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Shortening Radiation Course Duration Using Simultaneous Integrated Boost With Lower Intensity Elective Nodal Dosing and Concurrent Chemotherapy for High-Risk Anal Squamous Cell Carcinoma (SSIBLING)

10 września 2026 zaktualizowane przez: Christopher Anker, University of Vermont Medical Center

Shortening Radiation Course Duration Via Simultaneous Integrated Boost With Lower Intensity Elective Nodal Dosing While Giving Concurrent Chemotherapy for High-risk Anal Squamous Cell Carcinoma - a Phase 2 Study

This phase 2 single-arm study will evaluate whether a shortened course of mildly hypofractionated radiation therapy given with standard concurrent chemotherapy (mitomycin C and capecitabine) can provide acceptable tumor control in patients with high-risk non-metastatic anal squamous cell carcinoma. Standard chemoradiation for anal cancer typically requires approximately 5.5 to 6 weeks of daily radiation, which can create substantial logistical burden for patients and caregivers, particularly those in rural settings.

The investigational approach uses a 23-fraction radiation regimen designed to shorten treatment duration while maintaining biologically equivalent tumor-directed dosing compared with standard treatment. The primary question is whether this shorter chemoradiation regimen can achieve an acceptable 6-month complete clinical response rate while maintaining manageable toxicity.

Przegląd badań

Status

Rejestracja na zaproszenie

Warunki

Interwencja / Leczenie

Szczegółowy opis

Standard chemoradiation for high-risk non-metastatic anal squamous cell carcinoma typically requires approximately 27 to 30 fractions of radiation delivered over 5.5 to 6 weeks with concurrent chemotherapy. While effective, this prolonged treatment course creates substantial logistical burden for patients and caregivers, particularly for those living in rural regions with limited access to radiation oncology facilities.

This phase 2, single-arm study evaluates a shortened hypofractionated chemoradiation approach designed to reduce treatment duration while maintaining biologically comparable tumor-directed dosing relative to conventional treatment regimens. The investigational radiation regimen uses a simultaneous integrated boost (SIB) approach delivering 23 fractions over approximately 4.5 weeks, with reduced elective nodal dosing and concurrent standard-of-care chemotherapy consisting of mitomycin C and capecitabine.

The study focuses on patients with high-risk non-metastatic anal squamous cell carcinoma, including larger primary tumors and/or node-positive disease, a population for whom treatment de-escalation strategies are generally not appropriate. The primary objective is to evaluate whether this shortened regimen achieves an acceptable 6-month complete clinical response rate. Secondary objectives include assessment of survival outcomes, disease control, treatment interruptions, clinician- and patient-reported toxicity, quality of life, and treatment burden.

Exploratory correlative analyses will evaluate circulating tumor DNA (ctDNA) collected at protocol-specified time points to assess correlations between circulating biomarkers and clinical outcomes. The study also includes optional qualitative patient and caregiver interviews to better understand treatment experience and logistical burden associated with cancer therapy.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

24

Faza

  • Faza 2

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Lokalizacje studiów

    • Vermont
      • Burlington, Vermont, Stany Zjednoczone, 05401
        • University of Vermont Medical Center

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły
  • Starszy dorosły

Akceptuje zdrowych ochotników

Nie

Opis

Inclusion Criteria:

  • Age 18 years or older
  • Histologically or cytologically confirmed non-metastatic anal squamous cell carcinoma meeting one of the following criteria:

T2 tumor measuring ≥4 cm T3 or T4 disease Any node-positive disease

  • Patients with HPV-associated (p16-positive) perianal cancer are eligible if the tumor extends to the anal verge
  • Karnofsky Performance Status >60
  • Creatinine clearance >30 mL/min
  • Considered by the investigator to be appropriate candidates for concurrent capecitabine and mitomycin C chemotherapy
  • Ability to understand and willingness to provide informed consent
  • For participants of childbearing potential: negative pregnancy test or documented absence of pregnancy per institutional standard within 14 days prior to registration
  • Participants of reproductive potential must agree to use adequate contraception during study treatment and for 90 days after completion of therapy

Exclusion Criteria:

  • Prior pelvic radiation therapy
  • Uncontrolled intercurrent illness that, in the opinion of the investigator, would prevent safe receipt of radiation therapy or capecitabine
  • Prior or concurrent malignancy that, in the opinion of the investigator, could interfere with assessment of safety or efficacy
  • Current receipt of another investigational agent for treatment of anal squamous cell carcinoma

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Nie dotyczy
  • Model interwencyjny: Zadanie dla jednej grupy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Experimental: Hypofractionated Chemoradiation
Participants receive mildly hypofractionated radiation therapy delivered in 23 fractions using a simultaneous integrated boost approach with concurrent standard-of-care mitomycin C and capecitabine chemotherapy.
Participants receive mildly hypofractionated radiation therapy delivered in 23 fractions using a simultaneous integrated boost approach, given concurrently with standard-of-care mitomycin C and capecitabine chemotherapy.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Complete Clinical Response Rate at 6 Months
Ramy czasowe: 6 months after start of radiation therapy
Proportion of participants achieving complete clinical response, defined as absence of tumor and malignant ulceration in the anal canal and perianal skin on digital rectal examination and/or anoscopy, with resolution of palpable inguinal lymphadenopathy if present at baseline. Biopsy may be used when clinically indicated to confirm persistent disease.
6 months after start of radiation therapy

