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少数転移性腺様嚢胞癌の早期治療のための体幹部定位放射線治療 (SBRT): SOLAR 試験

2026年9月30日 更新者:Jonathan Schoenfeld, MD, MPH、Dana-Farber Cancer Institute

The aim of this study is to learn whether the early initiation of a specialized and focused type of radiation called stereotactic body radiation therapy (SBRT) will impact the progression of advanced adenoid cystic carcinoma, quality of life, and overall survival.

The name(s) of the study intervention involved in this study is:

  • Stereotactic Body Radiation Therapy (SBRT)

調査の概要

状態

募集

条件

介入・治療

詳細な説明

This is a randomized phase II, open-label and non-blinded two-arm study aimed to investigate the potential benefit of treating oligometastatic adenoid cystic carcinoma (ACC) with early initiation of stereotactic body radiotherapy (SBRT). Given the overall uncertainty about the role of local therapy in the treatment of ACC, there is also a prospective observational cohort that will investigate outcomes following local ablative treatments in patients with advanced or metastatic ACC.

This research study is investigating how the specialized and focused stereotactic body radiation therapy (SBRT) impacts disease progression, quality of life, and overall survival in patients with a limited number of metastases (one to five) from their adenoid cystic carcinoma cancer. The use of SBRT to treat all areas of disease after early spread of ACC is investigational. SBRT is a more focused form of radiation compared to the palliative radiation typically received per standard of care treatment. Recent retrospective studies conducted suggest that patients with adenoid cystic carcinoma cancer may benefit from early initiation of a targeted radiation therapy.

The research study procedures include screening for eligibility and study treatment including evaluations and follow up visits. After enrollment participants will be randomized into two groups: Standard of Care or Stereotactic body radiotherapy (SBRT). All participants in the study, regardless of treatment regimen, will be followed for up to 10 years.

It is expected that about 32 people will take part in this research study.

Two organizations, Gateway for Cancer Research and the Adenoid Cystic Carcinoma Research Foundation (ACCRF), are supporting this research study by providing funding.

研究の種類

介入

入学 (推定)

32

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

    • California
      • San Francisco、California、アメリカ、94158
        • 募集
        • University of California, San Francisco
        • コンタクト:
        • 主任研究者:
          • Sue Yom, MD, PhD
    • Illinois
      • Chicago、Illinois、アメリカ、60637
        • 募集
        • University of Chicago
        • 主任研究者:
          • Alexander T Pearson, MD, PhD
        • コンタクト:
    • Massachusetts
      • Boston、Massachusetts、アメリカ、02115
        • 募集
        • Brigham and Women's Hospital
        • 主任研究者:
          • Jonathan D Schoenfeld, MD, MPH
        • コンタクト:
      • Boston、Massachusetts、アメリカ、02215
        • 募集
        • Dana Farber Cancer Institute
        • コンタクト:
        • 主任研究者:
          • Jonathan D Schoenfeld, MD, MPH
    • Texas
      • Houston、Texas、アメリカ、77030
        • 募集
        • MD Anderson Cancer Center
        • コンタクト:
        • 主任研究者:
          • Matthew S Ning, MD, MPH

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • Subject must have histologically confirmed adenoid cystic carcinoma (ACC) of any primary site with distant metastases detected clinically or on imaging (biopsy of metastatic disease preferred, but not required)

  • Cohort 1

    • One to five detectable sites of metastatic disease at any organ or site (including bone and CNS involvement)

      • Maximum size of 3 cm for brain lesions.
      • Note: Measurable disease is not required
      • Note: Patients with isolated intracranial disease for whom SRS would be the preferred standard of care are not eligible.
      • Note: Patients may have additional sites of disease for which radiation is not feasible or indicated provided this disease is: 1) Less than 1 cm in maximum diameter on most recent imaging; or 2) Stable over the last 3 months as determined by the investigator
  • Cohort 2

    • At least 1 site of non-osseous disease
  • Cohort 1

    • All (up to 5) metastatic foci should be amenable to SBRT as per review by a radiation oncologist based on protocol specified dose / dose constraints (there is no prespecified minimum or maximum size)
  • Cohort 2

    • At least one metastatic focus amenable to local ablative treatment with any of the following: radiation therapy; radiofrequency, microwave, or cryoablation; bland or chemoembolization
  • Cohort 1

    • Primary tumor either controlled, or amenable for local treatment with SBRT
    • Defined as no evidence of progression at primary or local site of disease (if known) within 6 months prior to enrollment
  • Age 18 years or older

  • ECOG performance status of 0-2

  • Prior systemic therapy is allowed but no therapy (cytotoxic or molecularly targeted agents) 2 weeks prior to the first fraction of radiotherapy, and until after the last fraction of SBRT.

  • Cohort 1

    • For patients with metastases that have been previously treated (prior resection, radiotherapy, radiofrequency or cryoablation):

      • If the previously treated site is controlled based on imaging, the patient is eligible for this trial and does not need further treatment of the controlled site
      • If the previously treated site is not controlled based on imaging, the patient is eligible for this trial as long as the site is amenable to SBRT
  • Ability to understand and the willingness to sign a written informed consent document.

  • Women of childbearing potential must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 72 hours prior to the start of (chemo)radiation therapy.

