- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03801876
Comparing Proton Therapy to Photon Radiation Therapy for Esophageal Cancer
Phase III Randomized Trial of Proton Beam Therapy (PBT) Versus Intensity Modulated Photon Radiotherapy (IMRT) for the Treatment of Esophageal Cancer
Study Overview
Status
Conditions
- Clinical Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IIIA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IIIB Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Clinical Stage I Esophageal Adenocarcinoma AJCC v8
- Clinical Stage I Esophageal Squamous Cell Carcinoma AJCC v8
- Clinical Stage II Esophageal Adenocarcinoma AJCC v8
- Clinical Stage II Esophageal Squamous Cell Carcinoma AJCC v8
- Clinical Stage IIA Esophageal Adenocarcinoma AJCC v8
- Clinical Stage III Esophageal Adenocarcinoma AJCC v8
- Clinical Stage III Esophageal Squamous Cell Carcinoma AJCC v8
- Clinical Stage IVA Esophageal Adenocarcinoma AJCC v8
- Clinical Stage IVA Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage I Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage I Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage IA Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage IA Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage IB Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage IB Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage IC Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage II Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage II Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage IIA Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage IIA Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage IIB Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage IIB Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage III Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage III Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage IIIA Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage IIIA Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage IIIB Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage IIIB Esophageal Squamous Cell Carcinoma AJCC v8
- Pathologic Stage IVA Esophageal Adenocarcinoma AJCC v8
- Pathologic Stage IVA Esophageal Squamous Cell Carcinoma AJCC v8
- Clinical Stage II Gastroesophageal Junction Adenocarcinoma AJCC v8
- Clinical Stage IIB Esophageal Adenocarcinoma AJCC v8
- Clinical Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage IIIA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage IIIB Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage III Esophageal Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage III Esophageal Squamous Cell Carcinoma AJCC v8
- Postneoadjuvant Therapy Stage IIIA Esophageal Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IIIA Esophageal Squamous Cell Carcinoma AJCC v8
- Postneoadjuvant Therapy Stage IIIB Esophageal Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IIIB Esophageal Squamous Cell Carcinoma AJCC v8
- Postneoadjuvant Therapy Stage IVA Esophageal Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage IVA Esophageal Squamous Cell Carcinoma AJCC v8
- Clinical Stage IIA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Clinical Stage IIB Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage IB Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage IC Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage II Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage IIA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage IIB Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage II Esophageal Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage II Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage I Esophageal Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage I Esophageal Squamous Cell Carcinoma AJCC v8
- Postneoadjuvant Therapy Stage II Esophageal Squamous Cell Carcinoma AJCC v8
- Clinical Stage I Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage I Gastroesophageal Junction Adenocarcinoma AJCC v8
- Pathologic Stage IA Gastroesophageal Junction Adenocarcinoma AJCC v8
- Postneoadjuvant Therapy Stage I Gastroesophageal Junction Adenocarcinoma AJCC v8
- Thoracic Esophagus Squamous Cell Carcinoma
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To determine if overall survival (OS) is improved with proton beam radiation therapy (PBT) treatment as compared to intensity modulated photon radiation therapy (IMRT) as part of planned protocol treatment for patients with esophageal cancer.
II. To determine if OS with PBT is non-inferior to IMRT as part of planned protocol treatment and that there will be less grade 3+ cardiopulmonary toxicity with PBT than with IMRT.
SECONDARY OBJECTIVES:
I. To compare the symptom burden and impact on functioning of patients between treatment modalities based on Patient Reported Outcome (PRO) measures of symptoms using MD Anderson Symptom Inventory (MDASI) and Patient-Reported Outcomes Measurement Information System (PROMIS)-Fatigue.
II. To compare the Quality-Adjusted Life Years (QALY) using EuroQol five-dimensional questionnaire (EQ5D) as a health outcome between PBT and IMRT, if the protocol primary endpoint is met.
III. To assess the pathologic response rate between PBT and IMRT. IV. To assess the cost-benefit economic analysis of treatment between radiation modalities.
V. To compare the length of hospitalization after protocol surgery between PBT and IMRT.
VI. To compare the incidence of grade 4 lymphopenia during chemoradiation between PBT and IMRT.
VII. To compare lymphocyte nadir at first follow-up visit after completion of chemoradiation between PBT & IMRT.
VIII. To estimate the locoregional failure, distant metastatic free survival, and progression-free survival of patients treated with PBT versus IMRT.
IX. To compare incidence of both early (< 90 days from treatment start) and late (≥ 90 days from treatment start) cardiovascular and pulmonary events between PBT versus IMRT.
