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A Feasibility Trial of Nivolumab With Neoadjuvant CF or DCF Therapy for Locally Advanced Esophageal Carcinoma

Primary Purpose

Locally Advanced Esophageal Squamous Cell Carcinoma

Status
Active
Phase
Phase 1
Locations
Japan
Study Type
Interventional
Intervention
Nivolumab
5-FU
CDDP
DTX
Sponsored by
National Cancer Center, Japan
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Locally Advanced Esophageal Squamous Cell Carcinoma focused on measuring Esophageal squamous cell carcinoma, Neoadjuvant chemotherapy, Nivolumab, JCOG

Eligibility Criteria

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

Inclusion criteria:

  1. Endoscopic biopsy of esophageal primary lesion histologically diagnosed as squamous cell carcinoma, adenosquamous carcinoma or basal cell carcinoma
  2. All esophageal cancer lesions are localized in the thoracic esophagus
  3. Patients are classified as clinical stage T1N1-3M0 or T2-3N0-3M0 in the UICC-TNM classification 8th edition
  4. The age is over 20 years old and under 75 on the enrollment date
  5. PS 0-1
  6. With or without measurable lesions
  7. Patients who have no medical history of treatment for esophageal cancer
  8. Patients who have no medical history of chemotherapy, radiotherapy and endocrine therapy including treatment for other types of cancer
  9. The results of laboratory tests within 14 days before enrollment meet the inclusion criteria
  10. Esophageal cancer radical surgery (R0) by open-chest surgery (or thoracoscopic surgery) and laparotomy (or laparoscopic surgery) is judged possible
  11. Patients who have no complication or history of thyroid dysfunction
  12. Patients who have no complication or history of autoimmune disease
  13. Patients who don't have treatment with systemic corticostroids (dose of 10mg/day over in prednisolone equivalent) or imunosuppressants within 14 days before enrollment
  14. Patinets who have no complication or hisoty of pneumonitis or pulmonary fibrosis which had been diagnosed by imaging tests or phisical examination
  15. For females, who have agreed with contraception from start of investigational drug administration to 5 months after last dose of investigational drug. For males who have agreed with contraception from start of investigational drug administration to 7 months after last dose of investigational drug.
  16. Obtained the written informed consent from patients"

Exclusion criteria:

  1. Patients who have active multiple cancers
  2. Patients who have infectious disease which is active and need the systemic treatment
  3. Positive with HBs antigen, or HCV-RNA or anti HIV antibody, or anti HTLV-1 antibody tests
  4. Negative with HBs antigen test and positive with anti HBs antibody or anti HBc antibody tests, and positive with HBV-DNA quantitative test
  5. Pregnant, suspected pregnant or lactating
  6. Patients who have Psycosis or psychiatric symptoms are judged inappropriate for paticipation of the trial
  7. Patients who need the treatment with continued use of flucytosine, phenytoin or warfalin pottasium
  8. Ptients who have a medical history of allergy to iodine
  9. Patients who have hypersensitivity to docetaxel, cisplatin, and drug containing polysorbate 80
  10. Patients who have a complication or a history of highly sensitive reactions to antibody formulations
  11. Even if insulin or oral hypoglycemic agent is continued to use, the result of HbA1c test is 6.5% or more in JDS or 6.9% or more in NGSP
  12. Patients who have advanced pulmonary emphysema which is observed by pulmonary function test or CT test
  13. Patients who have uncontrollable hypertension
  14. Patients who have unstable angina or a medical history of myocardial infarction within 6 months before for enrollment
  15. Patients who have diverticulitis or symptomatic peptic ulcer disease
  16. Patients who have history of transplantation therapy such as hematopoietic stem cell transplantation
  17. Patients who have medical history of treatment with anti PD-1 antibody, anti PD-L1 antibody, anti PD-L2 antibody, anti CD137 antibody, anti CTLA-4 antibody or any other antibody for inhibition or modulation of T cell costimulatory pathway or cancer vaccine"

Sites / Locations

  • National Cancer Center Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Cohort A

Cohort B

Cohort C

Cohort D

Arm Description

"Nivolumab: 360 mg, every 3 week 5-FU: 800 mg/m^2, every 3 week CDDP: 80 mg/m^2, every 3 week "

"Nivolumab: 240 mg lead-in followed by 360 mg, every 3 week 5-FU: 800 mg/m^2, every 3 week CDDP: 80 mg/m^2, every 3 week "

"Nivolumab: 360 mg, every 3 week 5-FU: 750 mg/m^2, every 3 week CDDP: 70 mg/m^2, every 3 week DTX: 70mg/m^2, every 3 weeks"

