Stereotactic Ablative Radiotherapy for Oligo-Progressive Disease REfractory to Systemic Therapy in Metastatic Cancer

NCT ID: NCT04989725

Last Updated: 2023-12-12

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

PHASE2

Total Enrollment

46 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-01

Study Completion Date

2027-12-01

Brief Summary

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A registry-based randomized phase II trial. A total of 46 patients with metastatic head and neck cancer on systemic therapy with oligoprogression to 1-5 extracranial lesions will be randomized using a 1:1 ratio to standard of care (begin next-line systemic therapy, best supportive care, continue current systemic line, based on treating physician decision) vs. receive stereotactic ablative radiotherapy to all oligoprogressive lesions while continuing their current systemic therapy.

Detailed Description

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Conditions

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Head and Neck Cancer Metastatic Cancer Oligoprogressive

Keywords

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head and neck cancer metastatic cancer oligoprogression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized screening phase II trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Standard of care

Switch to subsequent systemic therapy line, best supportive care or continue current systemic line

Group Type ACTIVE_COMPARATOR

Standard arm

Intervention Type OTHER

Patients on the standard arm will be treated as per standard of care in our institution. Treatment options could include switching to next systemic therapy line, best supportive care or continuing on current systemic therapy.

Experimental SABR arm

Definitive SABR to oligoprogressive lesions + continue current systemic therapy

Group Type EXPERIMENTAL

Experimental arm

Intervention Type RADIATION

SABR to all oligoprogressive lesions + continuation of current systemic therapy

Interventions

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Standard arm

Patients on the standard arm will be treated as per standard of care in our institution. Treatment options could include switching to next systemic therapy line, best supportive care or continuing on current systemic therapy.

Intervention Type OTHER

Experimental arm

SABR to all oligoprogressive lesions + continuation of current systemic therapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years
* Biopsy proven HNSCC (oropharynx, oral cavity, nasopharynx, sinonasal, larynx or hypopharynx)
* Metastatic HNSCC, with pathological or radiological proof of metastasis
* Ability to provide written informed consent
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2
* Progressive disease while on systemic treatment (any line), defined as per RECIST criteria 1.1 on CT metrics as a greater than 20% increase in the sum measurement of lesions, non-target unequivocal progressive disease or a new lesion on CT.
* Oligoprogression to 1-5 extracranial lesions ≤ 5cm and involving ≤ 3 organs. Progression at the primary tumor site should be counted within the total of 5 lesions. For patients with lymph node metastases, each node is counted as one site of metastasis.
* All sites of disease can, in the opinion of the investigator, be safely treated and targetable with SABR (taking into account prior local therapy, organ function and underlying medical condition such as inflammatory bowel disease, pulmonary fibrosis, etc.)
* Patients with prior metastases that have been treated with ablative therapies (e.g. radiotherapy, surgery or radiofrequency ablation) before their current line of systemic therapy, are eligible.

Exclusion Criteria

* Pregnancy or breastfeeding
* Any medical condition that could, in the opinion of the investigator, preclude radiotherapy or prevent follow-up after radiotherapy.
* Presence of spinal cord compression
* Metastatic disease that invades the GI tract (including esophagus, stomach, small or large bowel
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre hospitalier de l'Université de Montréal (CHUM)

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Centre Hospitalier de l'Université de Montréal

Montreal, Quebec, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Silvine Benth

Role: CONTACT

Phone: 514-890-8254

Email: [email protected]

Mom Phat

Role: CONTACT

Phone: 514-890-8254

Email: [email protected]

Facility Contacts

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Silvine Benth

Role: primary

Other Identifiers

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Suppress

Identifier Type: -

Identifier Source: org_study_id