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Adjuvant Therapy in POLE-Mutated and p53-Wildtype/NSMP Early Stage Endometrial Cancer RAINBO BLUE & TAPER

Phase 2
Recruiting
Conditions
Endometrial Cancer
Interventions
Radiation: Adjuvant radiotherapy (EBRT +/- brachytherapy)
Radiation: Vaginal brachytherapy
Other: Observation
Registration Number
NCT05640999
Lead Sponsor
Canadian Cancer Trials Group
Brief Summary

This protocol tests de-escalated adjuvant treatment in patients with POLE-mutated or p53wt/NSMP (p53 wildtype/no specific molecular profile) early-stage endometrial cancer (EC). Patients may be enrolled in one of two sub-studies

* EN10.A/RAINBO BLUE: POLE-mutated EC

* EN10.B/TAPER: p53 wildtype / NSMP EC

Detailed Description

This study is being done in order to find out if this new approach is better or worse than the usual approach for early-stage endometrial cancer. The usual approach is defined as the care most people get for early-stage endometrial cancer.

The usual approach for patients who are not in a study is treatment with surgery. Tissue that is removed as part of this procedure is analyzed in the pathology laboratory to guide the doctor to decide whether or not additional treatment such as radiation and or chemotherapy should be recommended.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
393
Inclusion Criteria
  • Patients must have had surgery consisting of hysterectomy and bilateral salpingo-oophorectomy. Lymph node dissection can be performed as per institutional standards. There must be no macroscopic residual disease after surgery.
  • Patients must have histologically confirmed Stage I to III endometrial carcinoma which can be endometrioid, serous, clear cell, un/dedifferentiated, carcinosarcoma or mixed.
  • Patients' Eastern Cooperative Group (ECOG) performance status must be 0, 1, or 2.
  • HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial.
  • Patients' age must be ≥ 18 years.
  • Patient consent must be appropriately obtained in accordance with applicable local and regulatory requirements.
  • Patient is able (i.e. sufficiently fluent) and willing to complete the patient-reported outcomes (PRO) questionnaires in either English, French or a validated language
  • Patients must be accessible for treatment and follow-up. Patients enrolled on this trial must be treated and followed at the participating centre
  • Protocol treatment is to begin within 10 weeks of hysterectomy/bilateral salpingo-oophorectomy
Exclusion Criteria
  • Prior Neoadjuvant chemotherapy for current endometrial cancer diagnosis.
  • Prior pelvic radiation.
  • Patients with a history of other malignancies, except: carcinoma in-situ without evidence of invasive disease when resected, adequately treated non-melanoma skin cancer, or other tumours curatively treated with no evidence of disease for ≥ 5 years.
  • Clinical evidence of distant metastasis as determined by pre-surgical or post-surgical imaging (CT scan of chest, abdomen and pelvis or whole-body PET-CT scan)
  • Patients with a documented positive surgical margin.
  • Patients with a documented positive peritoneal washings, if performed.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sub-Study A: RAINBO BLUE Cohort A2 ExploratoryAdjuvant radiotherapy (EBRT +/- brachytherapy)Observation or Adjuvant Radiotherapy
Sub-Study B: TAPERObservationObservation or Vaginal Brachytherapy
Sub-study A: RAINBO BLUE Cohort A1ObservationObservation
Sub-Study A: RAINBO BLUE Cohort A2 ExploratoryObservationObservation or Adjuvant Radiotherapy
Sub-Study B: TAPERVaginal brachytherapyObservation or Vaginal Brachytherapy
Primary Outcome Measures
NameTimeMethod
Estimate the rate of pelvic recurrence at 3 years in patients who are treated with de-escalated adjuvant treatment directed by tumour molecular status3 years
Secondary Outcome Measures
NameTimeMethod
Estimate recurrence-free survival9 years
Estimate the rate of distant metastasis at 3 years3 years
Estimate overall survival9 years
Describe the impact of molecular classification on fear of recurrence by Fear of Recurrence Inventory9 years
Estimate the rate of isolated vaginal recurrence at 3 years3 years
Estimate the rate of para-aortic recurrence at 3 years3 years
Estimate endometrial cancer-specific survival9 years

Trial Locations

Locations (64)

Ohio State University Comprehensive

🇺🇸

Columbus, Ohio, United States

Alaska Womens Cancer Care

🇺🇸

Anchorage, Alaska, United States

University of Arizona Cancer Center

🇺🇸

Tucson, Arizona, United States

Cedars-Sinai Medical Center

🇺🇸

Los Angeles, California, United States

Huntington Memorial Hospital

🇺🇸

Pasadena, California, United States

Sutter Medical Center Sacramento

🇺🇸

Sacramento, California, United States

UCHealth University of Colorado Hospital

🇺🇸

Aurora, Colorado, United States

Piedmont Hospital

🇺🇸

Atlanta, Georgia, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Northwestern Medicine Cancer Center Warrenville

