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RESTAGE (REpurposing STAtins to Improve Outcomes in GastroEsophageal Cancer) Trial (RESTAGE)

29. maj 2026 opdateret af: Lorenzo Ferri, McGill University Health Centre/Research Institute of the McGill University Health Centre

RESTAGE (REpurposing STAtins to Improve Outcomes in GastroEsophageal Cancer) Trial: A Phase II Randomized Open-Label Trial of Perioperative Simvastatin Plus Standard-of-Care Systemic Therapy in Gastroesophageal Adenocarcinoma

Esophageal and gastroesophageal junction cancers are serious diseases with limited cure rates, even when patients receive chemotherapy and surgery. New ways to improve treatment are urgently needed.

This study will test whether adding a commonly used cholesterol-lowering medication, simvastatin, to standard cancer treatment can improve outcomes. Simvastatin is widely used, safe, and inexpensive. Research suggests that it may also slow cancer growth by blocking pathways that cancer cells rely on for survival.

In this trial, patients will receive standard chemotherapy (with or without immunotherapy) before surgery. Half of the patients will also take simvastatin daily for up to two years. Researchers will compare how well tumors respond to treatment and whether patients remain cancer-free longer.

If successful, this approach could offer a simple and accessible way to improve survival for patients with these cancers without adding significant side effects or cost.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

184

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Canada
      • Montreal, Canada
        • McGill University Health Center
        • Kontakt:

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  1. Signed, informed consent.
  2. Age, 18 years or older.
  3. Histological diagnosis of adenocarcinoma or poorly differentiated carcinoma of the esophagus or EGJ.
  4. The tumour must be deemed potentially resectable by the surgical team. This assessment is based on complete staging imaging studies (detailed below) - clinical staging of the tumor and ruling out metastatic disease.
  5. Locally advanced disease as defined per AJCC/UICC 8th edition37: stage IIA, IIB, III, IVA (T1-4a N2-3).
  6. Eligibility for standard-of-care perioperative systemic therapy with FLOT+/-D.
  7. Life expectancy greater than 3 months.
  8. ECOG performance status < 2.

Exclusion Criteria:

  1. Prior esophageal or gastric malignancy.
  2. History of allergic reactions to simvastatin or atorvastatin or similar chemical or biological compounds.
  3. Ongoing cholesterol-lowering therapy (statins, fibrates, ezetimibe, PCSK9 inhibitors), in which case the patient is offered enrollment in the observational arm.
  4. Hepatic dysfunction (alanine aminotransferase level more than three times the upper limit of the normal range) or renal dysfunction (creatinine level more than three times the upper limit of the normal range).
  5. Predisposing factors for rhabdomyolysis: hypothyroidism, reduced renal function, muscle disease, or excessive alcohol consumption AND creatine kinase up to less than five times the upper limit (measured in the presence of predisposing factors).
  6. Concurrent medication with potent CYP3A4-inhibitors, e.g. ketokonazole, erythromycin, gemfibrozil, cyclosporine, or danazol.
  7. Pre-existing medical conditions precluding treatment, including any contraindication systemic chemotherapy or major surgery.
  8. Psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule, discussed before registration in the trial.
  9. Pregnant and breastfeeding women.
  10. Unwillingness to undergo per-protocol investigations or treatments.

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: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Control
SOC neoadjuvant FLOT (or FLOT-D)
Medicin: SOC neoadjuvant FLOT (or FLOT-D)
Standard of care neoadjuvant FLOT (or FLOT-D).
Eksperimentel: Experimental
SOC neoadjuvant FLOT (or FLOT-D) + simvastatin
Medicin: SOC neoadjuvant FLOT (or FLOT-D) + simvastatin
Standard of care neoadjuvant FLOT (or FLOT-D) + simvastatin

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
MPR
Tidsramme: From enrolment to surgical pathology assessment, 16 weeks
Major Pathological Response
From enrolment to surgical pathology assessment, 16 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Statin-enhanced toxicity of standard-of-care regimen, specifically grade 3 or 4 adverse events
Tidsramme: Start of neoadjuvant therapy to the end of adjuvant therapy (weeks 2-28)
Statin-enhanced toxicity of standard-of-care regimen, specifically grade 3 or 4 adverse events (as per CTCAE v6.0 36) warranting dosage modification or stoppage of interventional drug or chemotherapy.
Start of neoadjuvant therapy to the end of adjuvant therapy (weeks 2-28)
2-year EFS
Tidsramme: Elapsed time from date of randomization to date of recurrence or death, within 2 years from resection
2-year EFS, defined as elapsed time from date of randomization to date of recurrence (local or distant) or death, occurring after resection
Elapsed time from date of randomization to date of recurrence or death, within 2 years from resection

Samarbejdspartnere og efterforskere

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

Sponsor

McGill University Health Centre/Research Institute of the McGill University Health Centre

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)

1. januar 2027

Primær færdiggørelse (Anslået)

1. april 2029

Studieafslutning (Anslået)

1. april 2031

Datoer for studieregistrering

Først indsendt

29. maj 2026

Først indsendt, der opfyldte QC-kriterier

29. maj 2026

Først opslået (Faktiske)

4. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

29. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • THOR-ESO-2026-01

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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