Adbelimumab Combined With Chemotherapy and Apatinib in Patients With Resectable Esophageal Squamous Cell Carcinoma
A Prospective, Single-arm, Single-center, Exploratory Study of the Safety and Efficacy of Adbelimumab Combined With Chemotherapy and Apatinib in Patients With Resectable Esophageal Squamous Cell Carcinoma
Esophageal cancer is a prevalent digestive tract tumor, with around 400,000 new cases and 300,000 deaths globally each year. In the past few decades, surgery, radiotherapy, chemotherapy and other treatments were continuously improved, however, the mortality of esophageal squamous cell carcinoma (ESCC) patients was not significantly decreased. For patients with locally advanced esophageal cancer, direct surgery is not effective. It is difficult to achieve radical resection by surgery merely, and even if many patients receive surgery, they may eventually have tumor recurrence and poor survival rate.
Therefore, it is necessary to explore effective perioperative neoadjuvant treatment to reduce the risk of postoperative recurrence and improve the postoperative survival rate of patients. According to the reports, the expression of PD-L1 in esophageal cancer was about 41.4%. Therefore, PD-1/ PD-L1 immunocheckpoint inhibitor may become a new method for the treatment of ESCC. Preliminary clinical results showed that immunotherapy combined with chemoradiotherapy provided a synergies antitumor effect.
The results of the Phase 1b trial evaluating adbelimumab monotherapy as a neoadjuvant treatment for locally advanced resectable ESCC demonstrated that patients receiving two cycles of neoadjuvant sequential surgery exhibited favorable safety profiles, with no adverse reactions of grade 3 or higher. The trial reported a major pathological response (MPR) rate of 24%, a pathological complete response (pCR) rate of 8%, a 2-year overall survival (OS) rate of 92%, and a 2-year recurrence-free survival (RFS) rate of 100%. The effectiveness of combining adbelizumab with chemotherapy and targeted therapy for locally advanced esophageal cancer is uncertain.
This study aims to assess the efficacy and safety of using adbelizumab with chemotherapy and apatinib as neoadjuvant therapy for resectable ESCC.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Ming Wu, M.D
- Phone Number: +8613757118715
- Email: iwuming22@zju.edu.cn
Study Locations
-
-
China
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Hangzhou, China, China, 310009
- Recruiting
- 2nd Affiliated Hospital, School of Medicine, Zhejiang University
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Contact:
- Ming Wu, M.D
- Phone Number: +8613757118715
- Email: iwuming22@zju.edu.cn
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Signed informed consent.
- Patients age 18 to 75 years old.
- Primary resectable, histologically confirmed esophageal squamous cell cancer.
- Esophageal squamous cell carcinoma the clinical stage was II-IVA (according to AJCC TNM stage, 8th edition).
- ECOG PS 0-1.
- No distant metastasis, the diseases could be resectable assessed by thoracic oncologist.
Exclusion Criteria:
- With significant cardiovascular disease.
- Current treatment with anti-viral therapy or HBV.
- Female patients who are pregnant or lactating.
- History of malignancy within 5 years prior to screening.
- Active or history of autoimmune disease or immune deficiency.
- Signs of distant metastases.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Adbelimumab, chemotherapy and apatinib
Preoperative neoadjuvant therapy for 4 cycles.
Radical surgery is performed 4-6 weeks after the last dose.
Postoperative radiotherapy is determined according to the clinical situation and pathological stage of the patient.
Adbelimumab can be aintained for a maximum of 1 year.
During the study, patients were be followed until disease progression, withdrawal of informed consent, loss of follow-up, or death.
|
Adbelimumab 1200mg Day 1; Albumin paclitaxel 260mg/m2, Day 1; carboplatin AUC=5, Day 1; Apatinib 250mg Po Day 2-4.
Preoperative neoadjuvant therapy for 4 cycles, one cycle every 21 days.
Other Names:
Prior to each surgical procedure, the department engaged in comprehensive discussions and deliberations to ascertain and establish the most suitable course of action.
Minimally invasive IvorLewis (intrathoracic anastomosis) or McKeown (neck anastomosis) esophagectomy, including two field extensive lymphadenectomies, was performed according to the tumor location.
The resection length should be at least 5cm from the tumor origin according to prechemotherapy by endoscopy.
The surgeries will be performed by surgeons with rich experience.
Minimally invasive esophagectomy, can be performed using the da Vinci surgical robot, thoracoscope, or laparoscope, or by using an open approach, as judged appropriate by the surgeon.
Blood, Tumour will be Collected from participant.
Fate of sample is Destruction after use.
20 ml of peripheral blood was collected the day before each of the immunotherapy sessions and after surgery.
Tumour sample will be collected before neoadjuvant therapy and after surgery.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pathological Complete Response (PCR)
Time Frame: 1 month after surgery
|
The pCR will be defined as the proportion of participants with absence of residual tumor in the resected primary tumor and all resected lymph nodes after completion of neoadjuvant treatment.
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1 month after surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of Treatment-related Adverse Events
Time Frame: 1 month after surgery
|
Incidence of Treatment-related Adverse Events as Assessed by CTCAE v5.0
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1 month after surgery
|
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The changes in the peripheral blood immunoprofile and tumor tissue sample among non-PCR (NPCR) and PCR patients
Time Frame: 3 months after surgery
|
By using mass spectrometry (CyTOF) and single-cell analysis, we comprehensively characterized the immune landscape in the peripheral blood and tumor sample of ESCC patients before and after anti-PD-1 immunotherapy, aiming to explore the immune subsets correlated with neoadjuvant immunotherapy response.
|
3 months after surgery
|
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2-year and 5-year overall survival
Time Frame: 2-year and 5-year after enrolled
|
The proportion of all study cases in which no death from any cause occurred within 2 years and 5 years after enrolled
|
2-year and 5-year after enrolled
|
|
Major Pathological Response (MPR)
Time Frame: 1 month after surgery
|
The MPR will be defined as the proportion of participants with less 10% of residual tumor in the resected primary tumor and all resected lymph nodes after completion of neoadjuvant treatment.
|
1 month after surgery
|
|
Objective Response Rate (ORR)
Time Frame: before surgery
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The ORR will be defined as the proportion of participants who have a complete response or partial response before surgery as assessed by the investigator per RECIST v1.1 in all participants with measurable disease at baseline
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before surgery
|
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R0 resection rate
Time Frame: 1 month after surgery
|
This will be defined as the proportion of participants with R0 resection
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1 month after surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Wang, 2nd Affiliated Hospital, School of Medicine, Zhejiang University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Digestive System Diseases
- Gastrointestinal Diseases
- Head and Neck Neoplasms
- Neoplasms, Glandular and Epithelial
- Esophageal Diseases
- Carcinoma
- Neoplasms, Squamous Cell
- Carcinoma, Squamous Cell
- Esophageal Neoplasms
- Esophageal Squamous Cell Carcinoma
- Organic Chemicals
- Surgical Procedures, Operative
- Coordination Complexes
- Digestive System Surgical Procedures
- Carboplatin
- apatinib
- Esophagectomy
Other Study ID Numbers
Other Study ID Numbers
- 2024-0949
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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