OLIGO-10: Stereotactic Ablative Radiation Therapy for Metastatic Patients With 6 to 10 Metastatic Sites

NCT ID: NCT06856603

Last Updated: 2025-03-04

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-07

Study Completion Date

2030-12-31

Brief Summary

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Currently, the standard of care for patients with diagnosed metastatic cancer is drug therapy (chemotherapy, targeted therapy, or immunotherapy). However, the approach to oligometastatic disease (1-5 metastases) is evolving. An increasing number of de novo, persistent, and progressive oligometastatic tumors are now being treated with curative intent, with radiation therapy among the most effective treatment options, applied to metastatic sites in ablative doses. Emerging results from the SABR-COMET 3 and 5 trials, which investigate stereotactic ablative radiotherapy for patients with 1-3 and 1-5 metastatic sites, demonstrate a clear improvement in overall survival. However, patients with more than five metastases remain in a gray area.

The aim of our study is to assess the safety and effectiveness of radiation treatment for patients with tumors of various localizations and 6 to 10 metastases in the bones and internal organs. Stereotactic radiation therapy will be applied to patients with persistent or progressive metastatic forms of tumors, without changing their ongoing drug therapy regimen.

Detailed Description

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1. A patient with a previously verified diagnosis of a malignant neoplasm of any localization (ICD 10-11 codes C) who meets the inclusion criteria, after approval by the tumor board for the study group, will undergo the following procedures:

Three-dimensional/four-dimensional computed tomography for simulation using specialized fixation devices (the choice of the CT method and fixation devices will depend on the location of the metastasis).

The resulting images will be added to the contouring program.

Delineation of targets and organs at risk will be performed.

Clinical volumes and error margins will be determined.
2. The total dose per target and dose limits for critical structures will be prescribed.

Dosimetric planning for the course of external beam radiation therapy will be carried out.

Irradiation sessions will be conducted on a linear accelerator with a multi-leaf collimator, including a function for visual control of the target using cone beam tomography with kilo-voltage/mega-voltage radiation.

When the target is localized in the lungs, liver, or adrenal glands, to reduce the radiation load on surrounding healthy tissues and achieve necessary control over the position of the metastasis, irradiation will be performed with a deep breath hold or at specific phases of respiration.
3. Tumor Localization / Description / Total Focal Dose (Gy) / Number of Fractions / Single Focal Dose (Gy) / Irradiation Mode:

Lung Tumors:

Tumors ≤ 3 cm located in the parenchyma: TD 45 Gy in 3 fractions with 15 Gy each day Tumors adjacent to the chest wall or \< 3 cm: TD 50 Gy in 5 fractions with 10 Gy each day Tumors within 2 cm of the mediastinum or brachial plexus: TD 60 Gy in 8 fractions with 7.5 Gy each day Bones: TD 24 Gy in 3 fractions with 8 Gy each day

Brain Metastases:

Tumor volume from 0.5 to 5 cm³: TD 20-22 Gy in 1 fraction at a time Tumor volume from 5 to 10 cm³: TD 16-18 Gy or TD 18-20 Gy in 1 fraction at a time Liver: Radiation regimen selection based on the tolerance of surrounding tissues and proximity to critical structures: TD 30-60 Gy in 3-8 fractions with 6-15 Gy each day

Adrenal Glands: TD 60 Gy in 8 fractions with 7.5 Gy each day
4. Expected Duration of Patient Participation in Clinical Testing:

Pre-hospital period: Comprehensive examination of the patient before treatment. Inpatient period: Includes pre-radiation preparation for up to 3 working days, SABR treatment for 1 to 8 working days.

Follow-up period: 3, 6, 9, and 12 months post-treatment; thereafter, follow-up will occur every 6 months up to 60 months.

Collection and processing of received data.

Conditions

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Metastatic Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

SABR for Extra- and Intracranial Metastatic Disease with 6-10 Sites
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A single-arm: Stereotactic Ablative Radiotherapy (SABR) for 6-10 mts

The method of stereotactic ablative radiation therapy will be used in patients with metastatic tumors (6-10 sites) of various localizations, following the current line of chemotherapy (T1-4, N0-3, M0-1), and who are over 18 years old at the time of treatment initiation.

Group Type OTHER

stereotactic radiation therapy in ablative doses to each metastatic site

Intervention Type RADIATION

Stereotactic ablative radiation therapy will be utilized for each metastatic site in patients with 6 to 10 sites of metastasis (persistent or progressive disease).

Interventions

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stereotactic radiation therapy in ablative doses to each metastatic site

Stereotactic ablative radiation therapy will be utilized for each metastatic site in patients with 6 to 10 sites of metastasis (persistent or progressive disease).

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* ECOG status 0-3
* Persistent or progressive cancer disease with 6 to 10 metastases
* ≤ 5 metastases in one organ
* Life expectancy \> 6 months for intracranial lesions
* Inability to surgically resect all metastatic lesions
* Positive tumor board decision for trial inclusion
* Signed informed consent

Exclusion Criteria

* ECOG status 4
* De novo metastatic disease
* Radiological complete response after drug therapy
* Brain metastasis only
* Brain metastasis \> 3 cm, requiring neurosurgery
* Size of any metastasis \> 5 cm
* Previous radiation therapy for any metastatic site
* Leptomeningeal, pleural, or peritoneal carcinomatosis
* Spinal cord compression, requiring neurosurgery
* Invasion of great vessels, skin, or GI tract
* Negative tumor board decision for trial inclusion
* Unsigned informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Medical Research Radiological Centre of the Ministry of Health of Russia

OTHER

Sponsor Role lead

Responsible Party

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Konstantin Gordon

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrey Kaprin, PhD

Role: STUDY_CHAIR

National Medical Research Radiological Centre of the Ministry of Health of Russia

Locations

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A. Tsyb Medical Radiological Research Center

Obninsk, Kaluga Oblast, Russia

Site Status RECRUITING

Countries

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Russia

Central Contacts

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Konstantin gordon, PhD

Role: CONTACT

0079105184148

Facility Contacts

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Konstantin Gordon, PhD

Role: primary

+79105184148

Other Identifiers

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2024_06_13

Identifier Type: -

Identifier Source: org_study_id

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