- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03087864
PDL-1 Targeting in Resectable Oesophageal Cancer (PERFECT)
PDL-1 Targeting in Resectable Oesophageal Cancer: a Phase II Feasibility Study of Atezolizumab and Chemoradiation.
Study Overview
Status
Intervention / Treatment
Detailed Description
Objectives The primary objective of the study of this study is to assess the feasibility of preoperative treatment with atezolizumab combined with preoperative chemoradiation (carboplatin, paclitaxel and radiation) in terms of completion of treatment with atezolizumab.
Secondary objectives are:
- To assess toxicities of atezolizumab alone and in combination with chemoradiation.
- To assess completion of chemotherapy and radiation treatment
- To assess withdrawal rate from surgery
- To assess post-operative complications.
- To assess pathological response.
- To assess R0 resection rate.
- To assess the relation between gut microbiota composition and response.
- To assess the relation between gut microbiota composition and toxicity.
Explorative objectives are:
To perform exploratory biomarker analyses from tumor tissue and blood-derived samples and correlate with safety and clinical outcome. Biomarker analyses include (but are not limited to):
- Expression of PD-1, PD-L1 and FOXP3, presence of tumor infiltrating CD8+/CD4+ cytotoxic/helper T lymphocytes, IFNγ expression, presence of tumor macrophages, STAT3 and STAT6 expression, MHC classI, MHC class II, EBV and MSI status on tumor tissue.
- RNA sequencing and whole exome sequencing to develop a predictive profile for response to treatment.
- Analysis of ctDNA extracted from plasma of patients at four time points (baseline, directly after chemoradiation, at surgery and 3 months after surgery) and analyzed using Ion Torrent Next Generation sequence technology as a non-invasive marker for response to treatment.
- Analysis of peripheral blood mononuclear cells (PBMCs) extracted from whole blood of patients at three time points ((baseline, directly after chemoradiation, at surgery) )
- Duodenal biopsy and morning faeces sample analysis as predictor of response will be done by HIT Chip flora mapping, an established sensitive RT-qPCR method which is developed for exact and sensitive enumeration of bacterial population.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Amsterdam, Netherlands, 1100 DD
- Academic Medical Center, Medical Oncology
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Histologically proven adenocarcinoma of the esophagus or gastro esophageal junction.
- Surgical resectable (<T4b, N0 or N+, M0), as determined by Endoscopic Ultra Sound (EUS) and CT scan of neck, thorax and abdomen. Tumors that cannot be passed with an endoscope for endoscopic ultrasound are eligible if all other criteria are fulfilled.
- T1N+ tumors are eligible.
- Tumor length longitudinal ≤ 10 cm; if larger than 10 cm, inclusion should be discussed with the principal investigator.
- If the tumor extends below the gastroesophageal (GE) junction into the proximal stomach, the bulk of the tumor must involve the esophagus or GE junction.
- Age ≥ 18.
- ECOG performance status 0 or 1 (cf. Appendix A).
Adequate hematological, renal and hepatic functions defined as:
- neutrophiles ≥ 1.5 x 109/L
- platelets ≥ 100 x 109/L
- hemoglobin ≥ 5.6 mmol
- total bilirubin ≤ 1.5 x upper normal limit
- creatinine clearance (Cockroft) > 60 ml/min
- Written, voluntary informed consent
- Patients must be accessible to follow up and management in the treatment center
Exclusion Criteria:
- Past or current history of malignancy other than entry diagnosis interfering with prognosis of esophageal cancer.
- Invasion of the tracheobronchial tree or presence of tracheoesophageal fistula.
- T1N0 tumors or in situ carcinoma.
- Pregnancy (positive serum pregnancy test), planning to become pregnant, and lactation.
- Patient (male or female) is not willing to use highly effective methods of contraception (per institutional standard) during treatment and for 6 months (male or female) after the end of treatment.
- Previous chemotherapy, radiotherapy, and/or treatment with checkpoint inhibitors.
- Clinically significant cardiovascular disease (including myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) precluding major surgery.
- Pulmonary fibrosis and/or severely impaired lung function precluding major surgery.
- Pre-existing motor or sensory neurotoxicity greater than WHO grade 1.
- Serious underlying medical condition which would impair the ability of the patient to receive the planned treatment, including prior allergic reactions to drugs containing Cremophor, such as teniposide or cyclosporine.
- Dementia or altered mental status that would prohibit the understanding and giving of informed consent
- Inadequate caloric- and/or fluid intake despite consultation of a dietician and/or tube feeding.
- Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine for patients with a history of autoimmune-related hypothyroidism, insulin for patients with type 1 diabetes mellitus, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. Patients with vitiligo with dermatological manifestations only are eligible to enter the study.
- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy (>10 mg/day prednisone or equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment.
- Has evidence of interstitial lung disease or active, non-infectious pneumonitis.
- Has an active infection requiring systemic therapy which has not resolved 3 days (simple infection such as cystitis) to 7 days (severe infection such as pyelonephritis) prior to the first dose of trial treatment.
- Patients with prior allogeneic stem cell or solid organ transplantation.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Atezolizumab and Chemoradiation
Atezolizumab 1200 mg i.v.
day 1-22-43-64-85 Carboplatin AUC = 2 i.v day 1-8-15-22-29 Paclitaxel 50 mg/m2 i.v day 1-8-15-22-29 Radiotherapy 23 x 1.8 Gy
|
Chemotherapy
Chemotherapy
Atezolizumab 1200 mg i.v.
day 1-22-43-64-85
Radiotherapy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
feasibility defined as percentage completion of treatment with atezolizumab.
Time Frame: up to 3 months
|
The primary endpoint is feasibility defined as percentage completion of treatment with atezolizumab
|
up to 3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence and severity of toxicity
Time Frame: up to 3 months
|
Incidence and severity of toxicity defined to CTCAE v4.03 and Radiation Oncology Group (RTOG) criteria.
|
up to 3 months
|
Percentage completion of chemotherapy and radiation treatment
Time Frame: up to 3 months
|
Percentage completion of chemotherapy and radiation treatment
|
up to 3 months
|
Percentage withdrawal rate from surgery due to atezolizumab related complications
Time Frame: up to 3 months
|
Percentage withdrawal rate from surgery due to atezolizumab related complications
|
up to 3 months
|
Percentage delay of surgery due to atezolizumab related complications
Time Frame: up to 3 months
|
Percentage delay of surgery due to atezolizumab related complications
|
up to 3 months
|
Incidence and severity of post-operative complications to the Dindo classification
Time Frame: up to 3 months
|
Incidence and severity of post-operative complications to the Dindo classification
|
up to 3 months
|
Pathological response according to the Mandard criteria
Time Frame: up to 3 months
|
Pathological response according to the Mandard criteria
|
up to 3 months
|
R0 resection rate.
Time Frame: up to 3 months
|
R0 resection rate.
|
up to 3 months
|
Progression free survival
Time Frame: up to 3 months
|
Progression free survival
|
up to 3 months
|
Overall survival
Time Frame: up to 3 months
|
Overall survival
|
up to 3 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Potential biomarker development based on assessment of tumour biopsies, blood- and faecal samples and the proposed mechanism of action of study drugs.
Time Frame: up to 3 months
|
Potential biomarker development based on assessment of tumour biopsies, blood- and faecal samples and the proposed mechanism of action of study drugs.
|
up to 3 months
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Hanneke WM van Laarhoven, Prof. dr., Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms
- Neoplasms by Site
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Head and Neck Neoplasms
- Esophageal Diseases
- Esophageal Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Carboplatin
- Paclitaxel
- Atezolizumab
Other Study ID Numbers
- 2016_325
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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.
Clinical Trials on Esophageal Cancer, Stage II
-
Tianjin Medical University Cancer Institute and...Sun Yat-sen University; Cancer Institute and Hospital, Chinese Academy of Medical... and other collaboratorsNot yet recruitingStage III Esophageal Cancer | Stage II Esophageal Cancer
-
Tianjin Medical University Cancer Institute and...UnknownStage III Esophageal Cancer | Stage II Esophageal CancerChina
-
University of WashingtonNational Center for Complementary and Integrative Health (NCCIH); National...RecruitingStage II Pancreatic Cancer AJCC v8 | Stage III Pancreatic Cancer AJCC v8 | Stage IV Pancreatic Cancer AJCC v8 | Clinical Stage III Gastric Cancer AJCC v8 | Clinical Stage IV Gastric Cancer AJCC v8 | Clinical Stage II Esophageal Adenocarcinoma AJCC v8 | Clinical Stage II Esophageal Squamous Cell... and other conditionsUnited States