X. To compare the Total Toxicity Burden (TTB) of IMRT versus PBT based on a composite index of 9 individual cardiopulmonary toxicities.
EXPLORATORY OBJECTIVES:
I. To collect biospecimens for future analyses, for example to assess cardiac and inflammatory biomarkers in association with treatment complications.
OUTLINE: Patients are randomized to 1 of 2 groups.
GROUP I: Patients undergo PBT over 28 fractions 5 days a week for 5.5 weeks. Patients also receive paclitaxel intravenously (IV) and carboplatin IV on days 1, 8, 15, 22, 29, and 36 while undergoing PBT.
GROUP II: Patients undergo IMRT over 28 fractions 5 days a week for 5.5 weeks. Patients also receive paclitaxel IV and carboplatin IV on days 1, 8, 15, 22, 29, and 36 while undergoing IMRT.
In both groups, within 4-8 weeks after completion of chemotherapy and radiation therapy, patients may undergo an esophagectomy per physician discretion.
After completion of study treatment, patients are followed up every 3-6 months for 3 years and then annually thereafter.
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
Arizona
-
Phoenix, Arizona, United States, 85054
- Recruiting
- Mayo Clinic Hospital in Arizona
-
Principal Investigator:
- Christopher L. Hallemeier
-
Contact:
- Site Public Contact
- Phone Number: 855-776-0015
-
Scottsdale, Arizona, United States, 85259
- Active, not recruiting
- Mayo Clinic in Arizona
-
-
Florida
-
Coral Gables, Florida, United States, 33146
- Recruiting
- UM Sylvester Comprehensive Cancer Center at Coral Gables
-
Contact:
- Site Public Contact
- Phone Number: 305-243-2647
-
Principal Investigator:
- William Jin
-
Deerfield Beach, Florida, United States, 33442
- Recruiting
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
-
Contact:
- Site Public Contact
- Phone Number: 305-243-2647
-
Principal Investigator:
- William Jin
-
Miami, Florida, United States, 33136
- Recruiting
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
Contact:
- Site Public Contact
- Phone Number: 305-243-2647
-
Principal Investigator:
- William Jin
-
Miami, Florida, United States, 33176
- Recruiting
- Miami Cancer Institute
-
Principal Investigator:
- Michael D. Chuong
-
Contact:
- Site Public Contact
- Phone Number: 786-596-2000
-
Orlando, Florida, United States, 32806
- Active, not recruiting
- Orlando Health Cancer Institute
-
-
Georgia
-
Atlanta, Georgia, United States, 30308
- Active, not recruiting
- Emory University Hospital Midtown
-
Atlanta, Georgia, United States, 30322
- Active, not recruiting
- Emory University Hospital/Winship Cancer Institute
-
Atlanta, Georgia, United States, 30342
- Active, not recruiting
- Emory Saint Joseph's Hospital
-
Atlanta, Georgia, United States, 30308
- Active, not recruiting
- Emory Proton Therapy Center
-
-
Illinois
-
Alton, Illinois, United States, 62002
- Recruiting
- Alton Memorial Hospital
-
Contact:
- Site Public Contact
- Phone Number: 618-463-7323
-
Principal Investigator:
- Gregory R. Vlacich
-
DeKalb, Illinois, United States, 60115
- Recruiting
- Northwestern Medicine Cancer Center Kishwaukee
-
Principal Investigator:
- Stephen A. Mihalcik
-
Contact:
- Site Public Contact
- Phone Number: 630-352-5360
- Email: Donald.Smith3@nm.org
-
Geneva, Illinois, United States, 60134
- Recruiting
- Northwestern Medicine Cancer Center Delnor
-
Principal Investigator:
- Stephen A. Mihalcik
-
Contact:
- Site Public Contact
- Phone Number: 630-352-5360
- Email: Donald.Smith3@nm.org
-
Shiloh, Illinois, United States, 62269
- Recruiting
- Memorial Hospital East
-
Contact:
- Site Public Contact
- Phone Number: 314-747-9912
- Email: dschwab@wustl.edu
-
Principal Investigator:
- Gregory R. Vlacich
-
Warrenville, Illinois, United States, 60555
- Recruiting
- Northwestern Medicine Cancer Center Warrenville
-
Principal Investigator:
- Stephen A. Mihalcik
-
Contact:
- Site Public Contact
- Phone Number: 630-352-5360
- Email: Donald.Smith3@nm.org
