REDEL Trial: Reduced Elective Nodal Dose for Anal Cancer Toxicity Mitigation

NCT ID: NCT05902533

Last Updated: 2025-12-18

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

33 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-14

Study Completion Date

2029-08-14

Brief Summary

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To determine the efficacy of reduced elective nodal radiation in anal cancer patients undergoing chemoradiation in reducing toxicity compared to standard nodal irradiation.

Detailed Description

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This is a multi-center, single arm prospective trial to evaluate whether reduced elective nodal dose (30.6 Gy) reduces toxicity as defined by the CTCAE Toxicity Index compared to historic patients treated with standard nodal dose on NRG/RTOG0529 and patient reported GI toxicity using the validated PRO-CTCAE scale for diarrhea compared to historic patients treated on UC-GI-1601.

Conditions

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Anal Cancer

Keywords

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Toxicity Mitigation Reduced Elective Nodal Dose

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Single arm prospective trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Reduced Elective Dose + Concurrent Capecitabine/Mitomycin C

Reduced elective nodal dose (30.6 Gy); (28- 30 fractions given M-F for approximately 5.5 to 6 weeks) Capecitabine 825 mg/m2 BID on days with RT Mitomycin C 10 mg/m2 slow IV push Days 1 and 29

Group Type EXPERIMENTAL

Radiation (reduced elective nodal dose (30.6 Gy)

Intervention Type RADIATION

28-30 fractions Monday through Friday of intended chemoradiation depending on the total dose required (50.4-54 Gy) which will occur over approximately 5.5 to 6 weeks.

Capecitabine

Intervention Type DRUG

825 mg/m2 BID (Oral Twice daily on days with RT)

Mitomycin c

Intervention Type DRUG

10 mg/m2 slow IV push Day 1 and 29

Interventions

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Radiation (reduced elective nodal dose (30.6 Gy)

28-30 fractions Monday through Friday of intended chemoradiation depending on the total dose required (50.4-54 Gy) which will occur over approximately 5.5 to 6 weeks.

Intervention Type RADIATION

Capecitabine

825 mg/m2 BID (Oral Twice daily on days with RT)

Intervention Type DRUG

Mitomycin c

10 mg/m2 slow IV push Day 1 and 29

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Age ≥18 years.
2. Patients must have stage T1-4N+M0 or T3/T4N0M0 locally advanced anal cancer as evidenced by a PET scan AND either a CT with contrast of the abdomen/pelvis or an MRI with contrast of the pelvis. All imaging must be from within 60 days prior to registration.

1. Note: Patients with T2N0 disease will be allowed if the primary tumor is \>4 cm. Patients with Stage I-T1N0M0 or Stage II-T2N0M0 (tumor ≤ 4cm) will be ineligible for participation.
2. Patients with perianal cancer that is HPV associated (P16+) will be eligible if the tumor extends to the anal verge and the CTV will include the mesorectal, internal/external iliac, and inguinal lymph nodes.
3. Patients with excision of the primary tumor but with node positive disease or residual disease at the primary if T3T4N0 will be eligible.
3. ECOG performance status 0 or 1 (or Karnofsky ≥70, see Appendix A).
4. Patients must be able to receive concurrent treatment with capecitabine and Mitomycin C in the opinion of the investigator.
5. Creatinine Clearance must be \> 30 ml/min.
6. Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria

1. Any prior pelvic radiation.
2. History of allergic reactions attributed to compounds of similar chemical or biologic composition to capecitabine.
3. Patients with uncontrolled intercurrent illness that in the opinion of the investigator would prevent receipt of radiation or capecitabine.

a. Note: HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial.
4. Pregnant or breastfeeding women are excluded from this study.
5. Patients with a prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen in the opinion of the investigator.
6. Patients with active autoimmune or connective tissue disease requiring systemic treatment are excluded from this study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Cincinnati

OTHER

Sponsor Role lead

Responsible Party

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Jordan Kharofa

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University of Cincinnati Medical Center

Cincinnati, Ohio, United States

Site Status

Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

University of Vermont

Burlington, Vermont, United States

Site Status

Countries

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United States

Other Identifiers

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UCCC-GI-23-01

Identifier Type: -

Identifier Source: org_study_id