- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04084158
A Study of Toripalimab Combined With Concurrent Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma.
A Phase II, Randomized, Open Label, Multi-center Design Study of Toripalimab Given Before and After Concurrent Chemoradiotherapy in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma
Study Overview
Status
Conditions
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Zhejiang
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Hangzhou, Zhejiang, China, 310022
- Zhejiang Cancer Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 18≤age≤75.
- Histologically or cytologically confirmed esophageal squamous carcinoma.
- Patients must have unresectable disease as assessed by thoracic surgeons or refuse surgical treatment.
- The investigator confirmed at least one measurable lesion according to RECIST 1.1.
- Stage II-IVA (AJCC 8th)
- No adjacent organs infringed confirmed by endoscopic ultrasonography (T1-3).
- ECOG PS 0-1.
- FEV1>0.8L
- Life expectancy is not less than 12 weeks.
- No prior chemotherapy, radiotherapy, biotherapy, immunotherapy or other anti-tumor treatment for esophageal cancer.
- Adequate organ function defined at baseline as: 1) ANC ≥1.5×109 /L,PLt ≥100×109 /L,Hb ≥90 g/L; 2) TBIL ≤1.5×ULN, ALT ≤2.5ULN, AST ≤2.5ULN, BUN and Cr ≤1×ULN or Ccr ≥50ml/min (Cockcroft-Gault formula); 3) INR ≤1.5×ULN or PT ≤1.5×ULN (If the patient is receiving anticoagulant therapy, PT should be within the intended use range of the anticoagulant drug); 4) Myocardial zymogram is within normal range.
- Women of childbearing age must have taken reliable contraceptive measures or have a pregnancy test (serum or urine) within 7 days prior to enrollment and the results are negative. Besides, subjects should agree to use effective methods of contraception during the trial and within 2 months of the last dose of anti-PD-1 antibody. For male subjects whose spouse are of childbearing age, effective contraceptive methods should be used during the trial and within 2 months after the last dose of anti-PD-1 antibodies;
- Subject volunteers to join the study, Signs informed consent, has good compliance and can cooperate with follow-up.
Exclusion Criteria:
- Those with prior or concurrent uncured malignant tumor. cured skin basal cell carcinoma, cervical cancer and superficial bladder cancer were excluded.
- Esophageal cancer patients with primary multifocal lesions.
- Those with the pathology of small cell esophageal carcinoma, esophageal adenocarcinoma or mixed carcinoma.
- Primary esophageal squamous carcinoma with active hemorrhage of the primary lesion within 2 months.
- Those with primary esophageal lesion that was closely related to tracheal bronchus and great vessels, and were evaluated with a great risk of perforation and massive bleeding by the researchers.
- Patients with any active autoimmune disease or autoimmune disease history (such as interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, vasculitis, myocarditis, nephritis, hyperthyroidism, and hypothyroidism (those with normal thyroid function after hormone replacement therapy could be enrolled); those with leucoderma or childhood asthma that was completely relieved and required no intervention during adulthood could be enrolled, while asthma patients requiring bronchodilators and medical intervention should not be enrolled.
- Patients with uncontrolled cardiovascular disease: grade II and above myocardial ischemia or myocardial infarction, and poorly-controlled arrhythmia (including the QTc interval of ≥470 ms); those with grade III-IV cardiac insufficiency according to the NYHA criteria, or those whose echocardiography revealed left ventricular ejection fraction (LVEF) of <50%; and those having myocardial infarction within 1 year.
- Those with active infection or fever of >38.5 ℃ with unknown cause during the screening period and before the first administration (patients with tumor-induced fever judged by the researchers could be enrolled).
- Those with interstitial lung disease or active non-infectious pneumonia history or evidence.
- Those with congenital or acquired immunodeficiency (such as those with HIV infection), active hepatitis B (HBV-DNA≥104 copies/ml) or hepatitis C (positive hepatitis C antibody, and the HCR-RNA was higher than the lower limit of detection of the analysis method).
- Those who had previously received other PD-1 antibody treatment or PD-1/PD-L1 targeted immune therapy.
- Those who were known to be allergic to paclitaxel, carboplatin, macromolecular protein preparation, or any anti-PD-1 antibody component.
- Subjects who required to use corticosteroids (prednison dose of > 10 mg/day) or other immunosuppressors for systemic treatment within the first 7 days of research. In the absence of active autoimmune disease, glucocorticoids at physiological dose (≤ 10 mg/day prednison or equivalent drug), inhalation or local application of steroid and adrenocortical hormone replacement treatment with prednison at the dose of > 10 mg/day.