-
-
Maryland
-
Baltimore, Maryland, United States, 21201
- Recruiting
- University of Maryland/Greenebaum Cancer Center
-
Contact:
- Site Public Contact
- Phone Number: 800-888-8823
-
Principal Investigator:
- Jason K. Molitoris
-
Baltimore, Maryland, United States, 21201
- Recruiting
- Maryland Proton Treatment Center
-
Contact:
- Site Public Contact
- Phone Number: 410-369-5226
- Email: info@mdproton.com
-
Principal Investigator:
- Jason K. Molitoris
-
Bel Air, Maryland, United States, 21014
- Recruiting
- UM Upper Chesapeake Medical Center
-
Contact:
- Site Public Contact
- Phone Number: 443-643-3010
-
Principal Investigator:
- Jack J. Hong
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02114
- Recruiting
- Massachusetts General Hospital Cancer Center
-
Principal Investigator:
- Florence K. Keane
-
Contact:
- Site Public Contact
- Phone Number: 877-726-5130
-
-
Michigan
-
Bay City, Michigan, United States, 48706
- Recruiting
- McLaren Cancer Institute-Bay City
-
Principal Investigator:
- Christian C. Hyde
-
Contact:
- Site Public Contact
- Phone Number: 313-576-9790
- Email: ctoadmin@karmanos.org
-
Dearborn, Michigan, United States, 48124
- Recruiting
- Beaumont Hospital - Dearborn
-
Principal Investigator:
- John M. Robertson
-
Contact:
- Site Public Contact
- Phone Number: 248-551-7695
-
Detroit, Michigan, United States, 48201
- Recruiting
- Wayne State University/Karmanos Cancer Institute
-
Principal Investigator:
- Christian C. Hyde
-
Contact:
- Site Public Contact
- Phone Number: 313-576-9790
- Email: ctoadmin@karmanos.org
-
Farmington Hills, Michigan, United States, 48334
- Recruiting
- Weisberg Cancer Treatment Center
-
Principal Investigator:
- Christian C. Hyde
-
Contact:
- Site Public Contact
- Phone Number: 313-576-9790
- Email: ctoadmin@karmanos.org
-
Flint, Michigan, United States, 48532
- Recruiting
- McLaren Cancer Institute-Flint
-
Principal Investigator:
- Christian C. Hyde
-
Contact:
- Site Public Contact
- Phone Number: 313-576-9790
- Email: ctoadmin@karmanos.org
-
Lansing, Michigan, United States, 48910
- Recruiting
- Karmanos Cancer Institute at McLaren Greater Lansing
-
Principal Investigator:
- Christian C. Hyde
-
Contact:
- Site Public Contact
- Phone Number: 313-576-9790
- Email: ctoadmin@karmanos.org
-
Lapeer, Michigan, United States, 48446
- Recruiting
- McLaren Cancer Institute-Lapeer Region
-
Principal Investigator:
- Christian C. Hyde
-
Contact:
- Site Public Contact
- Phone Number: 313-576-9790
- Email: ctoadmin@karmanos.org
-
Owosso, Michigan, United States, 48867
- Recruiting
- McLaren Cancer Institute-Owosso
-
Principal Investigator:
- Christian C. Hyde
-
Contact:
- Site Public Contact
- Phone Number: 313-576-9790
- Email: ctoadmin@karmanos.org
-
Royal Oak, Michigan, United States, 48073
- Recruiting
- William Beaumont Hospital-Royal Oak
-
Principal Investigator:
- John M. Robertson
-
Contact:
- Site Public Contact
- Phone Number: 248-551-7695
-
Troy, Michigan, United States, 48085
- Recruiting
- William Beaumont Hospital - Troy
-
Principal Investigator:
- John M. Robertson
-
Contact:
- Site Public Contact
- Phone Number: 248-551-7695
-
-
Minnesota
-
Albert Lea, Minnesota, United States, 56007
- Completed
- Mayo Clinic Health System in Albert Lea
-
Coon Rapids, Minnesota, United States, 55433
- Recruiting
- Mercy Hospital
-
Contact:
- Site Public Contact
- Phone Number: 952-993-1517
- Email: mmcorc@healthpartners.com
-
Principal Investigator:
- Charles Shideman
-
Fridley, Minnesota, United States, 55432
- Active, not recruiting
- Unity Hospital
-
Mankato, Minnesota, United States, 56001
- Completed
- Mayo Clinic Health Systems-Mankato
-
Maplewood, Minnesota, United States, 55109
- Recruiting
- Minnesota Oncology Hematology PA-Maplewood
-
Contact:
- Site Public Contact
- Phone Number: 952-993-1517
- Email: mmcorc@healthpartners.com
-
Principal Investigator:
