- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06244537
Study on the Safety and Efficacy of MR-Linac Technique in Patients With Unresectable Locally Advanced Colon Cancer (UNLACC)
February 25, 2024 updated by: Qian Peng, Sichuan Cancer Hospital and Research Institute
In this phase I single-arm clinical study, 20 patients with T4b unresectable locally advanced colon cancer are proposed to be enrolled, who will be treated with MR-Linac with short course radiotherapy (25Gy/5F), followed by 4 cycles of mFOLFOX6 or 3 cycles of XELOX chemotherapy, then radical surgical resection, and then postoperatively with 8 cycles of mFOLFOX6 or 5 cycles of XELOX.
The study will assess patients' surgical R0 resection rate, pCR or cCR rate, PFS, OS, and related adverse effects of treatment, aiming to explore the feasibility, safety, and efficacy of MR-Linac in the treatment of unresectable locally advanced colon cancer.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
20
Phase
- Not Applicable
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: Qian Peng, chief physician
- Phone Number: +086 17708130617
- Email: pengqian@scszlyy.org.cr
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
- Adult
- Older Adult
Accepts Healthy Volunteers
Yes
Description
Inclusion criteria:
- Patients over 18 years old
- Patients can remain in a stationary position on the treatment bed for 1-1.5 hours
- ECOG score 0-1
- Pathological diagnosis of colon adenocarcinoma, clinical stage cT4bN0-2M0
- Organ function is normal, and the following conditions are required: white blood cell count ≥3.5×10^9/L; platelet count ≥100×10^9/L; hemoglobin ≥90g/L. Total bilirubin level ≤1.5× upper limit of normal (ULN); AST and ALT levels ≤2.5 × ULN; endogenous creatinine clearance rate: 56-122ml/min; serum creatinine <1.0× ULN; serum albumin ≥30g/L.
- Able to adhere to the study protocol during the research period
- Signed written informed consent
Exclusion Criteria:
- Patients with dMMR or MSI-H
- Presence of other types of tumors in addition to colon adenocarcinoma
- Claustrophobia or inability to undergo MRI or treatment due to the presence of metal implants or other reasons
- Distant metastasis (M1)
- Pregnant or lactating women
- Previous anti-tumor treatment
- Concurrent use of prohibited drugs for treatment
- Known history of positive human immunodeficiency virus testing or known acquired immunodeficiency syndrome.
- Clinically significant (i.e., active) cardiovascular disease: cerebrovascular accident/stroke (<6 months prior to enrollment), myocardial infarction (<6 months prior to enrollment), unstable angina pectoris, congestive heart failure (≥New York Heart Association class II) or severe arrhythmia requiring medication treatment
- Individuals with uncontrolled epilepsy, central nervous system disorders or a history of mental illness, whose clinical severity may hinder signing informed consent or affect patient compliance with oral medication according to the investigator's judgement
- Organ transplant surgery requiring immunosuppressive therapy
- Severe, uncontrolled recurrent infections or other severe, uncontrolled comorbidities
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: MR-linac
Patients enrolled will be treated with MR-Linac with short course radiotherapy (25Gy/5F), followed by 4 cycles of mFOLFOX6 or 3 cycles of XELOX chemotherapy, then radical surgical resection, and then postoperatively with 8 cycles of mFOLFOX6 or 5 cycles of XELOX chemotherapy.
|
Patients enrolled will be treated with MR-Linac with short course radiotherapy (25Gy/5F), followed by 4 cycles of mFOLFOX6 or 3 cycles of XELOX chemotherapy, then radical surgical resection, and then postoperatively with 8 cycles of mFOLFOX6 or 5 cycles of XELOX chemotherapy.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
MRI-linac Treatment Completion Rate
Time Frame: 2 years
|
Is adaptive radiotherapy guided by MRI feasible for patients with locally advanced unresectable colon cancer?
