Study of Anti-PD-L1 in Combination With Chemo(Radio)Therapy for Resectable Esophageal Squamous Cell Carcinoma
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| ClinicalTrials.gov Identifier: NCT04568200 |
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Recruitment Status :
Recruiting
First Posted : September 29, 2020
Last Update Posted : September 29, 2020
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| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Esophageal Squamous Cell Carcinoma | Drug: Durvalumab Drug: Carboplatin Drug: Paclitaxel Radiation: Radiotherapy 23 x 1.8 Gy | Phase 2 |
The primary objective of the study is to assess the tumor response (by irRECIST) and pathological response of preoperative treatment with durvalumab combined with neoadjuvant therapy (carboplatin, paclitaxel with/without radiation).
Secondary objectives are:
To assess completion of treatment with durvalumab combined with chemotherapy with/without radiation treatment.
To assess toxicities of durvalumab in combination with chemoradiation. [Time Frame: up to 1 year] To assess completion of chemotherapy with/without radiation treatment. To assess withdrawal rate from surgery. To assess delay rate from surgery. To assess R0 resection rate. To assess post-operative complications. Progression Free Survival. [ Time Frame: up to 24 months ] Overall Survival. [ Time Frame: up to 24 months ]
| Study Type : | Interventional (Clinical Trial) |
| Estimated Enrollment : | 60 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | Single (Investigator) |
| Primary Purpose: | Treatment |
| Official Title: | A Prospective, Randomized Controlled Study to Evaluate the Efficacy and Safety of Durvalumab Combined With Neoadjuvant Therapy in Patients With Local Advanced Esophageal Squamous Cell Carcinoma |
| Actual Study Start Date : | June 19, 2020 |
| Estimated Primary Completion Date : | December 2021 |
| Estimated Study Completion Date : | December 2023 |
| Arm | Intervention/treatment |
|---|---|
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Experimental: durvalumab and neoadjuvant therapy
durvalumab 1500mg i.v. day 1-22-43-64 Carboplatin AUC = 4-5 i.v day 1-22-43-64 Paclitaxel 75 mg/m2 i.v day 1-22-43-64 with/without Radiotherapy 23 x 1.8 Gy
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Drug: Durvalumab
Durvalumab 1500mg i.v. day 1-22-43-64 Drug: Carboplatin Chemotherapy
Other Name: Chemotherapy Drug: Paclitaxel Chemotherapy
Other Name: Chemotherapy Radiation: Radiotherapy 23 x 1.8 Gy Radiotherapy 23 x 1.8 Gy
Other Name: Radiotherapy |
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Placebo Comparator: normal saline and neoadjuvant therapy
normal saline 500ml i.v. day 1-22-43-64 Carboplatin AUC = 4-5 i.v day 1-22-43-64 Paclitaxel 75 mg/m2 i.v day 1-22-43-64 with/without Radiotherapy 23 x 1.8 Gy
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Drug: Carboplatin
Chemotherapy
Other Name: Chemotherapy Drug: Paclitaxel Chemotherapy
Other Name: Chemotherapy Radiation: Radiotherapy 23 x 1.8 Gy Radiotherapy 23 x 1.8 Gy
Other Name: Radiotherapy |
- tumor response [ Time Frame: up to 12 months ]assess the tumor response (by irRECIST) of preoperative treatment with durvalumab combined with neoadjuvant therapy
- pathological response [ Time Frame: up to 12 months ]assess the pathological response (by CAP classification) of preoperative treatment with durvalumab combined with neoadjuvant therapy
- Percentage completion of treatment with durvalumab combined with chemotherapy with/without radiation treatment [ Time Frame: up to 3 months ]Percentage completion of treatment with durvalumab combined with chemotherapy with/without radiation treatment
- Incidence and severity of toxicity [ Time Frame: up to 12 months ]Incidence and severity of toxicity defined to CTCAE v4.03 and Radiation Oncology Group (RTOG) criteria
- Percentage completion of chemotherapy with/without radiation treatment [ Time Frame: up to 3 months ]Percentage completion of chemotherapy with/without radiation treatment
- Percentage withdrawal rate from surgery due to durvalumab related complications [ Time Frame: up to 3 months ]Percentage withdrawal rate from surgery due to durvalumab related complications
- Percentage delay of surgery due to durvalumab related complications [ Time Frame: up to 3 months ]Percentage delay of surgery due to durvalumab related complications
- R0 resection rate [ Time Frame: up to 3 months ]R0 resection rate
- Incidence and severity of post-operative complications to the Dindo classification [ Time Frame: up to 3 months ]Incidence and severity of post-operative complications to the Dindo classification
- Progression free survival [ Time Frame: up to 24 months ]Progression free survival
- Overall survival [ Time Frame: up to 24 months ]Overall survival
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
| Ages Eligible for Study: | 18 Years to 75 Years (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically proven squamous cell carcinoma of the esophagus.