- Charles Shideman
-
Minneapolis, Minnesota, United States, 55415
- Recruiting
- Hennepin County Medical Center
-
Contact:
- Site Public Contact
- Phone Number: 952-993-1517
- Email: mmcorc@healthpartners.com
-
Principal Investigator:
- Charles Shideman
-
Northfield, Minnesota, United States, 55057
- Recruiting
- Mayo Clinic Radiation Therapy-Northfield
-
Principal Investigator:
- Christopher L. Hallemeier
-
Contact:
- Site Public Contact
- Phone Number: 855-776-0015
-
Rochester, Minnesota, United States, 55905
- Recruiting
- Mayo Clinic in Rochester
-
Principal Investigator:
- Christopher L. Hallemeier
-
Contact:
- Site Public Contact
- Phone Number: 855-776-0015
-
-
Missouri
-
Creve Coeur, Missouri, United States, 63141
- Recruiting
- Siteman Cancer Center at West County Hospital
-
Contact:
- Site Public Contact
- Phone Number: 800-600-3606
- Email: info@siteman.wustl.edu
-
Principal Investigator:
- Gregory R. Vlacich
-
Saint Louis, Missouri, United States, 63110
- Recruiting
- Washington University School of Medicine
-
Contact:
- Site Public Contact
- Phone Number: 800-600-3606
- Email: info@siteman.wustl.edu
-
Principal Investigator:
- Gregory R. Vlacich
-
Saint Louis, Missouri, United States, 63129
- Recruiting
- Siteman Cancer Center-South County
-
Contact:
- Site Public Contact
- Phone Number: 800-600-3606
- Email: info@siteman.wustl.edu
-
Principal Investigator:
- Gregory R. Vlacich
-
Saint Louis, Missouri, United States, 63136
- Recruiting
- Siteman Cancer Center at Christian Hospital
-
Contact:
- Site Public Contact
- Phone Number: 800-600-3606
- Email: info@siteman.wustl.edu
-
Principal Investigator:
- Gregory R. Vlacich
-
Saint Peters, Missouri, United States, 63376
- Recruiting
- Siteman Cancer Center at Saint Peters Hospital
-
Contact:
- Site Public Contact
- Phone Number: 800-600-3606
- Email: info@siteman.wustl.edu
-
Principal Investigator:
- Gregory R. Vlacich
-
-
New Jersey
-
Basking Ridge, New Jersey, United States, 07920
- Recruiting
- Memorial Sloan Kettering Basking Ridge
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Principal Investigator:
- Abraham J. Wu
-
Middletown, New Jersey, United States, 07748
- Recruiting
- Memorial Sloan Kettering Monmouth
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Principal Investigator:
- Abraham J. Wu
-
Montvale, New Jersey, United States, 07645
- Recruiting
- Memorial Sloan Kettering Bergen
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Principal Investigator:
- Abraham J. Wu
-
-
New York
-
Commack, New York, United States, 11725
- Recruiting
- Memorial Sloan Kettering Commack
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Principal Investigator:
- Abraham J. Wu
-
Harrison, New York, United States, 10604
- Recruiting
- Memorial Sloan Kettering Westchester
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Principal Investigator:
- Abraham J. Wu
-
New York, New York, United States, 10065
- Recruiting
- Memorial Sloan Kettering Cancer Center
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Principal Investigator:
- Abraham J. Wu
-
New York, New York, United States, 10035
- Recruiting
- New York Proton Center
-
Contact:
- Site Public Contact
- Phone Number: 646-968-9031
- Email: ichoi@nyproton.com
-
Principal Investigator:
- Jehee I. Choi
-
Uniondale, New York, United States, 11553
- Recruiting
- Memorial Sloan Kettering Nassau
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Principal Investigator:
- Abraham J. Wu
-
-
Ohio
-
Avon, Ohio, United States, 44011
- Recruiting
- UH Seidman Cancer Center at UH Avon Health Center
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
-
Beachwood, Ohio, United States, 44122
- Recruiting
- UHHS-Chagrin Highlands Medical Center
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
Chardon, Ohio, United States, 44024
- Recruiting
- Geauga Hospital
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
