogeneic bone marrow transplantation; A history of interstitial lung disease or non-infectious pneumonia; Presence of active hepatitis B (HBV DNA ≥ 2000 IU/mL or 104 copies/mL), hepatitis C (positive for hepatitis C antibody, and HCV-RNA levels higher than the lower limit of the assay).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mian Xi, MD
Phone
02087340540
Email
ximian@sysucc.org.cn
Facility Information:
Facility Name
Sun yat-sen University Cancer center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Baoqing Chen, MD
Phone
02087340540
Email
chenbq@sysucc.org.cn

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28461255
Citation
Guttmann DM, Mitra N, Bekelman J, Metz JM, Plastaras J, Feng W, Swisher-McClure S. Improved Overall Survival with Aggressive Primary Tumor Radiotherapy for Patients with Metastatic Esophageal Cancer. J Thorac Oncol. 2017 Jul;12(7):1131-1142. doi: 10.1016/j.jtho.2017.03.026. Epub 2017 Apr 28.
Results Reference
background
PubMed Identifier
34188053
Citation
Liu S, Luo L, Zhao L, Zhu Y, Liu H, Li Q, Cai L, Hu Y, Qiu B, Zhang L, Shen J, Yang Y, Liu M, Xi M. Induction chemotherapy followed by definitive chemoradiotherapy versus chemoradiotherapy alone in esophageal squamous cell carcinoma: a randomized phase II trial. Nat Commun. 2021 Jun 29;12(1):4014. doi: 10.1038/s41467-021-24288-1.
Results Reference
background

Learn more about this trial

Concurrent Chemoradiotherapy for Stage IVB Esophageal Squamous Cell Carcinoma(EC-CRT-003)

We'll reach out to this number within 24 hrs