"Nivolumab: 240 mg lead-in followed by 360 mg, every 3 week 5-FU: 750 mg/m^2, every 3 week CDDP: 70 mg/m^2, every 3 week DTX: 70mg/m^2, every 3 weeks"

Outcomes

Primary Outcome Measures

Rate of participants with dose limiting toxicities (DLTs)
To evaluate the safety of combination chemotherapy with nivolumab as neoadjuvant Tx

Secondary Outcome Measures

Response rate (RR): percentage of participants with with a best response of CR or PR
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Pathological complete response rate
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Radical resection rate
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Treatment completion rate
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Adverse event (AE) expression rate
To evaluate the safety of combination chemotherapy with nivolumab as neoadjuvant Tx
Progression-free survival (PFS)
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Overall survival (OS)
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx

Full Information

First Posted
April 11, 2019
Last Updated
March 21, 2023
Sponsor
National Cancer Center, Japan
Collaborators
Ono Pharmaceutical Co. Ltd, Fiverings Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03914443
Brief Title
A Feasibility Trial of Nivolumab With Neoadjuvant CF or DCF Therapy for Locally Advanced Esophageal Carcinoma
Official Title
A Feasibility Trial of Nivolumab With Neoadjuvant CF or DCF Therapy for Locally Advanced Esophageal Carcinoma FRONTiER Trial
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 7, 2019 (Actual)
Primary Completion Date
February 1, 2023 (Actual)
Study Completion Date
August 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Center, Japan
Collaborators
Ono Pharmaceutical Co. Ltd, Fiverings Co., Ltd.

4. Oversight

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

5. Study Description

Brief Summary
The main purpose of this study is to evaluate the safety of the neoadjuvant therapy, nivolumab with CF (5-FU, CDDP) or nivolumab with DCF (5-FU, CDDP, DTX), for locally advanced esophageal carcinoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Locally Advanced Esophageal Squamous Cell Carcinoma
Keywords
Esophageal squamous cell carcinoma, Neoadjuvant chemotherapy, Nivolumab, JCOG

