TC Plus PD-1 Inhibitors Combined With Anlotinib for Advanced Advanced Esophageal Cancer (TC)

Paclitaxel and Carboplatin Plus PD-1 Inhibitors Combined With Anlotinib for Advanced Esophageal Cancer(ESCC)

A Controlled Clinical Study of TC/PD-1 Inhibitors Combined With anlotinib as First-line Treatment for Advanced ESCC

Study Overview

• Status: Not yet recruiting
• Conditions: ESCC
• Intervention / Treatment: Drug: TC/PD-1 inhibitor/anlotinib

Detailed Description

The incidence rate of esophageal cancer is high in China and mainly squamous cell carcinoma. In recent years, although the level of surgery, radiotherapy and chemotherapy of esophageal cancer has improved, and studies have confirmed the role of anlotinib and PD-1 mAb in the posterior line treatment of esophageal squamous cell carcinoma, the prognosis of esophageal cancer is still not ideal. How to expand the clinical benefits of immunotherapy in esophageal cancer has become a research hotspot. Recent studies have shown that PD-1 mAb combined with other therapies with different mechanisms can improve the efficacy of immunotherapy. In the impawer150 study, platinum containing dual drug chemotherapy plus anti angiogenesis therapy combined with immunotherapy showed statistically and clinically significant PFS benefits in the first-line treatment of advanced non-small-cell lung cancer, which provides a new choice for the first-line treatment of advanced non-small-cell lung cancer. So far, there is no report on the first-line treatment of advanced esophageal squamous cell carcinoma with platinum containing dual drug chemotherapy plus anti angiogenesis drugs combined with immunotherapy. The purpose of this study is to evaluate the efficacy of cisplatin plus cisplatin in the treatment of advanced esophageal cancer.

• Study Type: Interventional
• Enrollment (Anticipated): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Chongqing
    • Chongqing, Chongqing, China, 400042
      • Daping Hospital, Third Military Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Patients volunteered to participate in the study and signed the informed consent;
2. Age 18-75, both male and female;
3. Histologically or cytologically confirmed advanced or metastatic (stage IIIB, III C or IV) ESCC .
4. At least one measurable lesion according to RECIST 1.1,which should not be treated locally, such as radiotherapy.
5. ECOG PS 0-1- Page 3 of 5 [DRAFT] -
6. Expected survival ≥ 3 months
7. Patients who never received systemic therapy in the past, including radiotherapy ,chemotherapy, targeted therapy and immunotherapy , or patients who relapsed more than 6 months after adjuvant chemotherapy.
8. The main organ functions accorded with the following criteria within 7 days before treatment:

(1)Blood routine examination ( without blood transfusion in 14 days): hemoglobin (HB) ≥ 90 g/L; neutrophil absolute value (ANC) ≥ 1.5 *109/L; platelet (PLT) ≥80 *109/L.

(2) Biochemical tests should meet the following criteria: 1) total bilirubin (TBIL) ≤1.5 times of upper limit of normal (ULN); 2) alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 *ULN, if accompanied by liver metastasis, ALT and AST ≤ 5* ULN; 3) serum creatinine (Cr) ≤ 1.5* ULN or creatinine clearance rate (CCr) ≥ 60 ml/min;4) Serum albumin (≥35g/L). (3) Doppler echocardiography: left ventricular ejection fraction (LVEF) ≥the low limit of normal value (50%).

9 Tissue samples should be provided for biomarker analysis (such as PD-L1 ) Patients who could not provide new tissues could provide 5-8 paraffin sections of 3-5 μm by archival preservation.

