Neoadjuvant Anti-PD-1 Antibody SHR-1210 and Radiation in Resectable Esophageal Squamous Cell Carcinoma
Primary Purpose
Esophageal Neoplasms, Esophageal Diseases
Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
3-DCRT or IMRT radiation
anti-PD-1 antibody SHR-1210
Sponsored by
About this trial
This is an interventional treatment trial for Esophageal Neoplasms focused on measuring Esophageal Squamous Cell Carcinoma, PD-1, Neoadjuvant treatment
Eligibility Criteria
Inclusion Criteria:
- Patients must have histologically confirmed esophageal squamous cell carcinoma without prior treatments including surgery, chemotherapy, radiotherapy, and targeting treatment.
- With resectable disease of primary tumor in middle or lower thoracic esophagus and clinical stage Ⅱa-Ⅲ.
- age:18-75 years, male or female.
- Can provide either a newly obtained or archival tumor tissue sample.
- ECOG 0-1.
- Life expectancy of greater than 12 weeks.
- Without serious system dysfunction and could tolerate radiotherapy.
- Patients must have normal marrow function with a hemoglobin (HGB) of ≥90g/L, an white blood cell (WBC) counts of ≥4.0×109/L,a neutrophil count of ≥2.0×109/L, , a platelet count of ≥100×109/L, a total bilirubin (TBil) of ≤1.5 upper normal limitation (UNL), a creatinine (Cr) of ≤ 1.5 UNL, alanine aminotransferase (ALAT) and aspartate aminotransferase (ASAT) of ≤2.5 UNL.
- Patients must have normal electrocardiogram results and no history of congestive heart failure.
- Women of childbearing age should voluntarily take contraceptive measures.
- Without drug addition
- Patients must be with good compliance and agree to accept follow-up of disease progression and adverse events
- Patients must give written informed consent signed voluntarily by patients themselves or their supervisors witted by doctors.
Exclusion Criteria:
- Patients who have or are currently undergoing additional chemotherapy, radiation therapy, targeted therapy or immunotherapy.
- With unresectable disease including any T4b or M1 disease
- Complete obstruction of the esophagus, or patients who have the potential to develop perforation
- Other malignancy within 5 years prior to entry into the study, expect for curatively treated basal cell and squamous cell carcinoma of the skin and/or curatively resected in-situ cervical and/or breast cancers.
- Known central nervous system (CNS) metastases.
- Subjects with any active autoimmune disease or history of autoimmune disease.
- Uncontrolled clinically significant heart disease, including but not limited to the following: (1) > NYHA II congestive heart failure; (2) unstable angina, (3) myocardial infarction within the past 1 year; (4) clinically significant supraventricular arrhythmia or ventricular arrhythmia requirement for treatment or intervention;
- Active infection or an unexplained fever > 38.5°C during screening or before the first scheduled day of dosing (subjects with tumor fever may be enrolled at the discretion of the investigator);
- History of Interstitial Pneumonia or active non-infectious pneumonitis.
- Known Human Immunodeficiency Virus (HIV) infection、active Hepatitis B or Hepatitis C.
- Prior therapy with a PD-1, anti-PD-Ligand 1 (PD-L1) agent.
- Known history of hypersensitivity to macromolecular protein preparation or any components of the SHR-1210 formulation.
- Concurrent medical condition requiring the use of cortisol (>10mg/day Prednisone or equivalent dose) or other systematic immunosuppressive medications within 14 days before the study treatment. Except: inhalation or topical corticosteroids. Doses > 10 mg/day prednisone orequivalent for replacement therapy.
- Received a live vaccine within 4 weeks of the first dose of study medication.
- Pregnancy or breast feeding.
- Decision of unsuitableness by principal investigator or physician-in-charge.
Sites / Locations
- Hangzhou Cancer HospitalRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Nimotuzumab with radiotherapy
Arm Description
Patients will receive neoadjuvant radiotherapy with concurrent anti-PD-1 antibody SHR-1210. Radiation of primary tumor and local lymph nodes with 95% planning target volume (PTV) of 40Gy/20f. SHR-1210 200mg fixed dose every 2 weeks delivered concurrent with radiation therapy. After 2-4 weeks of neoadjuvant treatment, patients will be evaluated by a multidisciplinary teams (MDTs) and esophagectomy will be given for patients with resectable disease.
Outcomes
Primary Outcome Measures
Pathologic Complete Response Rate
the Percentage of Patients Who Have No Evidence of Cancer in Their Surgical Specimen Following Surgery
Secondary Outcome Measures
Disease-Free Survival
Defined as the interval between the start date of treatment and the date of occurrence of progressive disease or death from any cause.
Numbers of adverse events and the degree of each adverse events according to the NCI CTCAE 4.0 criteria.
From the date of randomization to 6 months after esophagectomy. An expected average of 6 months
Full Information
NCT ID
NCT03200691
First Posted
June 22, 2017
Last Updated
August 3, 2017
Sponsor
Hangzhou Cancer Hospital
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT03200691
Brief Title
Neoadjuvant Anti-PD-1 Antibody SHR-1210 and Radiation in Resectable Esophageal Squamous Cell Carcinoma
Official Title
Phase II Study of Neoadjuvant Anti-PD-1 Antibody SHR-1210 and Radiation in Resectable Esophageal Squamous Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
August 2017
Overall Recruitment Status
Unknown status
Study Start Date
August 10, 2017 (Anticipated)
Primary Completion Date
June 30, 2018 (Anticipated)
Study Completion Date
July 1, 2020 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Hangzhou Cancer Hospital
Collaborators
Jiangsu HengRui Medicine 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 objective of this study is to evaluate the efficacy and safety of radiation therapy combined with anti-PD-1 antibody SHR-1210 followed by surgery in treating patients with resectable esophageal squamous cell carcinoma
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophageal Neoplasms, Esophageal Diseases
Keywords
Esophageal Squamous Cell Carcinoma, PD-1, Neoadjuvant treatment
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
21 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Nimotuzumab with radiotherapy
Arm Type
Experimental
Arm Description
Patients will receive neoadjuvant radiotherapy with concurrent anti-PD-1 antibody SHR-1210. Radiation of primary tumor and local lymph nodes with 95% planning target volume (PTV) of 40Gy/20f.