Cincinnati, Ohio, United States, 45219
- Recruiting
- University of Cincinnati Cancer Center-UC Medical Center
-
Principal Investigator:
- Jordan Kharofa
-
Contact:
- Site Public Contact
- Phone Number: 513-584-7698
- Email: cancer@uchealth.com
-
Cleveland, Ohio, United States, 44106
- Recruiting
- Case Western Reserve University
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
Elyria, Ohio, United States, 44035
- Suspended
- Mercy Cancer Center-Elyria
-
Mayfield Heights, Ohio, United States, 44124
- Recruiting
- UH Seidman Cancer Center at Landerbrook Health Center
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
Mentor, Ohio, United States, 44060
- Recruiting
- UH Seidman Cancer Center at Lake Health Mentor Campus
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
Middleburg Heights, Ohio, United States, 44130
- Recruiting
- UH Seidman Cancer Center at Southwest General Hospital
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
Parma, Ohio, United States, 44129
- Recruiting
- University Hospitals Parma Medical Center
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
Ravenna, Ohio, United States, 44266
- Recruiting
- University Hospitals Portage Medical Center
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
Sandusky, Ohio, United States, 44870
- Recruiting
- UH Seidman Cancer Center at Firelands Regional Medical Center
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
Wadsworth, Ohio, United States, 44281
- Recruiting
- University Hospitals Sharon Health Center
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
West Chester, Ohio, United States, 45069
- Recruiting
- University of Cincinnati Cancer Center-West Chester
-
Principal Investigator:
- Jordan Kharofa
-
Contact:
- Site Public Contact
- Phone Number: 513-584-7698
- Email: cancer@uchealth.com
-
Westlake, Ohio, United States, 44145
- Suspended
- UH Seidman Cancer Center at Saint John Medical Center
-
Westlake, Ohio, United States, 44145
- Recruiting
- UHHS-Westlake Medical Center
-
Principal Investigator:
- Lauren E. Henke
-
Contact:
- Site Public Contact
- Phone Number: 800-641-2422
- Email: CTUReferral@UHhospitals.org
-
-
Oklahoma
-
Oklahoma City, Oklahoma, United States, 73104
- Recruiting
- University of Oklahoma Health Sciences Center
-
Contact:
- Site Public Contact
- Phone Number: 405-271-8777
- Email: ou-clinical-trials@ouhsc.edu
-
Principal Investigator:
- Tyler Gunter
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19104
- Recruiting
- University of Pennsylvania/Abramson Cancer Center
-
Principal Investigator:
- John P. Plastaras
-
Contact:
- Site Public Contact
- Phone Number: 800-474-9892
-
-
Tennessee
-
Knoxville, Tennessee, United States, 37916
- Recruiting
- Thompson Cancer Survival Center
-
Contact:
- Site Public Contact
- Phone Number: 865-331-1812
-
Principal Investigator:
- Grant M. Clark
-
Knoxville, Tennessee, United States, 37932
- Recruiting
- Thompson Cancer Survival Center - West
-
Contact:
- Site Public Contact
- Phone Number: 865-331-1812
-
Principal Investigator:
- Grant M. Clark
-
Knoxville, Tennessee, United States, 37909
- Recruiting
- Thompson Proton Center
-
Contact:
- Site Public Contact
- Phone Number: 865-531-5118
- Email: jwilso31@covhlth.com
-
Principal Investigator:
- Grant M. Clark
-
Maryville, Tennessee, United States, 37804
- Recruiting
- Thompson Oncology Group-Maryville
-
Contact:
- Site Public Contact
- Phone Number: 865-331-1812
-
Principal Investigator:
- Grant M. Clark
-
Oak Ridge, Tennessee, United States, 37830
- Recruiting
- Thompson Oncology Group-Oak Ridge
-
Contact:
- Site Public Contact
- Phone Number: 865-331-1812
-
Principal Investigator:
- Grant M. Clark
-
-
Texas
-
Conroe, Texas, United States, 77384
- Recruiting
- MD Anderson in The Woodlands
-
Contact:
- Site Public Contact
- Phone Number: 866-632-6789
- Email: askmdanderson@mdanderson.org
-
Principal Investigator:
