Concurrent Chemoradiotherapy for Stage IVB Esophageal Squamous Cell Carcinoma(EC-CRT-003) (EC-CRT-003)
Metastatic Esophageal Squamous Cell Carcinoma
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
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).
Sites / Locations
- Sun yat-sen University Cancer centerRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Concurrent Chemoradiotherapy group
Control group
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.