SHR-1210 in Combination With Apatinib and Chemotherapy in Patients With Advanced Esophageal Squamous Cell Cancer
Primary Purpose
Esophageal Squamous Cell Carcinoma
Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
SHR-1210
Apatinib
Irinotecan Injection
Paclitaxel liposome
Nedaplatin
Sponsored by
About this trial
This is an interventional treatment trial for Esophageal Squamous Cell Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed squamous cell carcinoma of the esophagus, locally advanced, unresectable, recurrent or metastatic disease.
- Have not received prior systemic therapy.
- Measurable disease based on Response Evaluation Criteria In Solid Tumors (RECIST) 1.1.
- Eastern Collaborative Oncology Group (ECOG) Performance Status ≤ 1.
- Life expectancy >12 weeks.
- Adequate organ function.
- For females of child bearing potential, a negative urine or serum pregnancy test result within 72h before study treatment. Participants of reproductive potential must be willing to use adequate contraception for the course of the study until 2 months after the last dose of any of the drugs in the study.
- Willing and able to provide written informed consent and comply with the requirements of the study.
Exclusion Criteria:
- Any previous malignancy, except for non squamous-cell carcinoma of skin or carcinoma-in-situ of the uterine cervix within 5 years prior to study entry.
- Known central nervous system (CNS) metastases.
- Prior therapy with any of the immune check-point inhibitors.
- Known immediate or delayed hypersensitivity reaction to SHR-1210, apatinib, irinotecan, paclitaxel liposome, nedaplatin or their excipients.
- Subjects with any active autoimmune disease or history of autoimmune disease.
- Known Human Immunodeficiency Virus (HIV) infection, active Hepatitis B or Hepatitis C infection.
- 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 no more than 10 mg/day prednisone or equivalent.
- Received a live vaccine within 4 weeks of the first dose of study medication.
- Hypertension with a blood pressure of systolic> 140 millimeter of mercury (mm Hg) and/or diastolic > 90 mm Hg that is not effectively controlled by anti-hypertensive therapy.
- 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 requiring treatment or intervention.
- Unable to swallow oral medications or with gastrointestinal disorders that might interfere with proper absorption of oral drugs.
- Active digestive ulcer disease, inflammatory bowel disease, intestinal obstruction or any other condition that, in the clinical judgment of the Principal Investigator, may cause severe gastrointestinal bleeding or perforation.
- Active infection or an unexplained fever > 38.5°C before 4 weeks of enrollment.
- Unstable pulmonary embolism, deep vein thrombosis, or other significant arterial/venous thromboembolic conditions.
- Pregnant or lactating female.
- Familial, sociological or geographical conditions that, in the clinical judgment of the Principal Investigator, do not permit compliance with the protocol.
Sites / Locations
- Jing HuangRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Cohort 1
Cohort 2
Arm Description
Patients with advanced or metastatic esophageal squamous cell carcinoma are to receive SHR-1210 with apatinib and irinotecan injection in cohort 1.
Patients with advanced or metastatic esophageal squamous cell carcinoma are to receive SHR-1210 with apatinib and paclitaxel liposome plus nedaplatin in cohort 2.
Outcomes
Primary Outcome Measures
objective response rate
objective response rate of the patients in cohort 1 and cohort 2
Secondary Outcome Measures
progression-free survival (PFS)
progression-free survival (PFS) of the patients in cohort 1 and cohort 2
overall survival
overall survival of the patients in cohort 1 and cohort 2
treatment-related adverse events
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Full Information
NCT ID
NCT03603756
First Posted
July 20, 2018
Last Updated
February 9, 2020
Sponsor
Chinese Academy of Medical Sciences
1. Study Identification
Unique Protocol Identification Number
NCT03603756
Brief Title
SHR-1210 in Combination With Apatinib and Chemotherapy in Patients With Advanced Esophageal Squamous Cell Cancer
Official Title
SHR-1210, a Novel Anti-PD-1 Antibody, in Combination With Apatinib and Irinotecan/Paclitaxel Liposome Plus Nedaplatin in Patients With Previously Untreated Advanced or Metastatic Esophageal Squamous Cell Cancer: a Phase II Study
Study Type
Interventional
2. Study Status
Record Verification Date
February 2020
Overall Recruitment Status
Unknown status
Study Start Date
July 31, 2018 (Actual)
Primary Completion Date
March 28, 2020 (Anticipated)
Study Completion Date
March 28, 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Chinese Academy of Medical Sciences
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Patients with previously untreated advanced or metastatic esophageal squamous cell carcinoma are recruited to this prospective non-randomized study comprising two separate cohorts. Patients will receive SHR-1210, a novel anti-PD-1 antibody, with apatinib and either irinotecan or paclitaxel liposome plus nedaplatin. The primary endpoint is to determine the objective response rate (ORR) of patients in both cohorts. The regimen(s) of promising efficacy will be further verified in subsequent randomized studies to define the optimal combination of immunotherapy, anti-angiogenesis and chemotherapy in advanced esophageal cancer patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophageal Squamous Cell Carcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
45 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Cohort 1
Arm Type
Experimental
Arm Description
Patients with advanced or metastatic esophageal squamous cell carcinoma are to receive SHR-1210 with apatinib and irinotecan injection in cohort 1.