- Saumil Gandhi
-
Houston, Texas, United States, 77030
- Recruiting
- M D Anderson Cancer Center
-
Contact:
- Site Public Contact
- Phone Number: 877-632-6789
- Email: askmdanderson@mdanderson.org
-
Principal Investigator:
- Saumil Gandhi
-
Houston, Texas, United States, 77079
- Recruiting
- MD Anderson West Houston
-
Contact:
- Site Public Contact
- Phone Number: 877-632-6789
- Email: askmdanderson@mdanderson.org
-
Principal Investigator:
- Saumil Gandhi
-
League City, Texas, United States, 77573
- Recruiting
- MD Anderson League City
-
Contact:
- Site Public Contact
- Phone Number: 877-632-6789
- Email: askmdanderson@mdanderson.org
-
Principal Investigator:
- Saumil Gandhi
-
Sugar Land, Texas, United States, 77478
- Recruiting
- MD Anderson in Sugar Land
-
Contact:
- Site Public Contact
- Phone Number: 877-632-6789
- Email: askmdanderson@mdanderson.org
-
Principal Investigator:
- Saumil Gandhi
-
-
Utah
-
Salt Lake City, Utah, United States, 84112
- Recruiting
- Huntsman Cancer Institute/University of Utah
-
Contact:
- Site Public Contact
- Phone Number: 888-424-2100
- Email: cancerinfo@hci.utah.edu
-
Principal Investigator:
- Shane Lloyd
-
-
Virginia
-
Alexandria, Virginia, United States, 22304
- Recruiting
- Inova Alexandria Hospital
-
Contact:
- Site Public Contact
- Phone Number: 703-776-2580
- Email: Stephanie.VanBebber@inova.org
-
Principal Investigator:
- Avani D. Rao
-
Fairfax, Virginia, United States, 22031
- Recruiting
- Inova Schar Cancer Institute
-
Principal Investigator:
- Avani D. Rao
-
Contact:
- Site Public Contact
- Phone Number: 703-720-5210
- Email: Stephanie.VanBebber@inova.org
-
Fairfax, Virginia, United States, 22033
- Recruiting
- Inova Fair Oaks Hospital
-
Principal Investigator:
- Avani D. Rao
-
Contact:
- Site Public Contact
- Phone Number: 703-720-5210
- Email: Stephanie.VanBebber@inova.org
-
Leesburg, Virginia, United States, 20176
- Recruiting
- Inova Loudoun Hospital
-
Principal Investigator:
- Avani D. Rao
-
Contact:
- Site Public Contact
- Phone Number: 703-858-6000
- Email: Keary.janet@inova.org
-
-
Washington
-
Seattle, Washington, United States, 98195
- Active, not recruiting
- University of Washington Medical Center - Montlake
-
-
Wisconsin
-
Eau Claire, Wisconsin, United States, 54701
- Recruiting
- Mayo Clinic Health System-Eau Claire Clinic
-
Principal Investigator:
- Christopher L. Hallemeier
-
Contact:
- Site Public Contact
- Phone Number: 855-776-0015
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- PRIOR TO STEP 1 REGISTRATION:
- Histologically proven diagnosis of adenocarcinoma or squamous cell carcinoma of the thoracic esophagus or gastroesophageal junction (Siewert I-II)
Stage I-IVA, excluding T4b, according to the American Joint Committee on Cancer (AJCC) 8th edition based on the following diagnostic workup:
- History/physical examination
Whole-body fludeoxyglucose F-18 (FDG)-positron emission tomography (PET)/computed tomography (CT) with or without (+/-) contrast (preferred) or chest/abdominal (include pelvic if clinically indicated) CT with contrast
- For patients who DID NOT receive induction chemotherapy, scan must occur within 30 days prior to Step 1 registration
For patients who DID receive induction chemotherapy, scan must occur:
- Within 30 days after final induction chemotherapy dose; OR
- Within 30 days prior to Step 1 registration
- Note: Patients who had prior endoscopic mucosal resection (EMR) with a diagnosis of AJCC stage I-IVA, excluding T4b, esophageal cancer are eligible
- Surgical consultation to determine whether or not the patient is a candidate for resection after completion of chemoradiation
- Induction chemotherapy for the current malignancy prior to concurrent chemoradiation allowed if last dose is no more than 90 days and no less than 10 days prior to Step 1 registration. Only FOLFOX will be allowed as the induction chemotherapy regimen.