- Those receiving anti-tumor monoclonal antibody (mAb) and targeted small molecule treatment within 4 weeks before the initial use of the research drug, or those with unrecovered adverse events induced by the previous treatment (namely, grade ≤ 1 or reaching the baseline level). Apart from subjects with ≤ grade 2 nervous lesion or ≤ grade 2 alopecia, any subject that had received major surgery should sufficiently recover from the toxic reaction and/or complication resulted from the surgical intervention before the initiation of treatment.
- Those who were within 4 weeks before the initial use of the research drug (subjects that had entered the follow-up period were calculated at the final use of experimental drug or instrument) or those who were participating other clinical research.
- Patients should be inoculated with live vaccine within 4 weeks before the initial use of research drug, inactivated viral vaccine specific to seasonal influenza for injection was allowed, but the nasal use of live attenuated influenza vaccine was not allowed.
- Pregnant women or breast-feeding women.
Subjects who had other factors that might force them to terminate the research ahead of time, such as the development of other severe disease (including mental disease) that required combined treatment, seriously abnormal laboratory examination value, and family or social factors that might affect the subject safety or experimental data collection, as judged by the researchers.
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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 |
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Experimental: Toripalimab+chemoradiation
Induction immunotherapy: Toripalimab injection (JS001) 3mg/kg IV q 14 days x 2 cycles. Concurrent Chemoradiotherapy: Starting within 4 weeks after the first cycle induction immunotherapy. carboplatin AUC = 2 + albumin-bound paclitaxel 60 mg/m2 or paclitaxel liposome 45 mg/m2 or paclitaxel 45 mg/m2 IV weekly x 6 weeks concurrent with radiation to a total dose of 50.4 Gy given in 1.8 Gy fractions daily x 28 fractions. Progression of disease (PD): The progress of the disease will be assessed within 4 weeks after concurrent chemoradiotherapy. Patients without disease progression continue to receive consolidation and adjuvant therapy. Consolidation chemotherapy: carboplatin AUC = 6 + albumin-bound paclitaxel 260 mg/m2 or paclitaxel liposome 135 mg/m2 or paclitaxel 135 mg/m2 IV q 21 days x 6 cycles. Adjuvant immunotherapy:Toripalimab injection (JS001) 3mg/kg IV q 14 days up to 1 year. |
Toripalimab injection (JS001) is a humanized IgG4 monoclonal antibody against the programmed death-1 (PD-1) receptor, blocks the interaction of PD-1 with its ligands and promotes T cell activation in preclinical studies.
Paclitaxel
PTV 50.4Gy/28 fractions, PGTV 61.6Gy/28 fractions, once a day, 5 days a week.
carboplatin
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Active Comparator: chemoradiation
Concurrent Chemoradiotherapy: carboplatin AUC = 2 + albumin-bound paclitaxel 60 mg/m2 or Liposome paclitaxel 45 mg/m2 or paclitaxel 45 mg/m2 IV weekly x 6 weeks concurrent with radiation to a total dose of 50.4 Gy given in 1.8 Gy fractions daily x 28 fractions. Progression of disease (PD): The progress of the disease will be assessed within 4 weeks after concurrent chemoradiotherapy. Patients without disease progression continue to receive consolidation therapy. Consolidation chemotherapy: carboplatin AUC = 6 + albumin-bound paclitaxel 260 mg/m2 or paclitaxel liposome 135 mg/m2 or paclitaxel 135 mg/m2 IV q 21 days x 6 cycles. |
Paclitaxel
PTV 50.4Gy/28 fractions, PGTV 61.6Gy/28 fractions, once a day, 5 days a week.
carboplatin
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PFS
Time Frame: 2 years
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Progression-Free Survival
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2 years
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
OS
Time Frame: 3 years
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Overall Survival
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3 years
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Objective Response Rate
Time Frame: analysis is completed 4 weeks after concurrent chemoradiation
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Ratio of CR and PR (RECIST 1.1) in all subjects
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analysis is completed 4 weeks after concurrent chemoradiation
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DoR
Time Frame: 2 years
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Duration of Response
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2 years
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TTDM
Time Frame: 3 years
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Time to distant Metastasis
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3 years
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: chen ming, MD, Zhejiang Cancer Hospital
- Principal Investigator: Yujin Xu, MD, Zhejiang Cancer Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- Esophageal Neoplasms
- Carcinoma
- Carcinoma, Squamous Cell
- Esophageal Squamous Cell Carcinoma
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Paclitaxel
- Albumin-Bound Paclitaxel
Other Study ID Numbers
- IESO001
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
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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