Adjuvant Radioimmunotherapy Compared With Adjuvant Chemotherapy for UTUC

NCT ID: NCT06120374

Last Updated: 2025-12-30

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

Total Enrollment

178 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-01-01

Study Completion Date

2029-06-08

Brief Summary

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This study is an ambispective cohort observational study to analyze the efficacy of adjuvant radioimmunotherapy (radiotherapy and immunotherapy) compared with adjuvant chemotherapy in patients with the upper urinary tract urothelial carcinoma with high-risk factors (postoperative pathology suggestive of pT2 and above, N+, G3/high-grade and multiple tumors, positive cut margins). A subgroup analysis was performed to obtain the population of patients who might benefit from different treatment approaches. Patients with high risk factors for postoperative recurrence or metastasis will be treated with relevant adjuvant therapy, which in turn will benefit patients.

Detailed Description

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This study is an ambispective cohort observational study to analyze the efficacy of adjuvant radioimmunotherapy (radiotherapy and immunotherapy) compared with adjuvant chemotherapy in patients with the upper urinary tract urothelial carcinoma with high-risk factors (postoperative pathology suggestive of pT2 and above, N+, G3/high-grade and multiple tumors, positive cut margins). A subgroup analysis was performed to obtain the population of patients who might benefit from different treatment approaches. Patients with high risk factors for postoperative recurrence or metastasis will be treated with relevant adjuvant therapy, which in turn will benefit patients.

Conditions

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Urothelial Carcinoma

Keywords

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upper tract urothelial carcinoma adjuvant therapy adjuvant radiotherapy adjuvant chemotherapy immunotherapy safety analysis progression free survival overall survival

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Adjuvant radioimmunotherapy

Participants underwent adjuvant radioimmunotherapy

Radiotherapy

Intervention Type RADIATION

For participants eligible for enrollment, radiotherapy was started within 4-6 weeks after surgery. Rotational intensity-modulated radiotherapy (VMAT) with daily image-guided radiotherapy (Daily IGRT) technique was used.

Range of irradiation (patients were randomized into two groups - expanded field irradiation group and involved field irradiation group)

Immunotherapy

Intervention Type DRUG

For patients eligible for enrollment, sequential adjuvant immuotherapy was initiated at about 4-6 weeks after surgery, Immunotherapeutic agents include (PD-1/PD-L1) to be used every 21 days postoperatively for one year.

Adjuvant chemotherapy

Participants underwent radical total nephroureterectomy and adjuvant chemotherapy

Chemotherapy

Intervention Type DRUG

For patients eligible for enrollment, postoperative adjuvant chemotherapy was initiated at about 4-6 weeks after surgery, for a total of 4 cycles, with the chemotherapy regimen of gemcitabine + cisplatin. Administration: Gemcitabine 1,000 mg/m2 on days 1 and 8 (completed within 30-60 minutes), cisplatin 70 mg/m2 on day 1.

Interventions

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Radiotherapy

For participants eligible for enrollment, radiotherapy was started within 4-6 weeks after surgery. Rotational intensity-modulated radiotherapy (VMAT) with daily image-guided radiotherapy (Daily IGRT) technique was used.

Range of irradiation (patients were randomized into two groups - expanded field irradiation group and involved field irradiation group)

Intervention Type RADIATION

Chemotherapy

For patients eligible for enrollment, postoperative adjuvant chemotherapy was initiated at about 4-6 weeks after surgery, for a total of 4 cycles, with the chemotherapy regimen of gemcitabine + cisplatin. Administration: Gemcitabine 1,000 mg/m2 on days 1 and 8 (completed within 30-60 minutes), cisplatin 70 mg/m2 on day 1.

Intervention Type DRUG

Immunotherapy

For patients eligible for enrollment, sequential adjuvant immuotherapy was initiated at about 4-6 weeks after surgery, Immunotherapeutic agents include (PD-1/PD-L1) to be used every 21 days postoperatively for one year.

Intervention Type DRUG

Other Intervention Names

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SBRT Based on platinum and gemcitabine Mainly on PD-1/PD-L1

Eligibility Criteria

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Inclusion Criteria

* Confirmed pathologic diagnosis as upper urinary tract urothelial carcinoma(UTUC);
* High-risk UTUC: \>= pT2, pN+, tumor G3 grade, multifocality or positive surgical margins (according to AJCC 8th edition);
* Aged \>= 18 years old;

Exclusion Criteria

* With Distant metastases already found at the time of surgery; non-R0 resected ;
* History of pelvic and abdominal radiotherapy; history of inflammatory bowel disease; history of systemic chemotherapy;
* Pregnant or lactating women; or women of childbearing potential who are not using reliable contraception;
* History of malignant tumors (except skin cancer that is not malignant melanoma and in situ cervical cancer, tumors that have been cured for more than 5 years);
* Weight loss \> 10% within 6 months;
* Existing or coexisting bleeding disorders, active infection;
* Terrible condition cannot tolerate the intervention;
* Unable to sign informed consent due to psychological, family, social and other factors.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Peking University First Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xuesong Li

Department of Urology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xiaoying Li, M.D.

Role: PRINCIPAL_INVESTIGATOR

Department of Radiotherapy Oncology, Peking University First Hospital

Liqun Zhou, M.D.

Role: STUDY_CHAIR

Department of Urology, Peking University First Hospital

Locations

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Departmeng of Urology, Peking University First Hospital

Beijing, , China

Site Status RECRUITING

Department of Medical Oncology, Peking University First Hospital

Beijing, , China

Site Status RECRUITING

Department of Radiotherapy Oncology, Peking University First Hospital

Beijing, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xuesong Li, M.D.

Role: CONTACT

Phone: +86-15801399116

Email: [email protected]

Chunru Xu, M.D.

Role: CONTACT

Phone: +8617812172086

Email: [email protected]

Facility Contacts

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Xuesong Li, M.D.

Role: primary

Chunru Xu, M.D.

Role: backup

Shikai Wu, M.D.

Role: primary

Jinglin Yu, M.D.

Role: backup

Xianshu Gao, M.D.

Role: primary

Xiaoying Li, M.D.

Role: backup

References

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Seisen T, Krasnow RE, Bellmunt J, Roupret M, Leow JJ, Lipsitz SR, Vetterlein MW, Preston MA, Hanna N, Kibel AS, Sun M, Choueiri TK, Trinh QD, Chang SL. Effectiveness of Adjuvant Chemotherapy After Radical Nephroureterectomy for Locally Advanced and/or Positive Regional Lymph Node Upper Tract Urothelial Carcinoma. J Clin Oncol. 2017 Mar 10;35(8):852-860. doi: 10.1200/JCO.2016.69.4141. Epub 2017 Jan 3.

Reference Type BACKGROUND
PMID: 28045620 (View on PubMed)

Birtle A, Johnson M, Chester J, Jones R, Dolling D, Bryan RT, Harris C, Winterbottom A, Blacker A, Catto JWF, Chakraborti P, Donovan JL, Elliott PA, French A, Jagdev S, Jenkins B, Keeley FX Jr, Kockelbergh R, Powles T, Wagstaff J, Wilson C, Todd R, Lewis R, Hall E. Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial. Lancet. 2020 Apr 18;395(10232):1268-1277. doi: 10.1016/S0140-6736(20)30415-3. Epub 2020 Mar 5.

Reference Type BACKGROUND
PMID: 32145825 (View on PubMed)

Li X, Li H, Gao XS, Fang D, Qin S, Zhang Z, Zhou L, Li X, Wang D. Effectiveness of adjuvant radiotherapy for high recurrence risk patients with upper tract urothelial carcinoma. Urol Oncol. 2022 Sep;40(9):410.e1-410.e10. doi: 10.1016/j.urolonc.2022.03.006. Epub 2022 Apr 14.

Reference Type RESULT
PMID: 35431134 (View on PubMed)

Li X, Cui M, Gu X, Fang D, Li H, Qin S, Yang K, Zhu T, Li X, Zhou L, Gao XS, Wang D. Pattern and risk factors of local recurrence after nephroureterectomy for upper tract urothelial carcinoma. World J Surg Oncol. 2020 May 30;18(1):114. doi: 10.1186/s12957-020-01877-w.

Reference Type RESULT
PMID: 32473636 (View on PubMed)

Other Identifiers

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LUXUS2.0

Identifier Type: -

Identifier Source: org_study_id