The feasibility of each patient will be recorded as a binary variable (1=feasible; 0=not feasible).
|
2 years
|
Clinical complete response (cCR)
Time Frame: 2 years
|
Clinical complete response refers to the absence of detectable tumor clinically after treatment.
|
2 years
|
Pathological complete response (pCR)
Time Frame: 2 years
|
Pathological complete response is defined as the absence of any signs of cancer in tissue samples after treatment.
|
2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Toxicity reaction (CTC 4.0 standard)
Time Frame: long range
|
CTC 4.0, also known as Common Terminology Criteria for Adverse Events version 4.0, is an extensively used classification system for assessing drug toxicity.
This system categorizes drug toxicity into five levels: Grade 0, Grade 1, Grade 2, Grade 3, and Grade 4.
|
long range
|
R0 resection rate
Time Frame: 2 years
|
During surgery, the R0 resection rate refers to the complete removal of the entire tumor with no residual abnormalities present in the surrounding normal tissue.
|
2 years
|
Surgical complications
Time Frame: 2 years
|
Surgical complications refers to adverse events or problems that arise during or after a surgical procedure.
These complications can range from minor issues to serious complications that may have significant consequences for the patient.
|
2 years
|
Local control rate
Time Frame: 2 years
|
Proportion of cases in remission and stable disease after treatment, i.e., proportion of patients who did not experience disease progression.
|
2 years
|
Disease-free survival
Time Frame: 2 years
|
The time from the start of treatment to the first tumor recurrence/metastasis, or death of the subject due to any cause.
|
2 years
|
Overall survival
Time Frame: 2 years
|
Time from the start of the patient's treatment to the patient's death from any cause
|
2 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. Cancer statistics in China, 2015. CA Cancer J Clin. 2016 Mar-Apr;66(2):115-32. doi: 10.3322/caac.21338. Epub 2016 Jan 25.
- Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.
- Cao W, Chen HD, Yu YW, Li N, Chen WQ. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chin Med J (Engl). 2021 Mar 17;134(7):783-791. doi: 10.1097/CM9.0000000000001474.
- Chang H, Yu X, Xiao WW, Wang QX, Zhou WH, Zeng ZF, Ding PR, Li LR, Gao YH. Neoadjuvant chemoradiotherapy followed by surgery in patients with unresectable locally advanced colon cancer: a prospective observational study. Onco Targets Ther. 2018 Jan 17;11:409-418. doi: 10.2147/OTT.S150367. eCollection 2018.
- Qiu B, Ding PR, Cai L, Xiao WW, Zeng ZF, Chen G, Lu ZH, Li LR, Wu XJ, Mirimanoff RO, Pan ZZ, Xu RH, Gao YH. Outcomes of preoperative chemoradiotherapy followed by surgery in patients with unresectable locally advanced sigmoid colon cancer. Chin J Cancer. 2016 Jul 7;35(1):65. doi: 10.1186/s40880-016-0126-y.
- Intven MPW, de Mol van Otterloo SR, Mook S, Doornaert PAH, de Groot-van Breugel EN, Sikkes GG, Willemsen-Bosman ME, van Zijp HM, Tijssen RHN. Online adaptive MR-guided radiotherapy for rectal cancer; feasibility of the workflow on a 1.5T MR-linac: clinical implementation and initial experience. Radiother Oncol. 2021 Jan;154:172-178. doi: 10.1016/j.radonc.2020.09.024. Epub 2020 Sep 22.
- Yoshihara M, Hiyama T, Tanaka S. [Epidemiology of colorectal cancer]. Nihon Naika Gakkai Zasshi. 2007 Feb 10;96(2):200-6. doi: 10.2169/naika.96.200. No abstract available. Japanese.
- Schmoll HJ, Van Cutsem E, Stein A, Valentini V, Glimelius B, Haustermans K, Nordlinger B, van de Velde CJ, Balmana J, Regula J, Nagtegaal ID, Beets-Tan RG, Arnold D, Ciardiello F, Hoff P, Kerr D, Kohne CH, Labianca R, Price T, Scheithauer W, Sobrero A, Tabernero J, Aderka D, Barroso S, Bodoky G, Douillard JY, El Ghazaly H, Gallardo J, Garin A, Glynne-Jones R, Jordan K, Meshcheryakov A, Papamichail D, Pfeiffer P, Souglakos I, Turhal S, Cervantes A. ESMO Consensus Guidelines for management of patients with colon and rectal cancer. a personalized approach to clinical decision making. Ann Oncol. 2012 Oct;23(10):2479-2516. doi: 10.1093/annonc/mds236.
