Locally ablatIVe thErapy for oLigo-progressive gastrOintestiNal maliGnancies (LIVELONG) (LIVELONG)

This is a phase 2 pragmatic study that evaluates the clinical benefit of continuing systemic therapy with the addition of locally ablative therapies for oligo-progressive solid tumors as the primary objective. The primary outcome measure is the time to treatment failure (defined as time to change in systemic failure or permanent discontinuation of therapy) following locally ablative therapy.

Study Overview

• Status: Recruiting
• Conditions: Oligoprogressive; Gastric Cancer; Colorectal Cancer; Esophageal Cancer; Small Bowel Cancer; Intrahepatic Cholangiocarcinoma; Gall Bladder Cancer; Extrahepatic Cholangiocarcinoma; Appendiceal Cancer; Biliary Cancer; Gastroesophageal-junction Cancer
• Intervention / Treatment: Device: Ablative local therapy

Detailed Description

This is a phase 2 pragmatic study at a single site that evaluates the clinical benefit of continuing systemic therapy with the addition of locally ablative therapies for oligo-progressive solid tumors as the primary objective. The primary endpoint is disease control at 3 months, defined as continuation in systemic cancer therapy without any changes or permanent discontinuation for 3 months following first day of ablative local therapy. Participants will receive ablative local therapy per standard practices in addition to their systemic therapy and will be followed for up to 5 years following ablative local therapy. Participants will be assigned stereotactic ablative radiotherapy (SABR) or interventional radiology (IR) ablation therapy per the discretion of treating radiation oncologist and/or interventional radiologist.

• Study Type: Interventional
• Enrollment (Estimated): 300
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Selina Laqui; Phone Number: 916-734-0565; Email: sblaqui@ucdavis.edu

Study Locations

• United States
  • California
    • Sacramento, California, United States, 95817
      • Recruiting
      • University of California, Davis
      • Principal Investigator: Edward Kim, MD, PhD
      • Contact: Selina Laqui, MD, PhD; Phone Number: 916-734-0565; Email: sblaqui@ucdavis.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Must have one of the following histologically and/or biochemically confirmed cancers:

   1. Cohort A: Esophageal, Gastroesophageal Junction, Gastric
   2. Cohort B: Small bowel
   3. Cohort C: Colorectal and appendiceal
   4. Cohort D: Biliary including gallbladder, intrahepatic and extrahepatic cholangiocarcinoma
   5. Cohort E: Hepatocellular carcinoma
   6. Cohort F: Pancreatic and ampullary
2. Provision of signed and dated informed consent form.
3. Stated willingness to comply with all study procedures and availability for the duration of the study.
4. Age ≥18 years at time of consent.
5. Currently on systemic therapy and a candidate to continue their current line of systemic therapy with no more than a planned 30-day break to allow for local ablative therapy.
6. ≥ 1 line of systemic therapy for metastatic disease with ≥ 3 months of clinical benefit on most recent line of systemic therapy prior to the development of new metastatic lesions. [Clinical benefit: Treating provider assessment that majority of the tumor burden is stable on current systemic treatment and not requiring an immediate change in systemic treatment]
7. ≤ 5 progressing or new metastatic lesions.
8. All progressing or new metastatic lesions can be safely treated with locally ablative therapies at discretion of treating radiation oncologist and/ interventional radiologist.

Exclusion Criteria:

1. Medical comorbidities precluding locally ablative therapies.
2. History of treatment related toxicities that limit or prohibit application of locally ablative therapies.
3. Progressing intracranial lesions.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Ablative local therapy; Stereotactic ablative radiotherapy (SABR) or interventional radiology (IR) ablation therapy	Device: Ablative local therapy; Stereotactic ablative radiotherapy (SABR) or interventional radiology (IR) ablation therapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants with controlled disease	Number of participants with controlled disease at 3 months, defined as continuation in systemic cancer therapy without any changes or permanent discontinuation for 3 months following first day of ablative local therapy	3 months from the first day of ablative local therapy

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to treatment failure	Time to treatment failure, defined as time to change in systemic therapy or permanent discontinuation of cancer therapy	Up to 1 year from the first day of ablative local therapy
Median overall survival	Median overall survival stratified by primary tumor type	Up to 5 years from the first day of ablative local therapy
Number of participants experiencing grade ≥ 3 adverse events attributable to ablative local therapy	Number of participants experiencing grade ≥ 3 adverse events (except for hematologic and electrolyte abnormalities) attributable to ablative local therapy occurring up to 2 years from the first day of ablative local therapy	Up to 2 years from the first day of ablative local therapy

Collaborators and Investigators

• Sponsor: University of California, Davis
• Collaborators: National Cancer Institute (NCI)
• Investigators: Principal Investigator: Edward Kim, MD, PhD, University of California, Davis

Study record dates

Study Major Dates

• Study Start (Actual): October 5, 2023
• Primary Completion (Estimated): December 5, 2025
• Study Completion (Estimated): January 5, 2031

Study Registration Dates

• First Submitted: October 19, 2023
• First Submitted That Met QC Criteria: October 19, 2023
• First Posted (Actual): October 26, 2023

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 3, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Intestinal Diseases; Neoplasms by Histologic Type; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Neoplasms; Biliary Tract Diseases; Neoplasms, Glandular and Epithelial; Adenocarcinoma; Carcinoma; Gallbladder Diseases; Biliary Tract Neoplasms; Cecal Neoplasms; Cecal Diseases; Cholangiocarcinoma; Gallbladder Neoplasms; Appendiceal Neoplasms
• Other Study ID Numbers: UCDCC308

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: Yes
• product manufactured in and exported from the U.S.: No