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临床试验/NCT04278287
NCT04278287招募中1 期

A Phase I/II Study of Chemoradiotherapy Using Albumin-Bound Paclitaxel and Cisplatin in Unresectable Esophageal Squamous Cell Carcinomas Based on Nutritional Risk Screening Score (NRS2002)

Cancer Institute and Hospital, Chinese Academy of Medical Sciences5 个研究点 分布在 1 个国家目标入组 105 人开始时间: 2019年10月1日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
1 期
状态
招募中
入组人数
105
试验地点
5
主要终点
Local control rate

研究概览

简要总结

This phase I/II clinical study is designed to evaluate the 1 year local tumor control rate of chemoradiotherapy using albumin-bound paclitaxel and cisplatin in unresectable esophageal squamous cell carcinomas based on Nutritional Risk Screening NRS2002.

详细描述

This Phase I/II clinical study is meticulously designed to assess the one-year local tumor control rate of a chemoradiotherapy regimen that combines albumin-bound paclitaxel and cisplatin in patients with unresectable esophageal squamous cell carcinoma (ESCC). The selection of participants is guided by the Nutritional Risk Screening (NRS2002) tool, which ensures that nutritional risk factors are adequately considered and managed throughout the study.

The trial will enroll patients diagnosed with unresectable ESCC, a condition where surgical intervention is not feasible due to the tumor's location, size, or patient comorbidities. Participants will undergo a thorough nutritional assessment using the NRS2002 criteria, which evaluates factors such as weight loss, body mass index, dietary intake, and severity of disease to determine their nutritional risk score. This screening is crucial as it helps identify patients who may benefit from nutritional interventions, which could potentially improve their overall response to the treatment and quality of life.

Once enrolled, patients will receive a combination chemoradiotherapy of albumin-bound paclitaxel and cisplatin. Albumin-bound paclitaxel is chosen for its ability to improve the delivery and efficacy of paclitaxel, a chemotherapy drug, by enhancing its solubility and distribution within the body. Cisplatin, a platinum-based chemotherapy agent, is included due to its well-established efficacy in treating various cancers, including esophageal cancer. This combination aims to maximize tumor reduction while managing potential side effects.

The primary endpoint of the study is to determine the local tumor control rate at one year, which refers to the percentage of patients whose tumors have not progressed or recurred within the treated area during this period. Secondary endpoints include overall survival, progression-free survival, and assessment of treatment-related toxicity. Additionally, the study will monitor changes in patients' nutritional status and quality of life, aiming to provide comprehensive insights into the efficacy and safety of this chemoradiotherapy regimen.

Regular follow-ups and imaging studies, such as CT scans or PET scans, will be conducted to evaluate the tumor response and detect any signs of progression. Blood tests and other laboratory assessments will be performed periodically to monitor patients' overall health and manage any adverse effects promptly. The data collected from this study will contribute valuable information to the ongoing efforts to improve treatment outcomes for patients with unresectable esophageal squamous cell carcinoma.

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 75 Years(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • 18~75 years
  • Pathologically or cytologically proven unresectable esophageal squamous cell carcinomas in patients staged as T3N1M0-1b and T4N0-1M0-1b(AJCC 6th TNM staging,M1b limited to clavicular or celiac lymph node metastasis)
  • Primary treatment performed in Cancer Hospital, Chinese Academy of Medical Sciences
  • ECOG PS score: 0~1
  • NRS2002 score <3
  • Estimated survival time ≥3 months
  • Normal organ and marrow function as defined below:
  • Hemoglobin: greater than or equal to 100g/L ;Leukocytes: greater than or equal to 4,000 G/L; Neutrophil: greater than or equal to 2,000 G/L; Platelets: greater than or equal to 100,000/mm3 ; Creatinine: less than or equal to 1.5 times the upper limit or CCR greater than or equal to 60 ml/min; AST/ALT: less than or equal to 2.5 times the upper limit; Total bilirubin: less than or equal to 1.5 times the upper limit; INR: less than or equal to 1.5 times the upper limit; APTT: less than or equal to 1.5 times the upper limit; PT: less than or equal to 1.5 times the upper limit
  • Informed consent

排除标准

  • With any distant metastasis out of regional lymphatic drainage or in liver, lung, bone, CNS, etc
  • Patients with other cancer history in 5 years except cervical carcinoma in situ and non-malignant melanoma skin cancer
  • Existing active infection such as active tuberculosis and hepatitis
  • History of myocardial infarction within the past 6 months or history of ventricular arrhythmia
  • Uncontrolled illness including, but not limited to, active infection, symptomatic heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness
  • History of allergic reactions attributed to paclitaxel, albumin or cisplatin
  • Participation in other clinical trials currently or within 4 weeks of selection
  • Pregnant or lactating females

研究组 & 干预措施

Albumin-Bound Paclitaxel and Cisplatin based chemoradiotherapy

Experimental

Chemoradiotherapy arm receives intensity-modulated radiation therapy, volume modulated arc therapy or tomotherapy concurrently with albumin-bound paclitaxel and cisplatin (weekly intravenous infusion in 5-6 weeks).

干预措施: Radiotherapy (Radiation)

Albumin-Bound Paclitaxel and Cisplatin based chemoradiotherapy

Experimental

Chemoradiotherapy arm receives intensity-modulated radiation therapy, volume modulated arc therapy or tomotherapy concurrently with albumin-bound paclitaxel and cisplatin (weekly intravenous infusion in 5-6 weeks).

干预措施: Albumin-Bound Paclitaxel (Drug)

Albumin-Bound Paclitaxel and Cisplatin based chemoradiotherapy

Experimental

Chemoradiotherapy arm receives intensity-modulated radiation therapy, volume modulated arc therapy or tomotherapy concurrently with albumin-bound paclitaxel and cisplatin (weekly intravenous infusion in 5-6 weeks).

干预措施: Cisplatin (Drug)

结局指标

主要结局

Local control rate

时间窗: 1 year from the start of treatment to tumor recurrence

Control rate of primary esophageal cancer and metastatic lymph nodes within irradiation fields

次要结局

  • Number of participants with acute toxicities(10 week, from the start of treatment to 1 month after chemoradiotherapy)
  • Objective response rate(5.5 week)
  • Disease Free Survival(1 year, 2 year)
  • Progression Free Survival(1 year, 2 year)
  • Overall Survival(1 year, 2 year)
  • Radiomics analysis(5.5 week)
  • ctDNA analysis(4 week, 2 month, 1 year, 2 year)

研究者

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

XIN WANG

Principal Investigator

Cancer Institute and Hospital, Chinese Academy of Medical Sciences

研究点 (5)

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