- Wu C. Systemic Therapy for Colon Cancer. Surg Oncol Clin N Am. 2018 Apr;27(2):235-242. doi: 10.1016/j.soc.2017.11.001. Epub 2017 Dec 16.
- Karoui M, Rullier A, Luciani A, Bonnetain F, Auriault ML, Sarran A, Monges G, Trillaud H, Le Malicot K, Leroy K, Sobhani I, Bardier A, Moreau M, Brindel I, Seitz JF, Taieb J. Neoadjuvant FOLFOX 4 versus FOLFOX 4 with Cetuximab versus immediate surgery for high-risk stage II and III colon cancers: a multicentre randomised controlled phase II trial--the PRODIGE 22--ECKINOXE trial. BMC Cancer. 2015 Jul 10;15:511. doi: 10.1186/s12885-015-1507-3.
- Tomizawa K, Miura Y, Fukui Y, Hanaoka Y, Toda S, Moriyama J, Inoshita N, Ozaki Y, Takano T, Matoba S, Kuroyanagi H. Curative resection for locally advanced sigmoid colon cancer using neoadjuvant chemotherapy with FOLFOX plus panitumumab: A case report. Int J Surg Case Rep. 2017;31:128-131. doi: 10.1016/j.ijscr.2017.01.027. Epub 2017 Jan 17.
- Reima H, Soplepmann J, Elme A, Lohmus M, Tiigi R, Uksov D, Innos K. Changes in the quality of care of colorectal cancer in Estonia: a population-based high-resolution study. BMJ Open. 2020 Oct 8;10(10):e035556. doi: 10.1136/bmjopen-2019-035556.
- Foxtrot Collaborative Group. Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: the pilot phase of a randomised controlled trial. Lancet Oncol. 2012 Nov;13(11):1152-60. doi: 10.1016/S1470-2045(12)70348-0. Epub 2012 Sep 25.
- Reibetanz J, Germer CT. [Neoadjuvant chemotherapy for locally advanced colon cancer : Initial results of the FOxTROT study.]. Chirurg. 2013 Oct 13. doi: 10.1007/s00104-013-2631-8. Online ahead of print. No abstract available. German.
- Karoui M, Rullier A, Piessen G, Legoux JL, Barbier E, De Chaisemartin C, Lecaille C, Bouche O, Ammarguellat H, Brunetti F, Prudhomme M, Regimbeau JM, Glehen O, Lievre A, Portier G, Hartwig J, Goujon G, Romain B, Lepage C, Taieb J; for PRODIGE 22 investigators/collaborators. Perioperative FOLFOX 4 Versus FOLFOX 4 Plus Cetuximab Versus Immediate Surgery for High-Risk Stage II and III Colon Cancers: A Phase II Multicenter Randomized Controlled Trial (PRODIGE 22). Ann Surg. 2020 Apr;271(4):637-645. doi: 10.1097/SLA.0000000000003454.
- Ryan R, Gibbons D, Hyland JM, Treanor D, White A, Mulcahy HE, O'Donoghue DP, Moriarty M, Fennelly D, Sheahan K. Pathological response following long-course neoadjuvant chemoradiotherapy for locally advanced rectal cancer. Histopathology. 2005 Aug;47(2):141-6. doi: 10.1111/j.1365-2559.2005.02176.x.
- Huang CM, Huang MY, Ma CJ, Yeh Y-, Tsai HL, Huang CW, Huang CJ, Wang JY. Neoadjuvant FOLFOX chemotherapy combined with radiotherapy followed by radical resection in patients with locally advanced colon cancer. Radiat Oncol. 2017 Mar 7;12(1):48. doi: 10.1186/s13014-017-0790-3.