- Zubrod performance status 0, 1, or 2
Absolute neutrophil count (ANC) (within 30 days prior to Step 1 registration)
- For patients who DID NOT receive induction chemotherapy: ANC >= 1,500 cells/mm^3
- For patients who DID receive induction chemotherapy: ANC >= 1,000 cells/mm^3
Platelets (within 30 days prior to Step 1 registration)
- For patients who DID NOT receive induction chemotherapy: Platelets >= 100,000/uL
- For patients who DID receive induction chemotherapy: Platelets >= 75,000/uL
- Hemoglobin >= 8.0 g/dl (Note: The use of transfusion or other intervention to achieve Hgb >= 8.0 g/dl is acceptable) (within 30 days prior to Step 1 registration)
- Serum creatinine ≤ 1.5 x upper limit of normal (ULN) or Creatinine clearance > 40 mL/min estimated by Cockcroft-Gault formula (within 30 days prior to Step 1 registration)
- Total bilirubin =< 1.5 x upper limit of normal (ULN) (within 30 days prior to Step 1 registration)
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3 x ULN (within 30 days prior to Step 1 registration)
- Negative pregnancy test (serum or urine) within 14 days prior to Step 1 registration for women of child bearing potential
- The patient or a legally authorized representative must provide study-specific informed consent prior to study entry
Exclusion Criteria:
- Cervical esophageal cancers arisen from 15-18 cm from the incisors
- Patients with T4b disease according to the AJCC 8th edition
- Definitive clinical or radiologic evidence of metastatic disease
- Any active malignancy within 2 years of study registration that may alter the course of esophageal cancer treatment
- Prior thoracic radiotherapy that would result in overlap of radiation therapy fields
Severe, active co-morbidity defined as follows:
- Active uncontrolled infection requiring IV antibiotics at the time of Step 1 registration
- Uncontrolled symptomatic congestive heart failure, unstable angina, or cardiac arrhythmia not controlled by any device or medication at the time of Step 1 registration
- Myocardial infarction within 3 months prior to Step 1 registration
- Pregnant and/or nursing females
- Human immunodeficiency virus (HIV) positive with CD4 count < 200 cells/microliter. Note that patients who are HIV positive are eligible, provided they are under treatment with highly active antiretroviral therapy (HAART) and have a CD4 count >= 200 cells/microliter within 30 days prior to registration. Note also that HIV testing is not required for eligibility for this protocol. This exclusion criterion is necessary because the treatments involved in this protocol may be significantly immunosuppressive
- PRIOR TO STEP 2 REGISTRATION:
- Unable to obtain confirmation of payment coverage (insurance or other) for either possible radiation treatment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Group I (PBT, Chemotherapy, Esophagectomy)
Patients undergo PBT over 28 fractions 5 days a week for 5.5 weeks to a total dose of 50.4 Gy.
Patients also receive chemotherapy (Choice of 3 regimens: 1. Carboplatin/Paclitaxel, 2. FOLFOX/CAPOX or 3. Docetaxel/5-FU [with capecitabine as an acceptable substitute for 5-FU]) per institutional standards while undergoing PBT.
Within 4-8 weeks after completion of chemotherapy and radiation therapy, patients may undergo an esophagectomy per physician discretion.
|
Given IV
Other Names:
Ancillary studies
Other Names:
Ancillary studies
Given IV
Other Names:
Chemotherapy
Other Names:
Undergo esophagectomy
Other Names:
Undergo PBT
Other Names:
Folinic acid, flurouracil and oxaliplatin
Other Names:
Capecitabine combined with oxaliplatin
Other Names:
Chemotherapy
Other Names:
|
Active Comparator: Group II (IMRT, Chemotherapy, Esophagectomy)
Patients undergo IMRT over 28 fractions 5 days a week for 5.5 weeks to a total dose of 50.4 Gy.
Patients also receive chemotherapy (Choice of 3 regimens: 1. Carboplatin/Paclitaxel, 2. FOLFOX/CAPOX or 3. Docetaxel/5-FU [with capecitabine as an acceptable substitute for 5-FU]) per institutional standards while undergoing IMRT.
Within 4-8 weeks after completion of chemotherapy and radiation therapy, patients may undergo an esophagectomy per physician discretion.
|
Given IV
Other Names:
Ancillary studies
Other Names:
Ancillary studies
Given IV
Other Names:
Undergo IMRT
Other Names:
Chemotherapy
Other Names:
Undergo esophagectomy
Other Names:
Folinic acid, flurouracil and oxaliplatin
Other Names:
Capecitabine combined with oxaliplatin
Other Names:
Chemotherapy
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall survival (OS)
Time Frame: From the date of randomization to the date of death due to any cause or date of last follow-up for patients without an OS event reported. This analysis occurs after 173 deaths; estimated to occur 4 years after accrual completion
|
Will be estimated by the Kaplan-Meier method.
