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SBRT Combined With Thymalfasin for Metastatic Esophageal Cancer

Primary Purpose

Esophageal Cancer, Metastatic Esophageal Cancer, Stereotactic Body Radiation Therapy

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Stereotactic Body Radiation Therapy
Thymalfasin
Sponsored by
Hangzhou Cancer Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Esophageal Cancer focused on measuring Esophageal cancer, Metastatic esophageal cancer, Radiotherapy, Thymalfasin, ZADAXIN's®, Stereotactic Body Radiation Therapy

Eligibility Criteria

19 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients with histologically confirmed esophageal cancer which is persistent and metastatic or recurrent and metastatic;
  2. Patients must have at least 2 distinct measurable metastatic sites at least 1 cm of larger in their largest diameter;
  3. Age ≥18 years;
  4. Metastatic disease measurable on a CT/MRI scan. The primary tumor is not considered measurable disease. Metastatic lesions within a prior radiation field are acceptable as long as disease has progressed in the radiation field by RECIST criteria. The same imaging modality performed at baseline (CT or MRI) will be repeated at subsequent imaging.
  5. ECOG performance status: 0-1;
  6. Life expectancy ≥ 3 months.
  7. Patients have adequate baseline organ and marrow function as defined by an absolute neutrophil count greater than 1500 cells per μL, platelet concentration of greater than 50 000 per μL, total bilirubin less than 1•5 times the upper limit of normal (ULN), aspartate aminotransferase and alanine aminotransferase less than 2•5 times the ULN, and serum creatinine less than 1•5 times the ULN;
  8. Signed consent forms voluntarily;

Exclusion Criteria:

  1. Patients undergoing therapy with other investigational agents.
  2. Women who are pregnant or breastfeeding;
  3. Patients with known brain metastases can be included in this clinical trial but brain lesions are not eligible as target or non target lesion;
  4. Anticipated patient survival under 3 months;
  5. Active severe infection or known chronic infection with HIV, hepatitis B virus, or hepatitis C virus;
  6. Cardiovascular disease problems including unstable angina, therapy for life-threatening ventricular arrhythmia, myocardial infarction, stroke or congestive heart failure within the last 6 months;
  7. The subject has had another active malignancy within the past five years except for cervical cancer in site, in situ carcinoma of the bladder or non-melanoma carcinoma of the skin;
  8. Clinically significant and uncontrolled major medical conditions including but not limited to: active uncontrolled infection, symptomatic congestive heart failure, Unstable angina pectoris or cardiac arrhythmia, psychiatric illness/ social situation that would limit compliance with study requirements; any medical condition, which in the opinion of the study investigator places the subject at an unacceptably high risk for toxicities;
  9. Patients with any other concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for participation in the study.

Sites / Locations

  • Hangzhou Cancer HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SBRT and Thymalfasin arm

Arm Description

SBRT is given during combined therapy to one of the lesions, 25Gy in 5 fractions over one week, conformally to maximally spare normal tissue or organ. Thymalfasin treatment is given twice a week with an interval of 3-4 days until tumor progression of other metastatic lesions. Tumor response is evaluated by assessing clinical and CT/MRI response for all the other measurable metastatic sites.

Outcomes

Primary Outcome Measures

The proportion of patients with tumor responses after the initiation of treatment.

Secondary Outcome Measures

The number of participants with adverse events from the date of enrollment until 2 years from the opening of the study.
The proportion of patients alive with tumor responses from the date of enrollment until date of death from any cause, assessed up to 2 years from the opening of the study.

Full Information

First Posted
September 8, 2015
Last Updated
November 26, 2017
Sponsor
Hangzhou Cancer Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT02545751
Brief Title
SBRT Combined With Thymalfasin for Metastatic Esophageal Cancer
Official Title
A Phase II Study of Stereotactic Body Radiation Therapy and ZADAXIN's® (Thymalfasin) Induced Tumor Effects in Patients With Heavily Pretreated, Metastatic Esophageal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2017
Overall Recruitment Status
Unknown status
Study Start Date
January 2016 (undefined)
Primary Completion Date
December 2017 (Anticipated)
Study Completion Date
December 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Hangzhou Cancer Hospital