- Surgical resectable (T3 or T4b, N0 or N+, M0), as determined by Endoscopic Ultra Sound (EUS),PET/CT, Esophageal MRI and enhanced CT scan of neck, thorax and abdomen.
- Tumor length longitudinal ≤ 10 cm; if larger than 10 cm, inclusion should be discussed with the principal investigator.
- 18≤Age≤75.
- Tumor does not involve gastro-esophageal junction.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
- Adequate hematological, renal and hepatic functions defined as:
neutrophiles ≥ 1.5 x 109/L platelets ≥ 100 x 109/L alanine transaminase≤2 x upper normal limit hemoglobin ≥ 5.6 mmol total bilirubin ≤ 1.5 x upper normal limit creatinine clearance (Cockroft) ≥60 ml/min
- Written, voluntary informed consent.
Exclusion Criteria:
- Past or current history of malignancy other than entry diagnosis interfering with prognosis of esophageal cancer.
- T1, T2 tumors or in situ carcinoma.
- metastatic oesophageal cancer.
- Pregnancy (positive serum pregnancy test), planning to become pregnant, and lactation.
- Previous chemotherapy, radiotherapy, and/or treatment with checkpoint inhibitors.
- Clinically significant cardiovascular disease (including myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) precluding major surgery.
- Pulmonary fibrosis and/or severely impaired lung function precluding major surgery.
- Pre-existing motor or sensory neurotoxicity greater than WHO grade 1.
- Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy (>10 mg/day prednisone or equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment.
- Dementia or altered mental status that would prohibit the understanding and giving of informed consent
- Serious underlying medical condition which would impair the ability of the patient to receive the planned treatment, including prior allergic reactions to drugs containing Cremophor, such as teniposide or cyclosporine.
- Has an active infection requiring systemic therapy which has not resolved 3 days (simple infection such as cystitis) to 7 days (severe infection such as pyelonephritis) prior to the first dose of trial treatment.
- Has a diagnosis of acute or chronic hepatitis B, hepatitis C, known immunodeficiency or human immunodeficiency virus (HIV)
- Patients with prior allogeneic stem cell or solid organ transplantation.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04568200
| Contact: Jia He, MD | +86-13810096213 | hejia@126.com | |
| Contact: Luo Zhao, MD | +86-18519667758 | zhaoluo@pumch.cn |
| China, Beijing | |
| Peking Union Medical College Hospital | Recruiting |
| Beijing, Beijing, China, 100730 | |
| Contact: Jia He, MD +86-13810096213 hejia@126.com | |
| Contact: Luo Zhao, MD +86-18519667758 Zhaoluo@pumch.cn | |
| Study Chair: | Jia He, MD | Peking Union Medical College Hospital |
| Responsible Party: | Peking Union Medical College Hospital |
| ClinicalTrials.gov Identifier: | NCT04568200 |
| Other Study ID Numbers: |
69152630 |
| First Posted: | September 29, 2020 Key Record Dates |
| Last Update Posted: | September 29, 2020 |
| Last Verified: | September 2020 |
| Studies a U.S. FDA-regulated Drug Product: | No |
| Studies a U.S. FDA-regulated Device Product: | No |
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Carcinoma Carcinoma, Squamous Cell Esophageal Squamous Cell Carcinoma Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neoplasms, Squamous Cell Esophageal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Head and Neck Neoplasms Digestive System Diseases |
Esophageal Diseases Gastrointestinal Diseases Paclitaxel Carboplatin Durvalumab Antineoplastic Agents, Phytogenic Antineoplastic Agents Tubulin Modulators Antimitotic Agents Mitosis Modulators Molecular Mechanisms of Pharmacological Action Antineoplastic Agents, Immunological |