The distributions of OS between treatment arms will be compared using the log rank test.
|
From the date of randomization to the date of death due to any cause or date of last follow-up for patients without an OS event reported. This analysis occurs after 173 deaths; estimated to occur 4 years after accrual completion
|
Incidence of specific grade 3+ cardiopulmonary adverse events (AEs) that are definitely, probably, or possibly related to protocol treatment
Time Frame: From baseline up to 8 years
|
Will be assessed using Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0.
Difference in proportion of defined cardiopulmonary AEs will be analyzed with a chi-squared test.
|
From baseline up to 8 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pathologic response rate
Time Frame: At time of surgery
|
A Chi-square test will be used to compare the pathologic response rates between the treatment arms.
|
At time of surgery
|
Grade 4 lymphopenia during chemoradiation
Time Frame: From the start of chemoradiation to the end of chemoradiation treatment assessed up to 31 days
|
Will be assessed using Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0.
The proportion of patients experiencing grade 4 lymphopenia during chemoradiation will be compared between treatment arms using a chi-squared test.
|
From the start of chemoradiation to the end of chemoradiation treatment assessed up to 31 days
|
Lymphocyte counts
Time Frame: From the last date of chemoradiation up to 8 weeks post chemoradiation
|
Mean lymphocyte counts at first post chemoradiation follow-up will be compared between treatment arms using a t-test.
If the data do not satisfy the normality assumption, a Wilcoxin test may be used instead.
|
From the last date of chemoradiation up to 8 weeks post chemoradiation
|
Locoregional failure (LRF)
Time Frame: From the date of randomization to the date of first LRF or date of last follow-up for patients without an LRF event reported, assessed up to 8 years
|
Will be defined as local/regional recurrence or progression.
Will be estimated by the cumulative incidence method, with death as a competing risk.
The distribution of LRF estimates between the two arms will be compared using Gray?s test.
The Fine-Gray regression model will be used to analyze the effects of factors, in addition to treatment, which may be associated with LRF.
|
From the date of randomization to the date of first LRF or date of last follow-up for patients without an LRF event reported, assessed up to 8 years
|
Distant metastatic-free survival (DMFS)
Time Frame: From the date of randomization to the date of first DMFS failure or last follow-up for patients without a reported DMFS event, assessed up to 8 years
|
Will be defined as appearance of distant metastasis or death due to any cause.
Will be estimated by the Kaplan-Meier method and estimates between the two treatment arms will be compared using the log rank test.
The Cox proportional hazard regression model will be used to analyze the effects of factors, in addition to treatment, which may be associated with DMFS.
|
From the date of randomization to the date of first DMFS failure or last follow-up for patients without a reported DMFS event, assessed up to 8 years
|
Progression-free survival
Time Frame: From the date of randomization to the date of first PFS failure or last follow-up for patients without a reported PFS event, assessed up to 8 years
|
Will be defined as appearance of local/regional/distant failure or death due to any cause.
Will be estimated by the Kaplan-Meier method and estimates between the two treatment arms will be compared using the log rank test.
The Cox proportional hazard regression model will be used to analyze the effects of factors, in addition to treatment, which may be associated with PFS.
|
From the date of randomization to the date of first PFS failure or last follow-up for patients without a reported PFS event, assessed up to 8 years
|
Quality-adjusted life years (QALY)
Time Frame: Assessed up to 8 years
|
Will be evaluated and compared using EuroQol five-dimensional questionnaire (EQ-5D) only if the primary endpoint is met.
|
Assessed up to 8 years
|
Cost-benefit economic analysis of treatment
Time Frame: Assessed up to 8 years
|
Will be calculated by the visual analog scale (VAS) and index scores form the EQ-5D-5L only be done if primary endpoint is met.
Will be compared between treatment arms using a t-test with a 2-sided significance level of 0.05.
If there are significant differences, then a cost analysis will be conducted.
|
Assessed up to 8 years
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Steven Lin, NRG Oncology
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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 by Histologic Type
- Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Head and Neck Neoplasms
- Esophageal Diseases
- Neoplasms, Squamous Cell
- Carcinoma
- Adenocarcinoma
- Carcinoma, Squamous Cell
- Esophageal Neoplasms
- Esophageal Squamous Cell Carcinoma
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Docetaxel
- Carboplatin
- Paclitaxel
- Fluorouracil
- Albumin-Bound Paclitaxel
Other Study ID Numbers
- NRG-GI006 (Other Identifier: CTEP)
- U10CA180868 (U.S. NIH Grant/Contract)
- NCI-2018-03378 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- U10CA180822 (U.S. NIH Grant/Contract)
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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