A Multicenter Single-arm P2 to Evaluate Safety and Efficacy of the Total Neoadjuvant Therapy for cT2 Rectal Cancer

NCT ID: NCT05939661

Last Updated: 2023-07-11

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

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-25

Study Completion Date

2030-03-31

Brief Summary

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A multicenter single-arm phase 2 study to evaluate safety and efficacy of the total neoadjuvant therapy of short course radiation therapy followed by neoadjuvant oxaliplatin/fluorouracil-based chemotherapy (CAPOX) for cT2 rectal cancer

Detailed Description

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To evaluate the efficacy and safety of preoperative radiation therapy followed by preoperative chemotherapy and surgery for T2 advanced rectal cancer.

Conditions

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Rectal Cancer

Study Design

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Allocation Method

NA

Intervention Model

SEQUENTIAL

RT→Chemo→Surgery
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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TNT

Neoadjuvant radiation therapy : 5Gyx5 Neoadjuvant chemo therapy : CAPOX (Oxaliplatin 130mg/m2, Capecitabine2000mg/m2/day, d1-14, 3week)x6cycles Operation: Total methorectum excision wiht radical lymph node dissection

Group Type EXPERIMENTAL

Radiation

Intervention Type RADIATION

Neoadjuvant radiation therapy : 5Gyx5

Chemotherapy

Intervention Type DRUG

CAPOX (Oxaliplatin 130mg/m2, Capecitabine2000mg/m2/day, d1-14, 3week)x6cycles

Surgery

Intervention Type PROCEDURE

Operation: Total methorectum excision wiht radical lymph node dissection

Interventions

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Radiation

Neoadjuvant radiation therapy : 5Gyx5

Intervention Type RADIATION

Chemotherapy

CAPOX (Oxaliplatin 130mg/m2, Capecitabine2000mg/m2/day, d1-14, 3week)x6cycles

Intervention Type DRUG

Surgery

Operation: Total methorectum excision wiht radical lymph node dissection

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* 1\. The patient has been fully informed of the contents of the study and has given written consent.

2\. The patient has adenocarcinoma of the rectum confirmed by histological examination.

3\. No distant metastases are detected on imaging studies, and radical resection is clinically feasible.

4\. Age of 20 years or older on the date of consent. 5. ECOG Performance Status (PS) is 0 - 1 (PS 0 for age 71 years or older on the date of consent).

6\. Previously untreated rectal cancer with the lower margin of the tumor within 12 cm of the anal verge (AV).

7\. Patients with cT2N0M0 in the diagnosis before starting treatment (a lymph node with a short diameter of 7 mm or more is considered positive).

The conditions for lymph node metastasis shall be as follows. Contrast-enhanced CT or MRI (plain or contrast-enhanced) with a slice width of 5 mm or less.

(i) Short diameter of 10 mm or more (ii) Short diameter of 7 mm or more and one or more of the following a) to c) are met

(a) Edge irregularity (b) Low signal area with internal heterogeneity on MRI (c) Circular (long/short diameter ratio \< 1.5) If contrast-enhanced CT is not possible due to contrast medium allergy, renal dysfunction, or bronchial asthma, simple CT is acceptable.

8\. The following criteria for major organ function within 14 days prior to registration are met.

If more than one test result exists within this period, the most recent one should be used. No blood transfusions or hematopoietic factor products should be administered within 14 days prior to the test date.

1. Neutrophil count: greater than or equal to 1,500/mm3
2. Platelet count: \>= 10.0 x 104 /mm3
3. Hemoglobin concentration: \>=9.0 g/dL
4. Total bilirubin: 1.5 times or less than the upper limit of the institutional standard
5. AST, ALT, ALP: 2.5 times or less than the upper limit of the institutional standard
6. Serum creatinine: 1.5 times or less than the upper limit of the institutional standard or creatinine clearance: 45 mL/min or more

Exclusion Criteria

* 1\. underwent treatment by any of the following within a certain period of time prior to initiation of protocol therapy

1. extensive surgery (excluding CV port placement) within 4 weeks
2. Any anticancer therapy within 4 weeks
3. Radiation within 4 weeks 2. concomitant or pre-existing severe pulmonary disease (interstitial pneumonia, pulmonary fibrosis, severe emphysema, etc.) 3. patients who have had a colonic stent implanted 4. patients with serious comorbidities (heart failure, renal failure, liver failure, bleeding peptic ulcer, intestinal paralysis, bowel obstruction, poorly controlled diabetes, etc.) 5. patients with active multiple overlapping cancers (synchronous multiple overlapping cancers or iatrogenic multiple overlapping cancers with a disease-free period of 5 years or less). However, carcinoma in situ (intraepithelial carcinoma) or intramucosal carcinoma that is considered curable by local treatment is not considered active multiple overlapping carcinoma.

6\. pregnant or lactating women, positive pregnancy test or unwillingness to use contraception 7. HBs antigen positive or HCV antibody positive. 8. has known human immunodeficiency virus (HIV) infection. 9. otherwise judged by the principal investigator or subinvestigator to be unsuitable for this study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Osaka University

OTHER

Sponsor Role lead

Responsible Party

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Mamoru Uemura

Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Osaka General Medical Center

Osaka, , Japan

Site Status RECRUITING

Osaka University Hospital

Osaka, , Japan

Site Status RECRUITING

Countries

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Japan

Central Contacts

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Mamoru Uemura, MD, PhD

Role: CONTACT

+81-6-6879-3251

Yoshinori Kagawa, MD, PhD

Role: CONTACT

+81-6-6692-1201

Facility Contacts

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Yoshinori Kagawa

Role: primary

Mamoru Uemura

Role: primary

Other Identifiers

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jRCTs051230014

Identifier Type: -

Identifier Source: org_study_id

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