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临床试验/NCT04229459
NCT04229459进行中(未招募)2 期

A Phase II Study of the Addition of Nivolumab and Cetuximab to Chemoradiation in Locally Advanced Esophageal Squamous Cell Carcinoma (ESqCC).

Baruch Brenner1 个研究点 分布在 1 个国家目标入组 12 人开始时间: 2020年2月16日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
2 期
状态
进行中(未招募)
入组人数
12
试验地点
1
主要终点
Progression Free Survival (PFS)

研究概览

简要总结

This is a phase II, open label, two-centered study for evaluation of the addition of nivolumab and cetuximab after chemoradiation as a neoadjuvant treatment for locally advanced esophageal squamous cell carcinoma patients. Subjects must have received no prior treatment for esophageal cancer (chemotherapy, radiotherapy or surgery) and no prior treatment with checkpoint inhibitors.

Eligible subjects will receive induction chemotherapy with cetuximab for a period of 4 weeks, chemoradiation with cetuximab for a period of 6 weeks, 3 cycles of immunotherapy (nivolumab + cetuximab) for a period of 6 weeks, and will undergo surgery at the end of the treatment.

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

入选标准

  • Signed written IRB approved informed consent.
  • Age > 18 years.
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1
  • Subjects with histologically confirmed operable, primary (non-recurrent) locally advanced (T3NxM0, TxN1M0) middle (distal to the thoracic inlet) or distal (up to the gastroesophageal junction) ESqCC according to endoscopic ultrasound (EUS) and PET-CT.
  • No prior systemic or radiation therapy for esophageal cancer.
  • Presence of adequate contraception in fertile patients.
  • Women of childbearing potential must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 24 hours prior to the start of study drug.
  • Women must not be breastfeeding.
  • No previous (within the last 5 years) or concurrent malignancies, with the exception of adequately treated cone-biopsied in situ carcinoma of the cervix or basal cell carcinoma of the skin.

排除标准

  • Cervical esophageal tumors or tumors < 5 cm from the cricopharyngeal cartilage.
  • Gastric cancers with minor involvement of the GEJ or distal esophagus, or an esophageal tumor extending beyond 2 cm into the stomach.
  • Prior chest or upper abdomen radiotherapy, prior systemic chemotherapy within the past 5 years or prior esophageal or gastric surgery.
  • Patients with evidence of metastatic disease.
  • Biopsy proven tumor invasion of the tracheobronchial tree or presence of tracheo-esophageal (TE) fistula or recurrent laryngeal nerve or phrenic nerve paralysis.
  • New York Heart Association Class III or IV heart disease. Angina or myocardial infarction within the last 12 months, history of significant ventricular arrhythmia requiring medication with antiarrhythmics, or a history of a clinically significant conduction system abnormality.
  • Clinically significant hearing loss.
  • Patients with a history of seizure disorder who are receiving phenytoin, phenobarbital, or other antiepileptic medication.
  • Any positive test for hepatitis B virus or hepatitis C virus indicating active infection.
  • Ongoing immunosuppressive therapy.
  • Active autoimmune disease. [Subjects with type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll].
  • Prior organ transplant.
  • Prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways.
  • Known history of positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS).

研究组 & 干预措施

Neoadjuvant Treatment

Experimental

All subjects will receive induction chemotherapy and chemoradiation combined with cetuximab followed by nivolumab and cetuximab as neoadjuvant treatment

干预措施: Cisplatin (Drug)

Neoadjuvant Treatment

Experimental

All subjects will receive induction chemotherapy and chemoradiation combined with cetuximab followed by nivolumab and cetuximab as neoadjuvant treatment

干预措施: 5-FU (Drug)

Neoadjuvant Treatment

Experimental

All subjects will receive induction chemotherapy and chemoradiation combined with cetuximab followed by nivolumab and cetuximab as neoadjuvant treatment

干预措施: Radiation therapy (Radiation)

Neoadjuvant Treatment

Experimental

All subjects will receive induction chemotherapy and chemoradiation combined with cetuximab followed by nivolumab and cetuximab as neoadjuvant treatment

干预措施: Cetuximab (Drug)

Neoadjuvant Treatment

Experimental

All subjects will receive induction chemotherapy and chemoradiation combined with cetuximab followed by nivolumab and cetuximab as neoadjuvant treatment

干预措施: Nivolumab (Drug)

结局指标

主要结局

Progression Free Survival (PFS)

时间窗: The time interval from the first day of treatment to the first event of loco-regional failure, metastatic recurrence or death from any cause, assessed up to 66 months

PFS will be censored in patients without loco-regional failure, metastatic recurrence or death, at the last date known to be alive or at the start of a new anti-cancer treatment, whatever occurs first. PFS rate will be estimated using the Kaplan-Meier method

pathological complete response (pCR) rate

时间窗: Time from start of neoadjuvant treatment until surgical resection, assessed up to 24 months

pCR is defined when no tumor is found on pathology review of the surgical specimen (TRG -0)

Modified pathological complete response

时间窗: Time from start of neoadjuvant treatment until surgical resection in operated patients (pCR) and long-term (≥12 months) clinical complete response (cCR) in unoperated patients, assessed up to 24 months.

We defined a novel primary endpoint, combining pathological complete response (pCR) rate among operated patients and long-term (≥12 months) clinical complete response (cCR) rate for those electing watchful waiting, into a composite endpoint of modified pCR (mpCR) rate.

Incidence of Treatment-Emergent Adverse Events (Safety)

时间窗: Time from screening until the end of study drug administration, assessed up to 24 months

Treatment-emergent AEs will be graded according to NCI CTCAE v5.0, vital signs and clinical laboratory

次要结局

  • Overall survival (OS)(The time interval between the first day of treatment and the date of death from any cause, assessed up to 66 months)

研究者

申办方类型
Other
责任方
Sponsor Investigator
主要研究者

Baruch Brenner

Director of the Oncology Division and the Davidoff Cancer Center

Rabin Medical Center

研究点 (1)

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