Study of PD-1 Antibody Combined With Chemoradiotherapy in Oligometastatic Esophageal Cancer
Primary Purpose
Esophagus Cancer, Chemoradiotherapy, Oligometastatic Disease
Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
PD-1 antibody
Chemoradiation
Albumin-Bound Paclitaxel
Cisplatin
Sponsored by
About this trial
This is an interventional treatment trial for Esophagus Cancer
Eligibility Criteria
Inclusion Criteria:
•≥18 years;
- Esophageal squamous cell carcinomas;
- After radical treatment including surgery or definitive chemoradiotherapy
- Definition of oligometastases:≤3 metastases, including tumor beds and recurrent anastomotic sites;regional lymph node is defined as one metastatic site(AJCC8th, supraclavicular, mediastinal, abdominal);metastases lesion in liver, lung, bone and brain is no more than 1.
- Karnofsky performance status(KPS)≥ 70;
- No immunotherapy were performed after recurrence;
- a white-cell count of at least 3500G/L, a hemoglobin concentration of at least 100 g/L, a platelet count of at least 100,000/lL, aspartate aminotransferase and alanine aminotransferase levels of within 1.5 times the upper limit of normal, a serum bilirubin level of 1.5 mg/dL or less, a creatinine level of 1.1 mg/dL or less;
- Hepatitis virus indicators: normal or hepatitis virus DNA titer less than 500 at the same time in an infectious disease hospital, and with the consent of the doctor can be treated;
Exclusion Criteria:
- Pregnancy, possible pregnancy, or breast-feeding;
- Psychological, family, social and other factors lead to uninformed consent;
- An esophageal mediastinal fistula and/or an esophageal tracheal fistula prior to treatment;
- Serious complications such as ischemic heart disease, arrhythmias, or other types of heart disease requiring treatment; liver cirrhosis; interstitial pneumonia or pulmonary fibrosis; active gastrointestinal bleeding; mental disorders being treated with antipsychoticagents or requiring treatment;
- Controlled diabetes mellitus;
- A history of autoimmune disease, autoimmune disease (such as colitis, hepatitis, hyperthyroidism, including but not limited to these disease or syndrome) and a history of immune deficiency, including test positive for HIV, or has other acquired, congenital immunodeficiency disease, or have a history of organ transplantation and the history of allogeneic bone marrow transplantation;
- A history of interstitial lung disease and a history of non-infectious pneumonia;
- Active hepatitis B (HBV DNA ≥ 2000 IU/mL or 104 Copies /mL), hepatitis C ;(positive HCV antibody and HCV-RNA above the detection threshold of the assay)
- Any situation that is unstable or may compromise patient safety and compliance ;
- Active infections, such as active tuberculosis, are present;
Sites / Locations
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)Recruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Chemoradiotherapy Combined With PD-1 Antibody
Arm Description
The arm received chemoradiotherapy, 50-60Gy (BED) was given (1.8-2 Gy or 3-4Gy once daily , 5 days a week) to recurrent sites combined with chemotherapy(Cisplatin 75 mg/m2/day 1, and albumin paclitaxel 150 mg/m2/day 1 , every 3 weeks, 2 cycles ).PD-1 antibody (Tislelizumab) was performed simultaneously with concurrent chemoradiotherapy (Triprizumab 200mg,d1,every 3 weeks,2 cycles). After completion of chemoradiotherapy, PD-1 antibody was given continuously with 2-4 cycles of chemotherapy (the same regimen with concurrent chemotherapy) until 1 year or desease progression.
Outcomes
Primary Outcome Measures
Locoregional control rate
Secondary Outcome Measures
Number of participants with acute toxicities
Acute toxicities are evaluated by NCI-CTC version 5.0
Tumor response rate
Progression free survival
Overall survival
Objective response rate
Objective Response Rate are evaluated by RECIST 1.1
Radiomics analysis
Analysis of correlation between radiomics signature extracted by LASSO and the rate of participants who achieve pathological complete response (pCR) and the overall survival based on MRI and CT simulation.
