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

8. juli 2026 oppdatert av: 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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

184

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Canada
      • Montreal, Canada
        • McGill University Health Center
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Control
SOC neoadjuvant FLOT (or FLOT-D)
Legemiddel: FLOT (Fluorouracil+Leucovorin+Oxaliplatin+Docetaxel)
Standard of care neoadjuvant FLOT
Legemiddel: Durvalumab
Standard of care Durvalumab added to FLOT regimen.
Eksperimentell: Experimental
SOC neoadjuvant FLOT (or FLOT-D) + simvastatin
Legemiddel: FLOT (Fluorouracil+Leucovorin+Oxaliplatin+Docetaxel)
Standard of care neoadjuvant FLOT
Legemiddel: Durvalumab
Standard of care Durvalumab added to FLOT regimen.
Legemiddel: Simvastatin
Investigational drug added to standard of care FLOT or FLOT+D

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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 Common Terminology Criteria for Adverse Events (CTCAE) version 6.0, warranting dosage modification or stoppage of interventional drug or chemotherapy. CTCAE grading is from 1 to 5, while grade 1 is the least severe (mild) and grade 5 is the most severe (death).
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 event-free-survival (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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

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

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. januar 2027

Primær fullføring (Antatt)

1. april 2029

Studiet fullført (Antatt)

1. april 2031

Datoer for studieregistrering

Først innsendt

29. mai 2026

Først innsendt som oppfylte QC-kriteriene

29. mai 2026

Først lagt ut (Faktiske)

4. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

10. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

8. juli 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • THOR-ESO-2026-01

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

UBESLUTTE

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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