SHR-1210 200mg fixed dose every 2 weeks delivered concurrent with radiation therapy.
After 2-4 weeks of neoadjuvant treatment, patients will be evaluated by a multidisciplinary teams (MDTs) and esophagectomy will be given for patients with resectable disease.
Intervention Type
Radiation
Intervention Name(s)
3-DCRT or IMRT radiation
Intervention Description
Radiation of primary tumor and local lymph nodes with 95% planning target volume (PTV) of 40 Gy/20f.
Intervention Type
Drug
Intervention Name(s)
anti-PD-1 antibody SHR-1210
Intervention Description
SHR-1210 (200mg fixed dose every 2 weeks for 2 cycles) will be administered as an intravenous infusion over 60 minutes.
Primary Outcome Measure Information:
Title
Pathologic Complete Response Rate
Description
the Percentage of Patients Who Have No Evidence of Cancer in Their Surgical Specimen Following Surgery
Time Frame
2-4 weeks after completion of radiotherapy
Secondary Outcome Measure Information:
Title
Disease-Free Survival
Description
Defined as the interval between the start date of treatment and the date of occurrence of progressive disease or death from any cause.
Time Frame
2 years
Title
Numbers of adverse events and the degree of each adverse events according to the NCI CTCAE 4.0 criteria.
Description
From the date of randomization to 6 months after esophagectomy. An expected average of 6 months
Time Frame
6 months
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:
Patients must have histologically confirmed esophageal squamous cell carcinoma without prior treatments including surgery, chemotherapy, radiotherapy, and targeting treatment.
With resectable disease of primary tumor in middle or lower thoracic esophagus and clinical stage Ⅱa-Ⅲ.
age:18-75 years, male or female.
Can provide either a newly obtained or archival tumor tissue sample.
ECOG 0-1.
Life expectancy of greater than 12 weeks.
Without serious system dysfunction and could tolerate radiotherapy.
Patients must have normal marrow function with a hemoglobin (HGB) of ≥90g/L, an white blood cell (WBC) counts of ≥4.0×109/L,a neutrophil count of ≥2.0×109/L, , a platelet count of ≥100×109/L, a total bilirubin (TBil) of ≤1.5 upper normal limitation (UNL), a creatinine (Cr) of ≤ 1.5 UNL, alanine aminotransferase (ALAT) and aspartate aminotransferase (ASAT) of ≤2.5 UNL.
Patients must have normal electrocardiogram results and no history of congestive heart failure.
Women of childbearing age should voluntarily take contraceptive measures.
Without drug addition
Patients must be with good compliance and agree to accept follow-up of disease progression and adverse events
Patients must give written informed consent signed voluntarily by patients themselves or their supervisors witted by doctors.
Exclusion Criteria:
Patients who have or are currently undergoing additional chemotherapy, radiation therapy, targeted therapy or immunotherapy.
With unresectable disease including any T4b or M1 disease
Complete obstruction of the esophagus, or patients who have the potential to develop perforation
Other malignancy within 5 years prior to entry into the study, expect for curatively treated basal cell and squamous cell carcinoma of the skin and/or curatively resected in-situ cervical and/or breast cancers.
Known central nervous system (CNS) metastases.
Subjects with any active autoimmune disease or history of autoimmune disease.
Uncontrolled clinically significant heart disease, including but not limited to the following: (1) > NYHA II congestive heart failure; (2) unstable angina, (3) myocardial infarction within the past 1 year; (4) clinically significant supraventricular arrhythmia or ventricular arrhythmia requirement for treatment or intervention;
Active infection or an unexplained fever > 38.5°C during screening or before the first scheduled day of dosing (subjects with tumor fever may be enrolled at the discretion of the investigator);
History of Interstitial Pneumonia or active non-infectious pneumonitis.
Known Human Immunodeficiency Virus (HIV) infection、active Hepatitis B or Hepatitis C.
Prior therapy with a PD-1, anti-PD-Ligand 1 (PD-L1) agent.
Known history of hypersensitivity to macromolecular protein preparation or any components of the SHR-1210 formulation.
Concurrent medical condition requiring the use of cortisol (>10mg/day Prednisone or equivalent dose) or other systematic immunosuppressive medications within 14 days before the study treatment. Except: inhalation or topical corticosteroids. Doses > 10 mg/day prednisone orequivalent for replacement therapy.
Received a live vaccine within 4 weeks of the first dose of study medication.
Pregnancy or breast feeding.
Decision of unsuitableness by principal investigator or physician-in-charge.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
shixiu wu, MD
Phone
+8657186826086
Email
wushixiu@medmail.com.cn
Facility Information:
Facility Name
Hangzhou Cancer Hospital
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310002
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shixiu Wu, MD
Phone
+8657186826086
Email
wushixiu@medmail.com.cn
12. IPD Sharing Statement
Plan to Share IPD
No
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Neoadjuvant Anti-PD-1 Antibody SHR-1210 and Radiation in Resectable Esophageal Squamous Cell Carcinoma
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