NCT04656041招募中2 期
A Phase II Study of Neoadjuvant NAPOX Followed by Chemoradiation With Paclitaxel and Carboplatin in Locally Advanced Esophagogastric Cancer
适应症
干预措施
相关药物
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 入组人数
- 40
- 试验地点
- 3
- 主要终点
- Pathologic Complete Response Rate
研究概览
简要总结
In this research study, is studying how Liposomal Irinotecan in combination with the standard of care interventions FOLFOX, carboplatin paclitaxel, and radiation therapy affect gastroesophageal junction or esophagogastric cancer
This research study involves the following study intervention:
- Liposomal irinotecan
详细描述
The research study procedures include screening for eligibility and study treatment including evaluations and follow up visits.
This research study involves the following standard of care interventions:
- FOLFOX (leucovorin calcium, 5-Fluorouracil, and oxaliplatin)
- Carboplatin
- Paclitaxel
- Radiation therapy
This research study involves the following study intervention:
- Liposomal irinotecan
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Participants must meet all the following criteria in order to be eligible to participate in the study:
- •Histologically or cytologically confirmed T 3/4 or N+ (> 1 cm in size or FDG avid) Siewart 1-3 gastroesophageal (GE) junction or esophagogastric cancer. Diagnosis must be confirmed by a DF/HCC institution pathology department prior to registration.
- •Age 18 years or older. There will be no upper age restriction.
- •ECOG performance status ≤ 1
- •Life expectancy of greater than 3 months
- •Participants must have adequate organ and marrow function as defined below:
- •absolute neutrophil count ≥ 1,500 cells/mm3
- •platelets ≥ 75,000 cells/mm3
- •total bilirubin ≤ 1.5 x upper limit of normal OR for patients who have undergone biliary stenting, total bilirubin of ≤ 2.0 x upper limit of normal OR two down trending values.
- •AST(SGOT) ≤ 2.5 x upper limit of normal
- •ALT (SGPT) ≤ 2.5 x upper limit of normal
- •creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 30 mL/min/1.73 m2 for participants with creatinine levels above institutional normal.
- •The effects of both radiation therapy and the chemotherapy agents used in this trial are known to be teratogenic. Therefore, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation plus 30 days from the last date of study drug administration. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
- •Female subject of childbearing potential should have a negative urine or serum pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG). If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
- •Ability to understand and the willingness to sign a written informed consent document.
排除标准
- •Participants who fulfill any of the following criteria will be excluded from the study:
- •Evidence of metastatic disease as determined by chest CT scan, abdomen/pelvis CT scan (or MRI with gadolinium and/or manganese) within six weeks of study entry. Distant nodal disease is allowed if it is in the radiation port.
- •Any prior chemotherapy, targeted/biologic therapy, or radiation for treatment of the participant's esophagogastric cancer.
- •Treatment of other invasive carcinomas within the last five years with greater than 5% risk of recurrence at time of eligibility screening. Carcinoma in-situ and basal cell carcinoma/ squamous cell carcinoma of the skin are allowed.
- •Receipt of any other investigational agents within 4 weeks preceding the start of study treatment.
- •Serious concomitant systemic disorders incompatible with the study (at the discretion of the investigator), such as significant cardiac or pulmonary morbidity (e.g.congestive heart failure, symptomatic coronary artery disease and/or cardiac arrhythmias not well controlled with medication) or myocardial infarction within the last 12 months, or ongoing infection as manifested by fever.
- •History of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant, precluding informed consent, or interfering with compliance or drug intake.
- •Pregnant women are excluded from this study because radiation therapy and the chemotherapy agents to be used have the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with these agents, breastfeeding should be discontinued while the mother is receiving protocol therapy.
- •Major surgery, excluding laparoscopy, within 4 weeks of the start of study treatment, without complete recovery.
- •No concurrent administration of cimetidine (as it can decrease the clearance of 5-FU). Another H2-blocker or proton pump inhibitor may be substituted before study entry.
- •Known, existing uncontrolled coagulopathy.
- •Prior systemic fluoropyrimidine therapy (unless given in an adjuvant setting and at least six months earlier). Prior topical fluoropyrimidine use is allowed.
- •Known hypersensitivity to 5-fluorouracil or known DPD deficiency.
- •History of allergic reaction(s) attributed to compounds of similar chemical or biologic composition to 5-fluorouracil, irinotecan, or oxaliplatin.
研究组 & 干预措施
FOLFOX/ nal-IRI
Experimental
Treatment will be administered on an outpatient basis.
- FOLFOX with nal-IRI for eight two-week cycles (16 weeks total)
- Chemoradiation with proton or photon radiation therapy concurrent with weekly Paclitaxel and Carboplatin for 5 weeks
- Surgery
干预措施: FOLFOX/ nal-IRI (Drug)
FOLFOX/ nal-IRI
Experimental
Treatment will be administered on an outpatient basis.
- FOLFOX with nal-IRI for eight two-week cycles (16 weeks total)
- Chemoradiation with proton or photon radiation therapy concurrent with weekly Paclitaxel and Carboplatin for 5 weeks
- Surgery
干预措施: Paclitaxel (Drug)
FOLFOX/ nal-IRI
Experimental
Treatment will be administered on an outpatient basis.
- FOLFOX with nal-IRI for eight two-week cycles (16 weeks total)
- Chemoradiation with proton or photon radiation therapy concurrent with weekly Paclitaxel and Carboplatin for 5 weeks
- Surgery
干预措施: Carboplatin (Drug)
FOLFOX/ nal-IRI
Experimental
Treatment will be administered on an outpatient basis.
- FOLFOX with nal-IRI for eight two-week cycles (16 weeks total)
- Chemoradiation with proton or photon radiation therapy concurrent with weekly Paclitaxel and Carboplatin for 5 weeks
- Surgery
干预措施: Proton Radiation Therapy (Radiation)
结局指标
主要结局
Pathologic Complete Response Rate
时间窗: 38 Weeks
All patients will undergo a full pathological review of their surgical specimen according to the AJCC Staging Classification, 6th. Initial gross evaluation and identification of resection margins will be performed jointly by the surgeon and the pathologist. Pathological complete response will be defined as the absence of any viable tumor cells within the pathologic specimen.
次要结局
- Overall Survival(first date of protocol therapy to the date of death due to any cause and will be censored at the date of last follow-up for patients still alive up to 5 years)
- Number of Participants with Treatment Related Adverse Events as Assessed by CTCAE v5.0(first dose of protocol therapy until 5 years after the end of protocol therapy)
- Progression-Free Survival (PFS)(duration from the first date of protocol therapy to the earliest date of disease progression up 5 years)
- Clinical Response(25 Weeks)
研究者
Jennifer Wo
Principal Investigator
Massachusetts General Hospital
研究点 (3)
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