🇺🇸

Warrenville, Illinois, United States

Ascension Saint Vincent Indianapolis Hospital

🇺🇸

Indianapolis, Indiana, United States

University Medical Center New Orleans

🇺🇸

New Orleans, Louisiana, United States

UMass Memorial Medical Centre

🇺🇸

Worcester, Massachusetts, United States

Sidney Kimmel Cancer Center Washington Township

🇺🇸

Sewell, New Jersey, United States

Mount Sinai Chelsea

🇺🇸

New York, New York, United States

Mount Sinai Hospital

🇺🇸

New York, New York, United States

Upstate Cancer Center Radiation Oncology at Oswego

🇺🇸

Oswego, New York, United States

State University of New York

🇺🇸

Syracuse, New York, United States

Upstate Cancer Center at Hill Radiation Oncology

🇺🇸

Syracuse, New York, United States

Upstate Cancer Center at Verona

🇺🇸

Verona, New York, United States

UNC Lineberger Comprehensive Cancer Center

🇺🇸

Chapel Hill, North Carolina, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Duke Womens Cancer Care Raleigh

🇺🇸

Raleigh, North Carolina, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Penn State Milton S Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

Asplundh Cancer Pavilion

🇺🇸

Willow Grove, Pennsylvania, United States

Women and Infants Hospital

🇺🇸

Providence, Rhode Island, United States

Farmington Health Centre

🇺🇸

Farmington, Utah, United States

University of Utah Sugarhouse Health Centre

🇺🇸

Salt Lake City, Utah, United States

Huntsman Cancer Institute University of Utah

🇺🇸

Salt Lake City, Utah, United States

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

South Western Sydney Local Health District

🇦🇺

Liverpool, New South Wales, Australia

Calvary Mater Newcastle Hospital

🇦🇺

Waratah, New South Wales, Australia

Westmead Hospital

🇦🇺

Westmead, New South Wales, Australia

Mater Research Institute South Brisbane

🇦🇺

South Brisbane, Queensland, Australia

Monash Medical Centre

🇦🇺

Clayton, Victoria, Australia

Frankston Hospital

🇦🇺

Frankston, Victoria, Australia

The Royal Women's Hospital

🇦🇺

Parkville, Victoria, Australia

Canberra Hospital

🇦🇺

Garran, Australia

Royal Brisbane and Womens Hospital

🇦🇺

Herston, Australia

Arthur J.E. Child Comprehensive Cancer Centre

🇨🇦

Calgary, Alberta, Canada

Cross Cancer Institute

🇨🇦

Edmonton, Alberta, Canada

BCCA - Kelowna

🇨🇦

Kelowna, British Columbia, Canada

BCCA - Prince George

🇨🇦

Prince George, British Columbia, Canada

BCCA - Vancouver

🇨🇦

Vancouver, British Columbia, Canada

BCCA - Victoria

🇨🇦

Victoria, British Columbia, Canada

London Health Sciences Centre Research Inc.

🇨🇦

London, Ontario, Canada

Trillium Health Partners - Credit Valley Hospital

🇨🇦

Mississauga, Ontario, Canada

Odette Cancer Centre

🇨🇦

Toronto, Ontario, Canada

University Health Network

🇨🇦

Toronto, Ontario, Canada

CHUM-Centre Hospitalier de l'Universite de Montreal

🇨🇦

Montreal, Quebec, Canada

The Jewish General Hospital

🇨🇦

Montreal, Quebec, Canada

CIUSSS de l'Estrie - Centre hospitalier

🇨🇦

Sherbrooke, Quebec, Canada

European Institute of Oncology

🇮🇹

Milan, Italy

Radiotherapiegroep

🇳🇱

Arnhem, Gelderland, Netherlands

Maastro clinic (Maastricht UMC)

🇳🇱

Maastricht, Limburg, Netherlands

Catharina ziekenhuis

🇳🇱

Eindhoven, Noord Brabant, Netherlands

MC Haaglanden

🇳🇱

Den Haag, South Holland, Netherlands

Leiden University Medical Center (LUMC)

🇳🇱

Leiden, Netherlands

Erasmus Medical Center (EMC)

🇳🇱

Rotterdam, Netherlands

Auckland City Hospital

🇳🇿

Auckland, New Zealand

Christchurch Hospital

🇳🇿

Christchurch, New Zealand

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