Exclusion Criteria:

1. Severe allergic reactions to humanized antibodies or fusion proteins in the past
2. known to have hypersensitivity to any component contained in Endostar or antibody preparations;
3. Diagnosed of immunodeficiency or received systemic glucocorticoid therapy or any other form of immunosuppressive therapy within 14 days before the study, allowing physiological doses of glucocorticoids (≤10mg/day prednisone or equivalent);
4. Patients with active, known or suspected autoimmune diseases. Patients with type I diabetes, hypothyroidism requiring hormone replacement therapy, skin disorders requiring no systemic treatment(such as vitiligo, psoriasis or alopecia). Patients who would not triggers can be included.
5. Serious heart disease, include congestive heart failure, uncontrollable high-risk arrhythmia, unstable angina pectoris, myocardial infarction, and severe valvular disease.
6. Patients treated targeted drugs such as bevacizumab, sunitinib, sorafenib, imatinib, famitinib, regiffenil, apatinib and anlotinib
7. Patients recieved systemic antineoplastic therapy, including cytotoxic therapy, signal transduction inhibitors, immunotherapy (or mitomycin C within 6 weeks before the grouping),recieved over-extended-field radiotherapy (EF-RT) within 4 weeks before the grouping or limited-field radiotherapy to evaluate the tumor lesions within 2 weeks before the grouping
8. Positive hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus antibody (HCV Ab), indicating acute or chronic infection.
9. Patients with active pulmonary tuberculosis (TB) infection judged by chest X-ray examination, sputum examination and clinical physical examination. Patients with active pulmonary tuberculosis infection in the previous year should be excluded even if they have been treated; Patients with active pulmonary tuberculosis infection more than a year ago should also be excluded unless the course and type of antituberculosis treatment previously were appropriate.
10. Patients with brain metastases with symptoms or symptoms controlling less than 2 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: NON_RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: group A，TCCA; paclitaxel for Injection 175 mg/m2,IV, d1/paclitaxel for Injection (Albumin Bound) 260mg/m2,IV, d1, q3w +carboplatin AUC 4-6,IV, d12,q3w +anlotinib 10mg, PO, d1-14, q3w +camrelizumab 200 mg, IV, d1, q3w, after the treatment for 4-6 cycles, camrelizumab plus anlotinib for maintenance therapy until PD or intolerable toxicity	Drug: TC/PD-1 inhibitor/anlotinib; chemotherapy and immunotherapy plus antiangiogenic therapy; Other Names: TC/PD-1 inhibitor
EXPERIMENTAL: group B，TCC; paclitaxel for Injection 175 mg/m2,IV, d1/paclitaxel for Injection (Albumin Bound) 260mg/m2,IV, d1, q3w +carboplatin AUC 4-6,IV, d12,q3w +camrelizumab 200 mg, IV, d1, q3w, after the treatment for 4-6 cycles, camrelizumab for maintenance therapy until PD or intolerable toxicity	Drug: TC/PD-1 inhibitor/anlotinib; chemotherapy and immunotherapy plus antiangiogenic therapy; Other Names: TC/PD-1 inhibitor
OTHER: group C，TC; paclitaxel for Injection 175 mg/m2,IV, d1/paclitaxel for Injection (Albumin Bound) 260mg/m2,IV, d1, q3w +carboplatin AUC 4-6,IV, d12,q3w	Drug: TC/PD-1 inhibitor/anlotinib; chemotherapy and immunotherapy plus antiangiogenic therapy; Other Names: TC/PD-1 inhibitor

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
overall survival (OS)	overall survival is defined as the time from randomization to death from any cause	approximately 36 months
objective response rate(ORR)	complete response(CR)+partial response(PR) according to RECIST 1.1	approximately 18 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
progression-free survival(PFS)	progression-free survival is defined as the time from enrollment to the date of first document disease progression or death from any cause	approximately 36 months

Collaborators and Investigators

• Sponsor: Dong Wang

Study record dates

Study Major Dates

• Study Start (ANTICIPATED): September 1, 2020
• Primary Completion (ANTICIPATED): August 31, 2022
• Study Completion (ANTICIPATED): August 31, 2023

Study Registration Dates

• First Submitted: July 12, 2020
• First Submitted That Met QC Criteria: July 12, 2020
• First Posted (ACTUAL): July 15, 2020

Study Record Updates

• Last Update Posted (ACTUAL): July 15, 2020
• Last Update Submitted That Met QC Criteria: July 12, 2020
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Keywords: anlotinib; PD-1
• 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; Immune Checkpoint Inhibitors
• Other Study ID Numbers: TCAC-ESCC-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No