Full Information
NCT ID
NCT04821765
First Posted
March 15, 2021
Last Updated
March 26, 2021
Sponsor
Chinese Academy of Medical Sciences
1. Study Identification
Unique Protocol Identification Number
NCT04821765
Brief Title
Study of PD-1 Antibody Combined With Chemoradiotherapy in Oligometastatic Esophageal Cancer
Official Title
A Phase II Study of PD-1 Antibody Combined With Chemoradiotherapy in Oligometastatic Esophageal Squamous Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
March 2021
Overall Recruitment Status
Unknown status
Study Start Date
October 1, 2020 (Actual)
Primary Completion Date
September 30, 2023 (Anticipated)
Study Completion Date
September 30, 2023 (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
Chemoradiotherapy(CRT) is the main treatment for esophageal cancer patients with recurrent desease,and checkpoint blockade (PD-1) have been shown to be effective in advanced esophageal cancer. Therefore, PD-1 combined with chemoradiotherapy (CRT)may further improve the efficacy and become a new method for the treatment of esophageal cancer.This study intends to conduct a single-arm, prospective clinical study, aiming to evaluate the safety and efficacy of PD-1 combined with chemoradiotherapy(CRT) in patients with oligometastatic esophageal squamous cell carcinoma.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophagus Cancer, Chemoradiotherapy, Oligometastatic Disease, Immunotherapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
35 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Chemoradiotherapy Combined With PD-1 Antibody
Arm Type
Experimental
Arm Description
The arm received chemoradiotherapy, 50-60Gy (BED) was given (1.8-2 Gy or 3-4Gy once daily , 5 days a week) to recurrent sites combined with chemotherapy(Cisplatin 75 mg/m2/day 1, and albumin paclitaxel 150 mg/m2/day 1 , every 3 weeks, 2 cycles ).PD-1 antibody (Tislelizumab) was performed simultaneously with concurrent chemoradiotherapy (Triprizumab 200mg,d1,every 3 weeks,2 cycles). After completion of chemoradiotherapy, PD-1 antibody was given continuously with 2-4 cycles of chemotherapy (the same regimen with concurrent chemotherapy) until 1 year or desease progression.
Intervention Type
Drug
Intervention Name(s)
PD-1 antibody
Intervention Description
200mg, d1, q3W
Intervention Type
Radiation
Intervention Name(s)
Chemoradiation
Intervention Description
50-60Gy (BED) was given (1.8-2 Gy or 3-4Gy once daily , 5 days a week
Intervention Type
Drug
Intervention Name(s)
Albumin-Bound Paclitaxel
Intervention Description
150mg/m2, d1, q3W
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
75mg/m2, d1, q3W
Primary Outcome Measure Information:
Title
Locoregional control rate
Time Frame
3 year
Secondary Outcome Measure Information:
Title
Number of participants with acute toxicities
Description
Acute toxicities are evaluated by NCI-CTC version 5.0
Time Frame
10 week, from the start of treatment to 1 month after chemoradiotherapy
Title
Tumor response rate
Time Frame
2-3 months
Title
Progression free survival
Time Frame
1 year, 2 year, 3 year
Title
Overall survival
Time Frame
1 year, 2 year, 3 year
Title
Objective response rate
Description
Objective Response Rate are evaluated by RECIST 1.1
Time Frame
5.5 week
Title
Radiomics analysis
Description
Analysis of correlation between radiomics signature extracted by LASSO and the rate of participants who achieve pathological complete response (pCR) and the overall survival based on MRI and CT simulation.
Time Frame
1 year, 2 year, 3 year, 5 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
•≥18 years;
Esophageal squamous cell carcinomas;
After radical treatment including surgery or definitive chemoradiotherapy
Definition of oligometastases:≤3 metastases, including tumor beds and recurrent anastomotic sites;regional lymph node is defined as one metastatic site(AJCC8th, supraclavicular, mediastinal, abdominal);metastases lesion in liver, lung, bone and brain is no more than 1.
Karnofsky performance status(KPS)≥ 70;
No immunotherapy were performed after recurrence;
a white-cell count of at least 3500G/L, a hemoglobin concentration of at least 100 g/L, a platelet count of at least 100,000/lL, aspartate aminotransferase and alanine aminotransferase levels of within 1.5 times the upper limit of normal, a serum bilirubin level of 1.5 mg/dL or less, a creatinine level of 1.1 mg/dL or less;
Hepatitis virus indicators: normal or hepatitis virus DNA titer less than 500 at the same time in an infectious disease hospital, and with the consent of the doctor can be treated;
Exclusion Criteria:
Pregnancy, possible pregnancy, or breast-feeding;
Psychological, family, social and other factors lead to uninformed consent;
An esophageal mediastinal fistula and/or an esophageal tracheal fistula prior to treatment;
Serious complications such as ischemic heart disease, arrhythmias, or other types of heart disease requiring treatment; liver cirrhosis; interstitial pneumonia or pulmonary fibrosis; active gastrointestinal bleeding; mental disorders being treated with antipsychoticagents or requiring treatment;
Controlled diabetes mellitus;
A history of autoimmune disease, autoimmune disease (such as colitis, hepatitis, hyperthyroidism, including but not limited to these disease or syndrome) and a history of immune deficiency, including test positive for HIV, or has other acquired, congenital immunodeficiency disease, or have a history of organ transplantation and the history of allogeneic bone marrow transplantation;
A history of interstitial lung disease and a history of non-infectious pneumonia;
Active hepatitis B (HBV DNA ≥ 2000 IU/mL or 104 Copies /mL), hepatitis C ;(positive HCV antibody and HCV-RNA above the detection threshold of the assay)
Any situation that is unstable or may compromise patient safety and compliance ;
Active infections, such as active tuberculosis, are present;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xin Wang, MD
Phone
+861013311583220
Email
beryl_wx2000@163.com
Facility Information:
Facility Name
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC)
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100021
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xin Wang, MD
Email
beryl_wx2000@163.com
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Study of PD-1 Antibody Combined With Chemoradiotherapy in Oligometastatic Esophageal Cancer
We'll reach out to this number within 24 hrs