"Women of childbearing potential (WOCBP)" is defined as any female who has experienced menarche and who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) or who is not postmenopausal. Menopause is defined clinically as 12 months of amenorrhea in a woman over 45 in the absence of other biological or physiological causes. In addition, women under the age of 55 must have a documented serum follicle stimulating hormone (FSH) level less than 40 mIU/mL.

  • Men who are sexually active with WOCBP must agree to use any contraceptive method with a failure rate of less than 1% per year. Men who are sexually active with WOCBP will be instructed to adhere to contraception for a period of 1 month after treatment. Women who are not of childbearing potential (i.e., who are postmenopausal or surgically sterile as well as azoospermic men) do not require contraception. See Appendix B for further guidance on contraception.

Exclusion Criteria:

  • Cohort 1

    • Subject who has received systemic therapy for treatment of ACC within 2 weeks of enrollment.
  • Evidence of need for urgent surgical intervention for metastatic CNS or spine disease.

  • Cohort 1

    • Alternative locally ablative therapies received (radiofrequency ablation, cryotherapy, or [chemo]embolization) for any metastatic foci planned for SBRT at the time of study enrollment that precludes administration of SBRT.
  • Bone metastasis in a femoral bone for which surgical stabilization is recommended.

  • Cohort 1

    • Active disease >1 cm that is progressing and not amenable to SBRT.
  • Pregnant or lactating women.

  • Uncontrolled intercurrent illness including, but not limited to, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.

  • Has a known additional malignancy that is progressing or requires active treatment. Exceptions: include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer, and low-risk prostate adenocarcinoma being managed with active surveillance. A history of another separate malignancy in remission without evidence of active disease in the last 2 years is permitted.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
アクティブコンパレータ:Standard of Care (Cohort 1)

Participants will be randomly assigned and receive standard of care as determined by their physician and may include: palliative radiation and/or a systemic therapy (like chemotherapy, immunotherapy, or targeted therapies).

Participants will be randomly assigned and receive standard of care as determined by their physician and may include: palliative radiation and/or a systemic therapy (like chemotherapy, immunotherapy, or targeted therapies).

実験的:Stereotactic Body Radiotherapy (SBRT) 1-5 Metastatic Sites (Cohort 1)

Participants will be randomly assigned and receive SBRT to 1-5 sites of metastatic disease over the course of 1-8 business days to each area of cancer.

After SBRT is completed participant may go on to receive systemic therapy (like chemotherapy, immunotherapy, or targeted therapies) per discretion of their treating physician.

SBRT to 1-5 sites of metastatic disease over the course of 1-8 business days to each area of cancer

他の名前:
  • 体幹定位放射線治療
介入なし:Local Ablative Therapy (Cohort 2)

Participants embarking on standard of care local ablative therapy (not limited to radiofrequency, microwave, or cryoablation, bland or chemoembolization, palliative radiotherapy, or surgical metastasectomy) not eligible for cohort 1 will be enrolled and followed.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Progression Free Survival (PFS) (Cohort 1)
時間枠:Time from randomization to local, regional, distant progression or death due to any cause, whichever occurs first, assessed up to 5 years

Assessed using RECIST v1.1 and Kaplan-Meier

Time from randomization to local, regional, distant progression or death due to any cause, whichever occurs first, assessed up to 5 years
Local Control Rate (Cohort 2)
時間枠:2 years from enrollment

Estimating 2-year local control rate following local treatment of ACC lesions. Assessed using RECIST v1.1.

2 years from enrollment

二次結果の測定

結果測定
メジャーの説明
時間枠
Overall Survival (OS)
時間枠:Time from randomization to death from any cause or date last known alive, assessed up to 5 years

Assessed using RECIST v1.1 and Kaplan-Meier

Time from randomization to death from any cause or date last known alive, assessed up to 5 years
Toxicity Rate
時間枠:Enrollment to end of treatment up to 2 years

Assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0

Enrollment to end of treatment up to 2 years
Quality of Life (QOL) assessments by FACT-G
時間枠:Baseline and every 3 months for 2 years

Descriptive statistics will be performed to characterize QOL data

Baseline and every 3 months for 2 years
Local Disease Control Rate
時間枠:Time from randomization to free of locoregional progression, assessed up to 5 years

Free of locoregional progression within irradiated oligometastatic sites, assessed using Kaplan-Meier

Time from randomization to free of locoregional progression, assessed up to 5 years
Time to next systemic therapy for progression of disease
時間枠:Time from randomization to initiation of systemic therapy for progression of disease, assessed up to 5 years

Assessed using Kaplan-Meier

Time from randomization to initiation of systemic therapy for progression of disease, assessed up to 5 years
Time to local therapy for progression of disease
時間枠:Time from randomization to initiation of local therapy for progression of disease, assessed up to 5 years

Assessed using Kaplan-Meier

Time from randomization to initiation of local therapy for progression of disease, assessed up to 5 years

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

協力者

捜査官

  • 主任研究者:Jonathan D Schoenfeld, MD, MPH、Brigham and Women's Hospital

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2021年12月27日

一次修了 (推定)

2028年6月1日

研究の完了 (推定)

2030年6月1日

試験登録日

最初に提出

2021年5月3日

QC基準を満たした最初の提出物

2021年5月7日

最初の投稿 (実際)

2021年5月12日

学習記録の更新

投稿された最後の更新 (実際)

2026年10月5日

QC基準を満たした最後の更新が送信されました

2026年9月30日

最終確認日

2026年9月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • 21-171

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

はい

米国で製造され、米国から輸出された製品。

はい

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