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Patients with esophageal cancer that had metastatic lesions after been treated with definitive surgery or chemoradiotherapy are being asked to participate in this study. To observe immunity-mediated tumor response after Stereotactic Body Radiation Therapy(SBRT) of a metastatic site in metastatic esophageal cancer patients. To induce the efficacy (effectiveness) of a new combination of therapy, SBRT and thymalfasin for heavily pretreated, metastatic esophageal cancer patients; This study will help find out what effects (good or bad) the combination of radiotherapy and thymalfasin has on metastatic esophageal cancer.
Detailed Description
To observe immunity-mediated tumor response after Stereotactic Body Radiation Therapy(SBRT) of a metastatic site in metastatic esophageal cancer patients. To induce the efficacy (effectiveness) of a new combination of therapy, SBRT and thymalfasin for heavily pretreated, metastatic esophageal cancer patients; Eligible are patients with metastatic esphageal cancer who have achieved stable disease or have disease progression after systemic therapy (surgery or definitive chemoradiotherapy) and have at least two measurable sites of metastatic lesions. Extent of metastatic disease is recorded both at CT and PET/CT scanning. Radiation is given during combined therapy to one of the lesions, 25Gy in 5 fractions over one week interval with SBRT, conformally to maximally spare normal tissue or organ. Thymalfasin treatment is given twice a week with an interval of 3-4 days each week for a total of 8 weeks. Tumor response is evaluated by assessing clinical and CT/MRI response for all of the measurable metastatic sites. A Phase II clinical trial based on an optimum two-stage Phase II Simon design is used to conduct this pilot study. Ten patients will be treated in Stage one; if there are no tumor responses, the trial will be terminated. If there are one or more tumor responses in Stage One, the trial will proceed to enroll an additional 19 patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophageal Cancer, Metastatic Esophageal Cancer, Stereotactic Body Radiation Therapy, Thymalfasin
Keywords
Esophageal cancer, Metastatic esophageal cancer, Radiotherapy, Thymalfasin, ZADAXIN's®, Stereotactic Body Radiation Therapy

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
SBRT and Thymalfasin arm
Arm Type
Experimental
Arm Description
SBRT is given during combined therapy to one of the lesions, 25Gy in 5 fractions over one week, conformally to maximally spare normal tissue or organ. Thymalfasin treatment is given twice a week with an interval of 3-4 days until tumor progression of other metastatic lesions. Tumor response is evaluated by assessing clinical and CT/MRI response for all the other measurable metastatic sites.
Intervention Type
Radiation
Intervention Name(s)
Stereotactic Body Radiation Therapy
Other Intervention Name(s)
SBRT
Intervention Description
SBRT is given during combined therapy to one of the metastatic lesions, 25Gy in 5 fractions (5Gy per fraction) over one week, conformally to maximally spare normal tissue or organ.
Intervention Type
Drug
Intervention Name(s)
Thymalfasin
Other Intervention Name(s)
ZADAXIN's®
Intervention Description
Thymalfasin treatment is given twice a week with an interval of 3-4 days until progression of other metastatic lesions. Tumor response is evaluated by assessing clinical and CT/MRI response for all the other measurable metastatic sites.
Primary Outcome Measure Information:
Title
The proportion of patients with tumor responses after the initiation of treatment.
Time Frame
month 1- month 6
Secondary Outcome Measure Information:
Title
The number of participants with adverse events from the date of enrollment until 2 years from the opening of the study.
Time Frame
year 0- year 2
Title
The proportion of patients alive with tumor responses from the date of enrollment until date of death from any cause, assessed up to 2 years from the opening of the study.
Time Frame
year 0- year 2

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with histologically confirmed esophageal cancer which is persistent and metastatic or recurrent and metastatic; Patients must have at least 2 distinct measurable metastatic sites at least 1 cm of larger in their largest diameter; Age ≥18 years; Metastatic disease measurable on a CT/MRI scan. The primary tumor is not considered measurable disease. Metastatic lesions within a prior radiation field are acceptable as long as disease has progressed in the radiation field by RECIST criteria. The same imaging modality performed at baseline (CT or MRI) will be repeated at subsequent imaging. ECOG performance status: 0-1; Life expectancy ≥ 3 months. Patients have adequate baseline organ and marrow function as defined by an absolute neutrophil count greater than 1500 cells per μL, platelet concentration of greater than 50 000 per μL, total bilirubin less than 1•5 times the upper limit of normal (ULN), aspartate aminotransferase and alanine aminotransferase less than 2•5 times the ULN, and serum creatinine less than 1•5 times the ULN; Signed consent forms voluntarily; Exclusion Criteria: Patients undergoing therapy with other investigational agents. Women who are pregnant or breastfeeding; Patients with known brain metastases can be included in this clinical trial but brain lesions are not eligible as target or non target lesion; Anticipated patient survival under 3 months; Active severe infection or known chronic infection with HIV, hepatitis B virus, or hepatitis C virus; Cardiovascular disease problems including unstable angina, therapy for life-threatening ventricular arrhythmia, myocardial infarction, stroke or congestive heart failure within the last 6 months; The subject has had another active malignancy within the past five years except for cervical cancer in site, in situ carcinoma of the bladder or non-melanoma carcinoma of the skin; Clinically significant and uncontrolled major medical conditions including but not limited to: active uncontrolled infection, symptomatic congestive heart failure, Unstable angina pectoris or cardiac arrhythmia, psychiatric illness/ social situation that would limit compliance with study requirements; any medical condition, which in the opinion of the study investigator places the subject at an unacceptably high risk for toxicities; Patients with any other concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for participation in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shixiu Wu, MD
Email
wushixiu@medmail.com.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Tao Song, MD
Email
taosong01@hotmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shixiu Wu, MD
Organizational Affiliation
Hangzhou Cancer Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Hangzhou Cancer Hospital
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shixiu Wu, MD
Phone
+8657786826086
Email
wushixiu@medmail.com.cn

12. IPD Sharing Statement

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SBRT Combined With Thymalfasin for Metastatic Esophageal Cancer

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