Arm Title
Cohort 2
Arm Type
Experimental
Arm Description
Patients with advanced or metastatic esophageal squamous cell carcinoma are to receive SHR-1210 with apatinib and paclitaxel liposome plus nedaplatin in cohort 2.
Intervention Type
Drug
Intervention Name(s)
SHR-1210
Intervention Description
a novel anti-PD-1 antibody
Intervention Type
Drug
Intervention Name(s)
Apatinib
Intervention Description
a VEGFR-2 tyrosine kinase inhibitor
Intervention Type
Drug
Intervention Name(s)
Irinotecan Injection
Intervention Description
cytotoxic agent that binds to topoisomerase I
Intervention Type
Drug
Intervention Name(s)
Paclitaxel liposome
Intervention Description
cytotoxic agent that prevent depolymerization of cellular microtubules
Intervention Type
Drug
Intervention Name(s)
Nedaplatin
Intervention Description
cytotoxic agent that cross-links and denatures strands of DNA
Primary Outcome Measure Information:
Title
objective response rate
Description
objective response rate of the patients in cohort 1 and cohort 2
Time Frame
24 months
Secondary Outcome Measure Information:
Title
progression-free survival (PFS)
Description
progression-free survival (PFS) of the patients in cohort 1 and cohort 2
Time Frame
24 months
Title
overall survival
Description
overall survival of the patients in cohort 1 and cohort 2
Time Frame
24 months
Title
treatment-related adverse events
Description
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame
24 months
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:
Histologically or cytologically confirmed squamous cell carcinoma of the esophagus, locally advanced, unresectable, recurrent or metastatic disease.
Have not received prior systemic therapy.
Measurable disease based on Response Evaluation Criteria In Solid Tumors (RECIST) 1.1.
Eastern Collaborative Oncology Group (ECOG) Performance Status ≤ 1.
Life expectancy >12 weeks.
Adequate organ function.
For females of child bearing potential, a negative urine or serum pregnancy test result within 72h before study treatment. Participants of reproductive potential must be willing to use adequate contraception for the course of the study until 2 months after the last dose of any of the drugs in the study.
Willing and able to provide written informed consent and comply with the requirements of the study.
Exclusion Criteria:
Any previous malignancy, except for non squamous-cell carcinoma of skin or carcinoma-in-situ of the uterine cervix within 5 years prior to study entry.
Known central nervous system (CNS) metastases.
Prior therapy with any of the immune check-point inhibitors.
Known immediate or delayed hypersensitivity reaction to SHR-1210, apatinib, irinotecan, paclitaxel liposome, nedaplatin or their excipients.
Subjects with any active autoimmune disease or history of autoimmune disease.
Known Human Immunodeficiency Virus (HIV) infection, active Hepatitis B or Hepatitis C infection.
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 no more than 10 mg/day prednisone or equivalent.
Received a live vaccine within 4 weeks of the first dose of study medication.
Hypertension with a blood pressure of systolic> 140 millimeter of mercury (mm Hg) and/or diastolic > 90 mm Hg that is not effectively controlled by anti-hypertensive therapy.
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 requiring treatment or intervention.
Unable to swallow oral medications or with gastrointestinal disorders that might interfere with proper absorption of oral drugs.
Active digestive ulcer disease, inflammatory bowel disease, intestinal obstruction or any other condition that, in the clinical judgment of the Principal Investigator, may cause severe gastrointestinal bleeding or perforation.
Active infection or an unexplained fever > 38.5°C before 4 weeks of enrollment.
Unstable pulmonary embolism, deep vein thrombosis, or other significant arterial/venous thromboembolic conditions.
Pregnant or lactating female.
Familial, sociological or geographical conditions that, in the clinical judgment of the Principal Investigator, do not permit compliance with the protocol.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jing Huang, MD
Phone
86-10-87788102
Email
huangjingwg@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jianping Xu, MD
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jing Huang, MD
Organizational Affiliation
Cancer Hospital,CAMS
Official's Role
Principal Investigator
Facility Information:
Facility Name
Jing Huang
City
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jing Huang, MD
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
33314747
Citation
Zhang B, Qi L, Wang X, Xu J, Liu Y, Mu L, Wang X, Bai L, Huang J. Phase II clinical trial using camrelizumab combined with apatinib and chemotherapy as the first-line treatment of advanced esophageal squamous cell carcinoma. Cancer Commun (Lond). 2020 Dec;40(12):711-720. doi: 10.1002/cac2.12119. Epub 2020 Dec 12.
Results Reference
derived
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SHR-1210 in Combination With Apatinib and Chemotherapy in Patients With Advanced Esophageal Squamous Cell Cancer
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