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Phase II Trial Comparing Stereotactic Body Radiotherapy Versus Active Surveillance for Oligometastatic Adenoid Cystic Carcinoma

22. september 2026 opdateret af: Aman Sharma, All India Institute of Medical Sciences

SABR Oligo-ACC Trial: A Randomized Phase II Trial Comparing Stereotactic Body Radiotherapy Versus Active Surveillance for Oligometastatic Adenoid Cystic Carcinoma

The SABR Oligo-ACC Trial is a randomized phase II study comparing early initiation of SBRT to all metastases versus active surveillance in patients with oligometastatic ACC.

By directly comparing these strategies, the study will determine whether treating limited metastatic disease at the earliest opportunity translates into improved progression-free survival, while also evaluating overall survival, local control, subsequent patterns of progression, time to systemic therapy, toxicity and quality of life.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The oligometastatic state represents a potentially distinct phase of cancer dissemination in which eradication of all visible metastatic disease may alter subsequent disease progression. Prospective randomized trials in several solid tumors have provided evidence supporting this paradigm. In the phase II SABR-COMET trial, patients with a controlled primary tumor and 1-5 metastases randomized to comprehensive SABR had longer overall survival than those receiving standard treatment alone (median 41 vs 28 months; HR 0.57). Long-term follow-up demonstrated a 5-year overall survival of 42.3% with SABR versus 17.7% with standard treatment. There is robust prospective evidence that metastasis-directed therapy can modify the course of oligometastatic disease; however, their findings cannot be directly extrapolated to adenoid cystic carcinoma (ACC), which has distinct tumor biology and natural history.

A recent retrospective study has demonstrated that patients with oligometastatic ACC had more favorable outcomes than patients with higher metastatic burden, and that early initiation of local treatment was associated with improvement in PFS. However, these observations are subject to selection and other inherent biases of retrospective studies and cannot establish that local ablative therapy itself improves survival or progression-free survival.

The SABR Oligo-ACC Trial is therefore proposed as a randomized, phase II study comparing early initiation of SBRT to all metastases versus active surveillance in patients with oligometastatic ACC.

90 patients with histologically confirmed ACC of any primary site along with oligometastatic disease (1-5 active radiologically detectable extracranial metastatic lesions involving one or more organs) will be participating in this study.

They will be randomized (computer-generated randomization system) in a 1:1 ratio to either Stereotactic Body Radiotherapy (SBRT) or Active Surveillance.

Arm A=SBRT to all oligometastasis Arm B =Active surveillance Overall survival (OS), Progression Free Survival (PFS), Local Control of metatstatic lesion, SBRT toxicity (CTCAE version 5.0) and Quality of life (EORTC QLQ C-30) will be assessed at different timelines.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

90

Fase

  • Fase 2

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Age ≥18 years.
  2. Histologically confirmed adenoid cystic carcinoma (ACC) of any primary site.
  3. Oligometastatic disease, defined as 1-5 active radiologically detectable extracranial metastatic lesions involving one or more organs.
  4. Both synchronous/metachronous/ oligoprogressive oligometastatic disease are eligible.
  5. All active metastatic lesions must be amenable to comprehensive SBRT.
  6. Controlled primary tumor or loco-regional disease amenable to sugery and radiotherapy
  7. ECOG Performance Status 0-2.
  8. Adequate organ function to undergo SBRT and protocol-specified investigations.
  9. Ability and willingness to comply with study assessments and follow-up.
  10. Written informed consent.

Exclusion Criteria:

  1. >5 active metastatic lesions at the time of randomization.
  2. Any active metastatic lesion that is not safely amenable to SBRT according to protocol-defined dose and normal-tissue constraints.
  3. Uncontrolled or progressive primary/regional disease requiring immediate local treatment, except for newly diagnosed synchronous disease that has been appropriately managed and is suitable for protocol randomization.
  4. Symptomatic metastatic disease requiring immediate systemic therapy, surgery or palliative radiotherapy.
  5. Metastatic disease associated with an oncological emergency, including impending pathological fracture, spinal cord compression, unstable spinal disease, major airway compromise, major vascular compromise or other condition requiring urgent intervention.
  6. Active untreated CNS metastases requiring surgery, SRS or other CNS-directed treatment.
  7. Oligoinduced disease during active systemic therapy.
  8. Concurrent systemic anticancer therapy at randomization or during protocol-defined SBRT.
  9. Previous radiotherapy that precludes safe delivery of protocol-specified SBRT because of cumulative dose constraints.
  10. Another active malignancy requiring treatment or likely to interfere with assessment of ACC-related outcomes.
  11. Uncontrolled intercurrent illness or medical condition that would preclude protocol treatment or follow-up.
  12. Pregnancy or lactation.
  13. Inability or unwillingness to provide informed consent or comply with study procedures.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: SBRT ARM

Comprehensive SBRT to all active metastatic lesions that are safely amenable to stereotactic treatment.

SBRT will be delivered using image-guided, highly conformal radiotherapy with appropriate immobilization and image guidance, using institutionally validated dose-fractionation schedules based on the site, size, number, and proximity of lesions to critical organs. Treatment will be planned to achieve ablative tumor doses while respecting established organ-at-risk constraints. SBRT will preferably be completed within 1-2 weeks.

Ingen indgriben: Active surveillance

Observation with scheduled clinical and radiological assessment, with initiation of local or systemic treatment if clinically indicated.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Progression-free survival (PFS)
Tidsramme: 5 years

The length of time during and after the treatment of a disease, that a patient lives with the disease but it does not get worse.

5 years

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Lokal kontrol
Tidsramme: 5 år
5 år
Overall survival (OS)
Tidsramme: assessed at follow up visits 1 to 10 years

The length of time from the start of treatment for the disease, that patients diagnosed with the disease are still alive.

assessed at follow up visits 1 to 10 years
Radiation Toxicity
Tidsramme: 5 years

using CTCAE version 5.0. : Grade 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. Grade 2 Moderate; minimal, local or noninvasive intervention indicated; limiting age appropriate instrumental Activities of Daily Living. Grade 3 Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care Activities of Daily Living . Grade 4 Life-threatening consequences; urgent intervention indicated. Grade 5 Death related to AE.

5 years

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

20. december 2026

Primær færdiggørelse (Anslået)

20. december 2032

Studieafslutning (Anslået)

20. december 2032

Datoer for studieregistrering

Først indsendt

22. september 2026

Først indsendt, der opfyldte QC-kriterier

22. september 2026

Først opslået (Faktiske)

28. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

28. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

22. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • AIIMS SABR Oligo-ACC Trial

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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