- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05563922
Organ Preservation Strategy of Total Neoadjuvant Chemoradiotherapy for Low Rectal Carcinoma (OP-TNT)
September 28, 2022 updated by: Shanghai Zhongshan Hospital
Organ Preservation Strategy of Total Neoadjuvant Chemoradiotherapy for Early Low Rectal Carcinoma: A Prospective, Exploratory Trial
This study aims to evaluate the efficacy and safety of an organ-sparing strategy after neoadjuvant chemoradiotherapy followed by transanal endoscopic microsurgery (TEM) or endoscopic local resection for early low rectal cancer(cT 1-3N0M0).Besides, the clinical complete response rate and near-clinical complete response rate, organ preservation rate, local recurrence rate, distant metastasis rate and quality of life (QoL) will also be assessed.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Anticipated)
56
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Jian Wang, M.D.
- Phone Number: +8613816101686
- Email: wang.jian3@zs-hospital.sh.cn
Study Locations
-
-
Shanghai
-
Shanghai, Shanghai, China, 200032
- Recruiting
- Fudan University Zhongshan Hospital
-
Contact:
- Jian Wang
- Phone Number: +8613816101686
- Email: wang.jian3@zs-hospital.sh.cn
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
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:
- Age≥18 years
- cT1-3N0M0 assessed by CT, MRI and ultrasound colonoscopy
- Rectal adenocarcinoma confirmed by biopsy pathology and the lower edge of the lesion was within 5cm from the anal edge
- Patients who have a strong desire to preserve the anus and are willing to accept neoadjuvant treatment, meanwhile is suitable for the implementation of organ preservation strategy after discussion within the multidisciplinary team of the hospital
- No previous treatment (including endoscopic resection, transanal local resection, radiotherapy, chemotherapy, etc.) before enrollment
- No contraindications to chemoradiotherapy
- No other colorectal organic diseases
- Voluntarily sign the informed consent
Exclusion Criteria:
- Have received previous treatment (including endoscopic resection, transanal local resection, radiotherapy, chemotherapy, etc.) before enrollment
- Patients with concurrent colorectal organic diseases
- Patients with familial polyposis
- Patients with a previous history of colorectal surgery or pelvic radiotherapy that may affect the outcome of this treatment
- Pregnant or lactating women
- The patient or family members could not understand the conditions and objectives of this study
- With a history of uncontrolled epilepsy, central nervous system diseases, or mental disorders, their clinical severity may hinder the signing of an informed consent form or affect their compliance with oral medication
- It is difficult to achieve complete remission base on existing evidence , such as: maximum diameter of cT2/T3 tumor>4cm; suspicious Lateral lymph nodes (maximum diameter) =5mm; baseline CEA≥100; biopsy pathology contains signet ring cell carcinoma mucinous adenocarcinoma; evaluation team determines whether circumferential constrictive tumor should be included or not when necessary Severe heart disease, such as symptomatic coronary heart disease, New York Cardiology Association (NYHA) grade II or above severe congestive heart failure, or severe arrhythmia requiring pharmacological intervention, or a history of myocardial infarction within the last 12 months
- Organ transplantation requires immunosuppressive therapy
- Serious uncontrolled recurrent infections, or other serious uncontrolled concomitant diseases
- The baseline blood routine and biochemical indexes of the subject do not meet the following criteria: hemoglobin ≥90g / L; absolute neutrophil count (ANC) ≥1.5*10^9 / L; platelet ≥100*10^9 / L; ALT and AST≤ 2.5 times normal upper limit; ALP ≤2.5 times normal upper limit; serum total bilirubin <1.5 times normal upper limit; serum normal creatinine"<1 time upper limit; and serum albumin ≥30g / L
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
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: Neoadjuvant concurrent Chemoradiotherapy plus consolidation chemotherapy followed by TEM
All the patients will receive neoadjuvant chemoradiotherapy ( CapOx + radiotherapy) for 2 cycles, one week after chemoradiotherapy, the first evaluation including MRI, colonoscopy, digital rectal examination and serum CEA will be conducted.
Patients without tumor progression will continue 4 cycles of chemotherapy (CapOx) until next imaging and serum assessment.
After the second assessment, for patients with tumor regression and suitable for TEM will receive local resection otherwise TME.
Following treatment strategy will be made base on the final pathology evaluation after surgery, patients with good pathological response (ypT 0-1 without neural vascular invasion) will enter into the follow-up period, otherwise TME will be operated.
|
Radiotherapy:45Gy/25F+Boost 50Gy/25F. A total of 45 Gy, 25 fractions of 1.8 Gy, 5 fractions a week CapOx: Capecitabine 1000mg / m² po bid (1-14 days, 21 days a cycle) Oxaliplatin 130mg / m2 igtt(Day 1, 21 days a cycle) TEM or endoscopic local resection
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Organ preservation rate at 3 years
Time Frame: 3 years
|
Patients with a good pathological response(ypT 0-1 without neural vascular invasion)after neoadjuvant treatment followed by transanal endoscopic microsurgery(TEM)or endoscopic local resection will be offered an organ preservation strategy
|
3 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical complete response rate after neoadjuvant chemoradiotherapy
Time Frame: 18 weeks
|
Define as complete withdrawal of rectal cancer after neoadjuvant radiotherapy and chemotherapy, and no distant metastasis in imaging examination, and no tumor residue in imaging examination and endoscopic biopsy
|
18 weeks
|
3-year local recurrence rate
Time Frame: 3 years
|
Occurrence of local recurrence in patients with an organ preservation strategy
|
3 years
|
3-year distant metastases rate
Time Frame: 3 years
|
Occurrence of distant metastases in patients with an organ preservation strategy
|
3 years
|
3-year Disease-free survival(DFS)rates
Time Frame: 3 years
|
Disease free survival defined as the time from enrollment to the first documented disease progression of local recurrence or distance metastasis or death due to any cause
|
3 years
|
3-year overall survival(OS) rates
Time Frame: 3 years
|
OS is defined as the time from enrollment to death due to any cause
|
3 years
|
Quality of life (EORTC-QLQ-C 30, psychological status)
Time Frame: 20 weeks
|
Assess QLQ-C30 in patients with an organ preservation strategy
|
20 weeks
|
5-year Disease-free survival(DFS)rates
Time Frame: 5 years
|
Disease free survival defined as the time from enrollment to the first documented disease progression of local recurrence or distance metastasis or death due to any cause
|
5 years
|
5-year overall survival(OS) rates
Time Frame: 5 years
|
OS is defined as the time from enrollment to death due to any cause
|
5 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Jian Wang, M.D., Shanghai Zhongshan Hospital
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
September 1, 2022
Primary Completion (Anticipated)
August 31, 2025
Study Completion (Anticipated)
August 31, 2027
Study Registration Dates
First Submitted
September 4, 2022
First Submitted That Met QC Criteria
September 28, 2022
First Posted (Actual)
October 3, 2022
Study Record Updates
Last Update Posted (Actual)
October 3, 2022
Last Update Submitted That Met QC Criteria
September 28, 2022
Last Verified
September 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- B2022-334R
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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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