PD-L1 PET Imaging During Neoadjuvant (Chemo)Radiotherapy in Esophageal and Rectal Cancer

NCT ID: NCT04564482

Last Updated: 2024-03-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-01

Study Completion Date

2026-06-01

Brief Summary

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The overall aim of this pilot study is to prospectively monitor programmed death-ligand 1 (PD-L1) expression dynamics in vivo, during neoadjuvant chemoradiotherapy (CRT) or short-course preoperative radiotherapy (SCPRT) in rectal and esophageal cancer by a positron emission tomography (PET) imaging approach.

Detailed Description

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Conditions

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Rectal Cancer Stage Oesophageal Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Neoadjuvant Chemoradiotherapy (CRT)

Group Type OTHER

CRT

Intervention Type RADIATION

50 Gy in 2 Gy fractions over 25 working days + capecitabine 1650 mg/m2/d PO

PD-L1 PET

Intervention Type DIAGNOSTIC_TEST

10 mg atezolizumab IV followed by 37 MBq 89Zr-atezolizumab IV. PET imaging will be done before neoadjuvant CRT/SCPRT (day 0) and between day 10-14 during CRT/SCPRT.

Short-course preoperative radiotherapy (SCPRT)

Group Type OTHER

SCPRT

Intervention Type RADIATION

25 Gy in 5 Gy fractions over 5 working days

PD-L1 PET

Intervention Type DIAGNOSTIC_TEST

10 mg atezolizumab IV followed by 37 MBq 89Zr-atezolizumab IV. PET imaging will be done before neoadjuvant CRT/SCPRT (day 0) and between day 10-14 during CRT/SCPRT.

Neoadjuvant Chemoradiotherapy (CROSS protocol)

Group Type OTHER

CROSS Protocol

Intervention Type RADIATION

41.4 Gy in 1.8 Gy fractions over 23 working days + carboplatin AUC of 2 mg/ml/min + paclitaxel 50 mg/m2 IV Q1W

PD-L1 PET

Intervention Type DIAGNOSTIC_TEST

10 mg atezolizumab IV followed by 37 MBq 89Zr-atezolizumab IV. PET imaging will be done before neoadjuvant CRT/SCPRT (day 0) and between day 10-14 during CRT/SCPRT.

Interventions

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CRT

50 Gy in 2 Gy fractions over 25 working days + capecitabine 1650 mg/m2/d PO

Intervention Type RADIATION

SCPRT

25 Gy in 5 Gy fractions over 5 working days

Intervention Type RADIATION

CROSS Protocol

41.4 Gy in 1.8 Gy fractions over 23 working days + carboplatin AUC of 2 mg/ml/min + paclitaxel 50 mg/m2 IV Q1W

Intervention Type RADIATION

PD-L1 PET

10 mg atezolizumab IV followed by 37 MBq 89Zr-atezolizumab IV. PET imaging will be done before neoadjuvant CRT/SCPRT (day 0) and between day 10-14 during CRT/SCPRT.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* 18 years of age and older
* All sexes
* Histologically confirmed carcinoma of the rectum or oesophagus (squamous cell carcinoma and adenocarcinoma, including oesophago-gastric junction cancers)
* Medical need for a neoadjuvant CRT/SCPRT
* Suitable to withstand the course of neoadjuvant CRT/SCPRT
* Written informed consent form (ICF) for participation in the study

Exclusion Criteria

* Metastatic disease, which is considered incurable by local therapies (expect for oligometastatic disease with a curative intend)
* Previous surgery of the tumor other than biopsy
* Pregnancy, breastfeeding or expectancy to conceive
* Prior therapy with anti-CTLA-4, anti-PD-1, anti-PD-L1, anti-PD-L2 or any other agent directed against co-inhibitory T cell receptors or has previously participated in clinical studies with immunotherapy
* Disagreement of participants with reproductive potential to use contraception throughout the study period and for up to 180 days after the last dose of study therapy
* Hepatitis B or C
* Human immunodeficiency virus (HIV)
* Immunodeficiency
* Allogeneic tissue or solid organ transplantation
* Autoimmune disease that has required systemic therapy in the past 2 years with modifying agents, steroids or immunosuppressive drugs
* Active non-infectious pneumonitis
* Active infection requiring systemic therapy
* Systemic steroids or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment
* Diagnosed and/or treated additional malignancy within 5 years of randomization, with the exception of curatively-treated basal cell or squamous cell carcinoma of the skin and/or curatively-resected in situ cervical and/or breast cancers
* Treatment with botanical preparations (i.e. herbal supplements or traditional Chinese medicines) intended for general health support or to treat the disease under study within 2 weeks prior to randomization/treatment
* Participants with serious or uncontrolled medical disorders
* Uncontrolled or significant cardiovascular disease (myocardial infarction, uncontrolled angina, any history of clinically significant arrhythmias, QTc prolongation in males \> 450 ms and \> 470 ms in females, participants with history of myocarditis)
* Allergies and adverse drug reaction (history of allergy or hypersensitivity to study drug components, contraindications to any of the study drugs of the chemotherapy regimen)
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Johannes Laengle, MD, PhD

OTHER

Sponsor Role lead

Responsible Party

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Johannes Laengle, MD, PhD

Sub-Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Alexander Haug, MD

Role: PRINCIPAL_INVESTIGATOR

Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna

Locations

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Medical University of Vienna

Vienna, , Austria

Site Status RECRUITING

Countries

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Austria

Central Contacts

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Johannes Laengle, MD, PhD

Role: CONTACT

+43140400 69260

Michael Bergmann, MD

Role: CONTACT

+43140400 69260

Facility Contacts

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Johannes Laengle, MD, PhD

Role: primary

+43 1 40400 69260

Michale Bergmann, MD

Role: backup

+43 1 40400 69260

Other Identifiers

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2020-003142-37

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

PETNEC

Identifier Type: -

Identifier Source: org_study_id

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