-
Thomas Jefferson UniversityNational Cancer Institute (NCI)CompletedStage II Pancreatic Cancer AJCC v8 | Stage III Pancreatic Cancer AJCC v8 | Stage IV Pancreatic Cancer AJCC v8 | Clinical Stage III Gastric Cancer AJCC v8 | Clinical Stage IV Gastric Cancer AJCC v8 | Stage IV Colorectal Cancer AJCC v8 | Stage IVA Colorectal Cancer AJCC v8 | Stage IVB Colorectal Cancer... and other conditionsUnited States
-
Mayo ClinicNational Cancer Institute (NCI)Active, not recruitingStage III Lung Cancer AJCC v8 | Stage II Lung Cancer AJCC v8 | Stage IIA Lung Cancer AJCC v8 | Stage IIB Lung Cancer AJCC v8 | Stage IIIA Lung Cancer AJCC v8 | Stage IIIB Lung Cancer AJCC v8 | Stage I Lung Cancer AJCC v8 | Stage IA1 Lung Cancer AJCC v8 | Stage IA2 Lung Cancer AJCC v8 | Stage IA3 Lung Cancer... and other conditionsUnited States
-
City of Hope Medical CenterNational Cancer Institute (NCI)Active, not recruitingStage IV Prostate Cancer AJCC v8 | Hepatobiliary Neoplasm | Stage III Renal Cell Cancer AJCC v8 | Stage IV Renal Cell Cancer AJCC v8 | Stage III Uterine Corpus Cancer AJCC v8 | Stage IV Uterine Corpus Cancer AJCC v8 | Stage IVA Uterine Corpus Cancer AJCC v8 | Stage IVB Uterine Corpus Cancer AJCC v8 | Malignant Neoplasm and other conditionsUnited States
-
Wake Forest University Health SciencesNational Cancer Institute (NCI)CompletedAdenocarcinoma of the Gastroesophageal Junction | Stage II Gastric Cancer | Stage III Gastric Cancer | Squamous Cell Carcinoma of the Esophagus | Adenocarcinoma of the Stomach | Adenocarcinoma of the Esophagus | Stage III Esophageal Cancer | Stage II Esophageal CancerUnited States
-
The First Affiliated Hospital of Henan University...UnknownStage III Esophageal Squamous Cell Carcinoma | Stage II Esophageal Squamous Cell Carcinoma | Stage I Esophageal Adenocarcinoma | Stage II Esophageal Adenocarcinoma | Stage III Esophageal Adenocarcinoma | Stage I Esophageal Squamous Cell CarcinomaChina
-
University Hospital HeidelbergRecruitingEsophagus Cancer, Stage I | Esophagus Cancer, Stage IIGermany
-
Thomas Jefferson UniversitySuspendedMalignant Solid Neoplasm | Gastric Adenocarcinoma | Pancreatic Ductal Adenocarcinoma | Stage II Pancreatic Cancer AJCC v8 | Stage III Pancreatic Cancer AJCC v8 | Colorectal Adenocarcinoma | Small Intestinal Adenocarcinoma | Clinical Stage III Gastric Cancer AJCC v8 | Stage IV Colorectal Cancer AJCC v8 | Stage IVA Colorectal Cancer AJCC... and other conditionsUnited States
Clinical Trials on Paclitaxel
-
City of Hope Medical CenterNational Cancer Institute (NCI)Active, not recruitingRecurrent Breast Carcinoma | Stage IV Breast Cancer AJCC v6 and v7 | Stage III Breast Cancer AJCC v7 | Stage IIIA Breast Cancer AJCC v7 | Stage IIIB Breast Cancer AJCC v7 | Stage IIIC Breast Cancer AJCC v7 | Metastatic Breast Carcinoma | Locally Advanced Breast CarcinomaUnited States
-
Anne NoonanNational Cancer Institute (NCI)RecruitingStage IV Pancreatic Cancer AJCC v8 | Metastatic Pancreatic AdenocarcinomaUnited States
-
Shengjing HospitalRecruiting
-
Hutchison Medipharma LimitedSun Yat-sen UniversityActive, not recruitingAdvanced Gastric CancerChina
-
University of WashingtonNational Cancer Institute (NCI); Celgene CorporationCompletedRecurrent Non-Small Cell Lung Carcinoma | Stage IV Non-Small Cell Lung CancerUnited States
-
CTI BioPharmaTerminatedNSCLCUnited States, Canada, Bulgaria, Romania, Russian Federation, Ukraine, Mexico, Argentina, Hungary, Poland, United Kingdom
-
Mayo ClinicNational Cancer Institute (NCI)WithdrawnRecurrent Bladder Urothelial Carcinoma | Stage IV Bladder Urothelial CarcinomaUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Active, not recruitingAnatomic Stage I Breast Cancer AJCC v8 | Anatomic Stage IA Breast Cancer AJCC v8 | Anatomic Stage IB Breast Cancer AJCC v8 | Anatomic Stage II Breast Cancer AJCC v8 | Anatomic Stage IIA Breast Cancer AJCC v8 | Anatomic Stage IIB Breast Cancer AJCC v8 | Anatomic Stage III Breast Cancer AJCC v8 | Anatomic... and other conditionsUnited States
-
Novartis PharmaceuticalsCompletedMetastatic or Locally Advanced Solid TumorsNetherlands, Spain, Germany, Switzerland, Belgium
-
CTI BioPharmaTerminated