- Venigalla S, Chowdhry AK, Wojcieszynski AP, Lukens JN, Plastaras JP, Metz JM, Ben-Josef E, Mahmoud NN, Reiss KA, Shabason JE. Comparative Effectiveness of Neoadjuvant Chemoradiation Versus Upfront Surgery in the Management of Recto-Sigmoid Junction Cancer. Clin Colorectal Cancer. 2018 Sep;17(3):e557-e568. doi: 10.1016/j.clcc.2018.05.005. Epub 2018 May 17.
- Krishnamurty DM, Hawkins AT, Wells KO, Mutch MG, Silviera ML, Glasgow SC, Hunt SR, Dharmarajan S. Neoadjuvant Radiation Therapy in Locally Advanced Colon Cancer: a Cohort Analysis. J Gastrointest Surg. 2018 May;22(5):906-912. doi: 10.1007/s11605-018-3676-2. Epub 2018 Feb 9.
- Boldrini L, Intven M, Bassetti M, Valentini V, Gani C. MR-Guided Radiotherapy for Rectal Cancer: Current Perspective on Organ Preservation. Front Oncol. 2021 Mar 30;11:619852. doi: 10.3389/fonc.2021.619852. eCollection 2021.
- Chiloiro G, Boldrini L, Meldolesi E, Re A, Cellini F, Cusumano D, Corvari B, Mantini G, Balducci M, Valentini V, Gambacorta MA. MR-guided radiotherapy in rectal cancer: First clinical experience of an innovative technology. Clin Transl Radiat Oncol. 2019 Apr 12;18:80-86. doi: 10.1016/j.ctro.2019.04.006. eCollection 2019 Sep.
- Slotman B, Gani C. Online MR-guided radiotherapy - A new era in radiotherapy. Clin Transl Radiat Oncol. 2019 Apr 17;18:102-103. doi: 10.1016/j.ctro.2019.04.011. eCollection 2019 Sep. No abstract available.
- Winkel D, Bol GH, Kroon PS, van Asselen B, Hackett SS, Werensteijn-Honingh AM, Intven MPW, Eppinga WSC, Tijssen RHN, Kerkmeijer LGW, de Boer HCJ, Mook S, Meijer GJ, Hes J, Willemsen-Bosman M, de Groot-van Breugel EN, Jurgenliemk-Schulz IM, Raaymakers BW. Adaptive radiotherapy: The Elekta Unity MR-linac concept. Clin Transl Radiat Oncol. 2019 Apr 2;18:54-59. doi: 10.1016/j.ctro.2019.04.001. eCollection 2019 Sep.
- van Rossum PS, van Lier AL, van Vulpen M, Reerink O, Lagendijk JJ, Lin SH, van Hillegersberg R, Ruurda JP, Meijer GJ, Lips IM. Diffusion-weighted magnetic resonance imaging for the prediction of pathologic response to neoadjuvant chemoradiotherapy in esophageal cancer. Radiother Oncol. 2015 May;115(2):163-70. doi: 10.1016/j.radonc.2015.04.027. Epub 2015 May 19.
- Kontaxis C, Bol GH, Kerkmeijer LGW, Lagendijk JJW, Raaymakers BW. Fast online replanning for interfraction rotation correction in prostate radiotherapy. Med Phys. 2017 Oct;44(10):5034-5042. doi: 10.1002/mp.12467. Epub 2017 Aug 9.
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 (Estimated)
February 29, 2024
Primary Completion (Estimated)
June 30, 2025
Study Completion (Estimated)
December 31, 2025
Study Registration Dates
First Submitted
January 25, 2024
First Submitted That Met QC Criteria
February 2, 2024
First Posted (Actual)
February 6, 2024
Study Record Updates
Last Update Posted (Actual)
February 28, 2024
Last Update Submitted That Met QC Criteria
February 25, 2024
Last Verified
February 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SCCHEC-02-2024-017
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
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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