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
36 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort A
Arm Type
Experimental
Arm Description
"Nivolumab: 360 mg, every 3 week 5-FU: 800 mg/m^2, every 3 week CDDP: 80 mg/m^2, every 3 week "
Arm Title
Cohort B
Arm Type
Experimental
Arm Description
"Nivolumab: 240 mg lead-in followed by 360 mg, every 3 week 5-FU: 800 mg/m^2, every 3 week CDDP: 80 mg/m^2, every 3 week "
Arm Title
Cohort C
Arm Type
Experimental
Arm Description
"Nivolumab: 360 mg, every 3 week 5-FU: 750 mg/m^2, every 3 week CDDP: 70 mg/m^2, every 3 week DTX: 70mg/m^2, every 3 weeks"
Arm Title
Cohort D
Arm Type
Experimental
Arm Description
"Nivolumab: 240 mg lead-in followed by 360 mg, every 3 week 5-FU: 750 mg/m^2, every 3 week CDDP: 70 mg/m^2, every 3 week DTX: 70mg/m^2, every 3 weeks"
Intervention Type
Biological
Intervention Name(s)
Nivolumab
Other Intervention Name(s)
ONO-4538
Intervention Description
240 mg or 360 mg
Intervention Type
Drug
Intervention Name(s)
5-FU
Other Intervention Name(s)
5-Fluorouracil
Intervention Description
750 or 800 mg^2
Intervention Type
Drug
Intervention Name(s)
CDDP
Other Intervention Name(s)
Cisplatin
Intervention Description
70 or 80 mg/m^2
Intervention Type
Drug
Intervention Name(s)
DTX
Other Intervention Name(s)
Docetaxel
Intervention Description
70 mg/m^2
Primary Outcome Measure Information:
Title
Rate of participants with dose limiting toxicities (DLTs)
Description
To evaluate the safety of combination chemotherapy with nivolumab as neoadjuvant Tx
Time Frame
from initial dose to 30 post-operative days
Secondary Outcome Measure Information:
Title
Response rate (RR): percentage of participants with with a best response of CR or PR
Description
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Time Frame
from baseline to date of disease progression, approximately 24 months
Title
Pathological complete response rate
Description
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Time Frame
from baseline to operation, average of 10 weeks after initial dose
Title
Radical resection rate
Description
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Time Frame
at operation, average of 10 weeks after initial dose
Title
Treatment completion rate
Description
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Time Frame
from baseline to operation, average of 10 weeks after initial dose
Title
Adverse event (AE) expression rate
Description
To evaluate the safety of combination chemotherapy with nivolumab as neoadjuvant Tx
Time Frame
up to 30 postoperative days
Title
Progression-free survival (PFS)
Description
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Time Frame
from baseline to date of disease progression or death, approximately 24 month
Title
Overall survival (OS)
Description
To evaluate the efficacy of combination chemotherapy with nivolumab as neoadjuvant Tx
Time Frame
from baseline to date of death, approximately 24 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Endoscopic biopsy of esophageal primary lesion histologically diagnosed as squamous cell carcinoma, adenosquamous carcinoma, or basal cell carcinoma All esophageal cancer lesions are localized in the thoracic esophagus Patients are classified as clinical stage T1N1-3M0 or T2-3N0-3M0 in the UICC-TNM classification 8th edition The age is over 20 years old and under 75 on the enrollment date PS 0-1 With or without measurable lesions Patients who have no medical history of treatment for esophageal cancer Patients who have no medical history of chemotherapy, radiotherapy, and endocrine therapy, including treatment for other types of cancer The results of laboratory tests within 14 days before enrollment meet the inclusion criteria Esophageal cancer radical surgery (R0) by open-chest surgery (or thoracoscopic surgery) and laparotomy (or laparoscopic surgery) is judged possible Patients who have no complication or history of thyroid dysfunction Patients who have no complication or history of autoimmune disease Patients who don't have treatment with systemic corticosteroids (dose of 10mg/day over in prednisolone equivalent) or immunosuppressants within 14 days before enrollment Patients who have no complication or history of pneumonitis or pulmonary fibrosis which had been diagnosed by imaging tests or physical examination For females, who have agreed with contraception from start of investigational drug administration to 5 months after last dose of an investigational drug. For males who have agreed with contraception from start of investigational drug administration to 7 months after last dose of an investigational drug. Obtained written informed consent from patients" Exclusion criteria: Patients who have active multiple cancers Patients who have an infectious disease that is active and need the systemic treatment Positive with HBs antigen, HCV-RNA or anti-HIV antibody, or anti-HTLV-1 antibody tests Negative with HBs antigen test and positive with anti HBs antibody or anti HBc antibody tests, and positive with HBV-DNA quantitative test Pregnant, suspected pregnant, or lactating Patients who have Psycosis or psychiatric symptoms are judged inappropriate for participation in the trial Patients who need the treatment with continued use of flucytosine, phenytoin, or warfarin potassium Patients who have a medical history of allergy to iodine Patients who have hypersensitivity to docetaxel, cisplatin, and drug-containing polysorbate 80 Patients who have a complication or a history of highly sensitive reactions to antibody formulations Even if insulin or oral hypoglycemic agent is continued use, the result of HbA1c test is 6.5% or more in JDS or 6.9% or more in NGSP Patients who have advanced pulmonary emphysema, which is observed by pulmonary function test or CT test Patients who have uncontrollable hypertension Patients who have unstable angina or a medical history of myocardial infarction within 6 months before enrollment Patients who have diverticulitis or symptomatic peptic ulcer disease Patients who have a history of transplantation therapy, such as hematopoietic stem cell transplantation Patients who have a medical history of treatment with an anti-PD-1 antibody, anti-PD-L1 antibody, anti-PD-L2 antibody, anti-CD137 antibody, anti-CTLA-4 antibody, or any other antibody for inhibition or modulation of T cell costimulatory pathway or cancer vaccine."
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ken Kato, MD/PhD
Organizational Affiliation
Department of Gastrointestinal Medical Oncology, National cancer center hospital
Official's Role
Study Chair
Facility Information:
Facility Name
National Cancer Center Hospital
City
Tokyo
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
32396014
Citation
Yamamoto S, Kato K, Daiko H, Kojima T, Hara H, Abe T, Tsubosa Y, Nagashima K, Aoki K, Mizoguchi Y, Kitano S, Yachida S, Shiba S, Kitagawa Y. Feasibility study of nivolumab as neoadjuvant chemotherapy for locally esophageal carcinoma: FRONTiER (JCOG1804E). Future Oncol. 2020 Jul;16(19):1351-1357. doi: 10.2217/fon-2020-0189. Epub 2020 May 12.
Results Reference
derived

Learn more about this trial

A Feasibility Trial of Nivolumab With Neoadjuvant CF or DCF Therapy for Locally Advanced Esophageal Carcinoma

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