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Colostomy-Free Survival
Ramy czasowe: 2 years
Time from completion of treatment to colostomy placement or last follow-up without colostomy.
2 years
Disease-Free Survival
Ramy czasowe: 2 years
Time from study registration to disease progression, recurrence, or death from any cause.
2 years
Locoregional Control
Ramy czasowe: 2 years
Proportion of participants without locoregional disease failure involving the primary tumor or regional lymph node sites.
2 years
Local Control Rate
Ramy czasowe: 2 years
Proportion of participants without local recurrence at the primary tumor site.
2 years
Regional Control Rate
Ramy czasowe: 2 years
Proportion of participants without recurrence in regional lymph node sites.
2 years
Elective Regional Control Rate
Ramy czasowe: 2 years
Proportion of participants without recurrence in electively treated nodal regions.
2 years
Distant Metastasis-Free Survival
Ramy czasowe: 2 years
Time from study registration to development of distant metastatic disease or death.
2 years
Overall Survival
Ramy czasowe: 2 years
Time from study registration to death from any cause.
2 years
Treatment Interruption Rate
Ramy czasowe: During treatment (approximately 5 weeks)
Proportion of participants experiencing interruption or delay in planned protocol treatment.
During treatment (approximately 5 weeks)
Treatment-Related Toxicity
Ramy czasowe: Baseline through 24 months
Incidence of clinician-reported treatment-related adverse events graded according to CTCAE version 6.0.
Baseline through 24 months
Patient-Reported Treatment-Related Symptoms
Ramy czasowe: Baseline through 24 months
Patient-reported gastrointestinal, genitourinary, skin, and functional symptoms assessed using PRO-CTCAE.
Baseline through 24 months
Fecal Incontinence Severity Index Score
Ramy czasowe: Baseline through 24 months
The Fecal Incontinence Severity Index is a patient-reported measure of fecal incontinence severity based on the frequency of accidental leakage of gas, mucus, liquid stool, and solid stool. Total scores range from 0 to 61, with higher scores indicating more severe fecal incontinence.
Baseline through 24 months
Hazard Ratio for Clinical Recurrence According to HPV ctDNA Detection Status
Ramy czasowe: Baseline through 24 months

HPV ctDNA will be measured in serial plasma samples using a laboratory-based HPV ctDNA assay and categorized as detectable or undetectable. We will assess the correlation between baseline HPV ctDNA levels and selected clinical features via a Wilcoxon test. We will test for correlations between HPV ctDNA detection and recurrence-free survival using a landmark Cox proportional hazards model, with recurrence-free survival compared using the log-rank test

Clinical recurrence will be based on radiographic imaging, endoscopic assessment, and/or clinical examination, as determined by the evaluating physician. HPV ctDNA detection will not be considered a recurrence event.

Baseline through 24 months
Patient and Caregiver Treatment Experience Assessed Through Qualitative Interviews
Ramy czasowe: Approximately 3 months after treatment
Patient and caregiver experiences will be assessed using semi-structured Patient and Caregiver/Support Person Experience Interviews. Interview responses will be reviewed to identify common themes related to treatment burden, convenience, travel requirements, caregiver impact, treatment tolerance, and perceptions of the shortened treatment course.
Approximately 3 months after treatment
Fecal Incontinence Quality of Life Scale Domain Scores
Ramy czasowe: Baseline through 24 months
The Fecal Incontinence Quality of Life Scale measures quality of life across four domains: lifestyle, coping/behavior, depression/self-perception, and embarrassment. Domain scores range from 1 to 5, with higher scores indicating better quality of life.
Baseline through 24 months
Baseline HPV ctDNA Levels According to Selected Clinical Features
Ramy czasowe: Baseline
Baseline HPV ctDNA levels will be measured in plasma using a laboratory-based HPV ctDNA assay. Correlations between baseline HPV ctDNA levels and selected demographic and disease-related clinical features will be assessed using a Wilcoxon test.
Baseline

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Śledczy

  • Główny śledczy: Christopher L Anker, MD, University of Vermont Cancer Center

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

26 sierpnia 2026

Zakończenie podstawowe (Szacowany)

1 maja 2039

Ukończenie studiów (Szacowany)

1 kwietnia 2040

Daty rejestracji na studia

Pierwszy przesłany

2 sierpnia 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

17 sierpnia 2026

Pierwszy wysłany (Rzeczywisty)

20 sierpnia 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

15 września 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

10 września 2026

Ostatnia weryfikacja

1 września 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • UVMCC2604
  • temp (Inny numer grantu/finansowania: University of Vermont Cancer Center)

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Opis planu IPD

Individual participant data will not be shared because no IPD-sharing plan has been established for this small investigator-initiated study. Study findings may be reported in aggregate form.

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .