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出境医 / 临床实验 / VMAT Concurrent Cisplatin Plus Nab-paclitaxel for Local Advanced Cervical Cancer

VMAT Concurrent Cisplatin Plus Nab-paclitaxel for Local Advanced Cervical Cancer

Study Description
Brief Summary:
This is a single arm, open-lable Phase I clinical trial. Eligible patients will have Histologically proven stage IB2-IVA cervical cancer. We hypothesize that Nab-paclitaxel in combination with cisplatin and radiotherapy may have anti-tumor activity in patients with cervical cancer. Nab-paclitaxel has not previously been combined with conventional RT-CT to treat cervical cancer.

Condition or disease Intervention/treatment Phase
Cervical Cancer Drug: Drug: Cisplatin; nab-paclitaxel Not Applicable

Detailed Description:
During the phase I study, patients will receive radiation therapy to pelvis (50.4 Gy in 28fractions), and followed by HDR intracavitary (30Gy in 5 fractions) brachytherapy. Concurrent chemotherapy was administered with weekly cisplatin (40 mg/m^2) and an escalating dose of weekly Nab-paclitaxel starting at 10 mg/m^2 up to 70 mg/m^2. Chemotherapy agents were administered in escalating doses to cohorts of three patients at each dose level.
Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 15 participants
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Study of Radiation Therapy With Concomitant Nab-paclitaxel and Cisplatin Chemotherapy in Patients With Locally Advanced Cervical Cancer
Actual Study Start Date : September 1, 2019
Estimated Primary Completion Date : June 15, 2020
Estimated Study Completion Date : July 15, 2020
Arms and Interventions
Arm Intervention/treatment
Experimental: Chemotherapy+ Radiation therapy

Chemotherapy: Patients firstly receive an escalating dose of weekly Nab-paclitaxel starting at 10 mg/m^2 up to 70 mg/m^2, Patients secondly receive weekly cisplatin (40 mg/m^2). Treatment repeats every week until the disease recurrence or unacceptable toxicity, death or begin a novel therapeutic. Concurrent chemotherapy is a weekly regimen during radiotherapy. Patients will complete at least 4 cycles of concurrent chemoradiotherapy, until the maximal tolerated dose (MTD) appeared.

Radiation therapy: Patients also receive pelvic radiation therapy once daily (Monday-Friday) for a total of 28 fractions and intracavitary brachytherapy twice a week for a total 5 fractions. Complete radiotherapy within 55 days.

Drug: Drug: Cisplatin; nab-paclitaxel
Drug: Paclitaxel for Injection(Albumin Bound). Other Name: Ke ai li, ZhusheyongZishanchun(Baidanbai Jiehexing)

Outcome Measures
Primary Outcome Measures :
  1. Maximum Tolerated Dose(MTD)/Recommended Dose(RD) [ Time Frame: Up to 5 weeks ]
    Maximum Tolerated Dose (MTD) will be defined during the Dose Escalation Stage based on evaluation of the number of patients with Dose-limiting Toxicity (DLT). The MTD will be used to determine the Recommended Dose (RD).


Secondary Outcome Measures :
  1. Number of patients with Dose Limiting Toxicity (DLT) [ Time Frame: Up to 5 weeks ]
    Dose-limiting toxicity is defined as an adverse event that is considered to be drug-related and meets one of the Protocol definitions.

  2. Objective response rate (ORR) [ Time Frame: Up to 5 weeks ]
    ORR was assessed by the site Investigator using RECIST 1.1 and was defined as the percentage of patients with a confirmed overall response of CR or PR.


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age ≥ 18 years and ≤ 75 years.
  • Patients with histologically confirmed newly diagnosed advanced cervical cancer (squamous cell carcinoma, adenocarcinoma, and adenosquamous cell carcinoma): Federation of Gynecology and Obstetrics (FIGO) clinical stages IB2-IVA.
  • At least one measurable objective lesion was identified based on the RECIST1.1 criteria;
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2;
  • The expected survival after surgery ≥ 3 months;
  • LVEF≥55%;
  • Bone marrow function: Neutrophils ≥ 1.5×10^9/L, platelets ≥ 100×10^9/L, and hemoglobin ≥ 90 g/L;
  • Liver and renal function: Serum creatinine ≤ 1.5 times the upper limit of normal. AST and ALT ≤ 2.5 times the upper limit of normal Total bilirubin ≤ 1.5 times the upper limit of normal, or ≤ 2.5 times the upper limit of normal in patients with Gilbert's syndrome.
  • Subjects of child-bearing age must agree to take effective contraceptive measures during the study period; Serum or urine pregnancy tests must be negative for women of childbearing age;
  • Women must not lactate;
  • Signed informed content obtained prior to treatment;

Exclusion Criteria:

  • Patients previously treated with nab-paclitaxel;
  • Patients previously undergoing abdominal or pelvic radiotherapy;
  • Patients with CNS diseases or brain metastases;
  • Other malignant tumors other than cervical cancer occurred in the past 5 years;
  • Patients who had Grade 2 or above Peripheral neuropathy;
  • Patients had uncontrolled serious medical condition that the investigator considered may affect the subject's to receive treatment under the study program, For example, patients with severe medical diseases, including severe heart disease, cerebrovascular disease, uncontrolled diabetes, uncontrolled hypertension, uncontrolled infection, active peptic ulcer, etc;
  • Dementia, changing of mental state or any mental illness which could hinder understanding or informed consent or fill out questionnaires;
  • History of allergy or hypersensitivity to any therapeutic ingredient;
  • Combined with other malignant tumors excepted pancreatic cancer within the first 5 years of randomization, excepted well-treated basal cell or squamous cell carcinoma of the skin, localized prostate cancer after radical resection, and ductal carcinoma in situ of the breast after radical resection;
  • Previously received systemic therapy for advanced/metastatic pancreatic cancer;
  • Subjects who had previously been pathologically diagnosed with squamous cell carcinoma (no organ limitation) and received neoadjuvant/adjuvant therapy with taxa regimen;
  • Patients who had Grade 2 or above Peripheral neuropathy;
  • Known to be allergic, highly sensitive or intolerant to the study-related drugs or their excipients;
  • Participation in any trial drug treatment or another interventional clinical trial 30 days before screening period;
  • Severe infections including, but not limited to, complications of infection, bacteremia or severe pneumonia that require hospitalization within 4 weeks of study treatment initiation;
  • Subjects had hepatitis b surface antigen (HBsAg)-positive and HBV- DNA titer in peripheral blood greater than or equal to 1000 copy number /L; If HBsAg is positive and the peripheral blood HBV-DNA <1000 copy number /L, the subjects will be eligible for inclusion if the investigator considers that chronic hepatitis b is stable and does not increase the risk of subjects;
  • Human immunodeficiency virus (HIV)- or hepatitis C virus (HCV) positive patients;
  • The researchers considered that there were other conditions that were not suitable for enrollment.
Contacts and Locations

Contacts
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Contact: Junjie Wang, MD, PhD 13701076310 junjiewang_edu@sina.cn
Contact: Ping Jiang, MD 13439796018 jp7962@sohu.com

Locations
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China, Beijng
Peking University 3rd Hospital Recruiting
Beijing, Beijng, China, 100191
Contact: Junjie Wang, MD    010-82266699 ext 5920    junjiewang_edu@sina.cn   
Sponsors and Collaborators
Peking University Third Hospital
Investigators
Layout table for investigator information
Principal Investigator: Junjie Wang, MD, PhD Peking University Third Hospital
Tracking Information
First Submitted Date  ICMJE July 9, 2019
First Posted Date  ICMJE July 12, 2019
Last Update Posted Date April 28, 2020
Actual Study Start Date  ICMJE September 1, 2019
Estimated Primary Completion Date June 15, 2020   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: July 10, 2019)
Maximum Tolerated Dose(MTD)/Recommended Dose(RD) [ Time Frame: Up to 5 weeks ]
Maximum Tolerated Dose (MTD) will be defined during the Dose Escalation Stage based on evaluation of the number of patients with Dose-limiting Toxicity (DLT). The MTD will be used to determine the Recommended Dose (RD).
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: July 10, 2019)
  • Number of patients with Dose Limiting Toxicity (DLT) [ Time Frame: Up to 5 weeks ]
    Dose-limiting toxicity is defined as an adverse event that is considered to be drug-related and meets one of the Protocol definitions.
  • Objective response rate (ORR) [ Time Frame: Up to 5 weeks ]
    ORR was assessed by the site Investigator using RECIST 1.1 and was defined as the percentage of patients with a confirmed overall response of CR or PR.
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE VMAT Concurrent Cisplatin Plus Nab-paclitaxel for Local Advanced Cervical Cancer
Official Title  ICMJE Study of Radiation Therapy With Concomitant Nab-paclitaxel and Cisplatin Chemotherapy in Patients With Locally Advanced Cervical Cancer
Brief Summary This is a single arm, open-lable Phase I clinical trial. Eligible patients will have Histologically proven stage IB2-IVA cervical cancer. We hypothesize that Nab-paclitaxel in combination with cisplatin and radiotherapy may have anti-tumor activity in patients with cervical cancer. Nab-paclitaxel has not previously been combined with conventional RT-CT to treat cervical cancer.
Detailed Description During the phase I study, patients will receive radiation therapy to pelvis (50.4 Gy in 28fractions), and followed by HDR intracavitary (30Gy in 5 fractions) brachytherapy. Concurrent chemotherapy was administered with weekly cisplatin (40 mg/m^2) and an escalating dose of weekly Nab-paclitaxel starting at 10 mg/m^2 up to 70 mg/m^2. Chemotherapy agents were administered in escalating doses to cohorts of three patients at each dose level.
Study Type  ICMJE Interventional
Study Phase  ICMJE Not Applicable
Study Design  ICMJE Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Cervical Cancer
Intervention  ICMJE Drug: Drug: Cisplatin; nab-paclitaxel
Drug: Paclitaxel for Injection(Albumin Bound). Other Name: Ke ai li, ZhusheyongZishanchun(Baidanbai Jiehexing)
Study Arms  ICMJE Experimental: Chemotherapy+ Radiation therapy

Chemotherapy: Patients firstly receive an escalating dose of weekly Nab-paclitaxel starting at 10 mg/m^2 up to 70 mg/m^2, Patients secondly receive weekly cisplatin (40 mg/m^2). Treatment repeats every week until the disease recurrence or unacceptable toxicity, death or begin a novel therapeutic. Concurrent chemotherapy is a weekly regimen during radiotherapy. Patients will complete at least 4 cycles of concurrent chemoradiotherapy, until the maximal tolerated dose (MTD) appeared.

Radiation therapy: Patients also receive pelvic radiation therapy once daily (Monday-Friday) for a total of 28 fractions and intracavitary brachytherapy twice a week for a total 5 fractions. Complete radiotherapy within 55 days.

Intervention: Drug: Drug: Cisplatin; nab-paclitaxel
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: July 10, 2019)
15
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE July 15, 2020
Estimated Primary Completion Date June 15, 2020   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Age ≥ 18 years and ≤ 75 years.
  • Patients with histologically confirmed newly diagnosed advanced cervical cancer (squamous cell carcinoma, adenocarcinoma, and adenosquamous cell carcinoma): Federation of Gynecology and Obstetrics (FIGO) clinical stages IB2-IVA.
  • At least one measurable objective lesion was identified based on the RECIST1.1 criteria;
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2;
  • The expected survival after surgery ≥ 3 months;
  • LVEF≥55%;
  • Bone marrow function: Neutrophils ≥ 1.5×10^9/L, platelets ≥ 100×10^9/L, and hemoglobin ≥ 90 g/L;
  • Liver and renal function: Serum creatinine ≤ 1.5 times the upper limit of normal. AST and ALT ≤ 2.5 times the upper limit of normal Total bilirubin ≤ 1.5 times the upper limit of normal, or ≤ 2.5 times the upper limit of normal in patients with Gilbert's syndrome.
  • Subjects of child-bearing age must agree to take effective contraceptive measures during the study period; Serum or urine pregnancy tests must be negative for women of childbearing age;
  • Women must not lactate;
  • Signed informed content obtained prior to treatment;

Exclusion Criteria:

  • Patients previously treated with nab-paclitaxel;
  • Patients previously undergoing abdominal or pelvic radiotherapy;
  • Patients with CNS diseases or brain metastases;
  • Other malignant tumors other than cervical cancer occurred in the past 5 years;
  • Patients who had Grade 2 or above Peripheral neuropathy;
  • Patients had uncontrolled serious medical condition that the investigator considered may affect the subject's to receive treatment under the study program, For example, patients with severe medical diseases, including severe heart disease, cerebrovascular disease, uncontrolled diabetes, uncontrolled hypertension, uncontrolled infection, active peptic ulcer, etc;
  • Dementia, changing of mental state or any mental illness which could hinder understanding or informed consent or fill out questionnaires;
  • History of allergy or hypersensitivity to any therapeutic ingredient;
  • Combined with other malignant tumors excepted pancreatic cancer within the first 5 years of randomization, excepted well-treated basal cell or squamous cell carcinoma of the skin, localized prostate cancer after radical resection, and ductal carcinoma in situ of the breast after radical resection;
  • Previously received systemic therapy for advanced/metastatic pancreatic cancer;
  • Subjects who had previously been pathologically diagnosed with squamous cell carcinoma (no organ limitation) and received neoadjuvant/adjuvant therapy with taxa regimen;
  • Patients who had Grade 2 or above Peripheral neuropathy;
  • Known to be allergic, highly sensitive or intolerant to the study-related drugs or their excipients;
  • Participation in any trial drug treatment or another interventional clinical trial 30 days before screening period;
  • Severe infections including, but not limited to, complications of infection, bacteremia or severe pneumonia that require hospitalization within 4 weeks of study treatment initiation;
  • Subjects had hepatitis b surface antigen (HBsAg)-positive and HBV- DNA titer in peripheral blood greater than or equal to 1000 copy number /L; If HBsAg is positive and the peripheral blood HBV-DNA <1000 copy number /L, the subjects will be eligible for inclusion if the investigator considers that chronic hepatitis b is stable and does not increase the risk of subjects;
  • Human immunodeficiency virus (HIV)- or hepatitis C virus (HCV) positive patients;
  • The researchers considered that there were other conditions that were not suitable for enrollment.
Sex/Gender  ICMJE
Sexes Eligible for Study: Female
Ages  ICMJE 18 Years to 75 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Junjie Wang, MD, PhD 13701076310 junjiewang_edu@sina.cn
Contact: Ping Jiang, MD 13439796018 jp7962@sohu.com
Listed Location Countries  ICMJE China
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04017377
Other Study ID Numbers  ICMJE M2019163
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Junjie Wang, Peking University Third Hospital
Study Sponsor  ICMJE Peking University Third Hospital
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Junjie Wang, MD, PhD Peking University Third Hospital
PRS Account Peking University Third Hospital
Verification Date April 2020

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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