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Clinical Trials in China / NCT06187597
Recruiting Phase 2

Consolidation of Toripalimab After Chemoradiotherapy in Elderly Esophageal Cancer (EC-CRT-007)

NCT06187597 · tracked via the Priya Life Science China tracker
Sponsor
Sun Yat-sen University
Phase
Phase 2
Started
2024-03-01
Last updated
2024-03-12

Condition(s) studied

Locally Advanced Esophageal Squamous Cell Carcinoma

Investigational drug(s) / intervention(s)

S-1ToripalimabIntensity-modulated radiotherapy

S-1: Patients received S-1 administration, 70mg/m2 per day, orally on days 1 to 14 and 29 to 42 during radiotherapy.

Toripalimab: Patients received toripalimab 240 mg every 3 weeks for up to 16 cycles.

Intensity-modulated radiotherapy: All patients received external-beam radiation using intensity-modulated radiotherapy. The prescribed dose is 54 Gy in 27 fractions over 5-6 weeks.

Study summary

Although definitive chemoradiotherapy (CRT) is the standard treatment option for unresectable locally advanced esophageal cancer, elderly patients tolerate intravenous concurrent CRT less well with age and comorbidities. Previous trials have demonstrated that CRT with oral S-1 was tolerable and provided significant survival benefits over radiotherapy alone in elderly patients with esophageal squamous cell carcinoma (ESCC). However, as high as 54% of patients with elderly ESCC experienced locoregional or distant recurrence after CRT. Therefore, a more effective regimen for older patients is needed. Immune checkpoint inhibitors targeting PD-1/PD-L1 have shown substantial clinical benefits in advanced esophageal cancer. Recently, the combination of immunotherapy with CRT has emerged as a promising strategy to improve clinical outcomes in locally advanced esophageal cancer. The aim of this study was to evaluate the efficacy and safety of toripalimab (an anti-PD-1 antibody) after concurrent CRT in elderly patients with locally advanced ESCC.

Eligibility

Sex
ALL
Min age
70 Years
Max age
85 Years
Healthy volunteers
No
Inclusion Criteria: 1. Histologically confirmed squamous cell carcinoma of the esophagus; 2. Locally advanced, and absence of hematogenous metastasis disease according to UICC TNM version 8; 3. Not suitable for surgery (either for medical reasons or patient's choice); 4. Age at diagnosis 70 to 85 years; 5. No prior cancer therapy; 6. Estimated life expectancy \>6 months; 7. Eastern Cooperative Oncology Group performance status ≤ 2 8. No history of concomitant or previous malignancy; 9. The function of important organs meets the following requirements: a. white blood cell count (WBC) ≥4.0×109/L, absolute neutrophil count (ANC) ≥1.5×109/L; b. platelets ≥100×109/L; c. hemoglobin ≥9g/dL; d. serum albumin ≥2.8g/dL; e. total bilirubin ≤1.5×ULN, ALT, AST and/or AKP ≤2.5×ULN; f. serum creatinine ≤1.5×ULN or creatinine clearance rate \>60 mL/min; 10. Ability to understand the study and sign informed consent. Exclusion Criteria: 1. Patients who have been treated previously with anti-tumor therapy (including chemotherapy, radiotherapy, surgery, immunotherapy, etc.); 2. Patients with hematogenous metastasis disease or esophageal fistula at diagnosis; 3. Known or suspected allergy or hypersensitivity to monoclonal antibodies, any ingredients of cadonilimab, and the chemotherapeutic drugs paclitaxel or cisplatin; 4. Patients who have a preexisting or coexisting bleeding disorder; 5. Inability to provide informed consent due to psychological, familial, social and other factors; 6. Presence of CTC grade ≥2 peripheral neuropathy; 7. A history of malignancies other than esophageal cancer before enrollment, excluding non-melanoma skin cancer, in situ cervical cancer, or cured early prostate cancer 8. A history of diabetes for more than 10 years and poorly controlled blood glucose levels; 9. Patients who cannot tolerate chemoradiotherapy due to severe cardiac, lung, liver or kidney dysfunction, or hematopoietic disease or cachexia. 10. Active autoimmune diseases, a history of autoimmune diseases (including but not limited to these diseases or syndromes, such as colitis, hepatitis, hyperthyroidism), a history of immunodeficiency (including a positive HIV test result), or other acquired or congenital immunodeficiency diseases, a history of organ transplantation or allogeneic bone marrow transplantation; 11. A history of interstitial lung disease or non-infectious pneumonia; 12. A history of active pulmonary tuberculosis infection within 1 year or a history of active pulmonary tuberculosis infection more than 1 year ago but without formal anti-tuberculosis treatment; 13. Presence of active hepatitis B (HBV DNA ≥ 2000 IU/mL or 104 copies/mL), hepatitis C (positive for hepatitis C antibody, and HCV-RNA levels higher than the lower limit of the assay).

Primary outcome measure(s)

Trial sites (1)

FacilityCityRegionStatus
Mian Xi Guangzhou Guangdong Recruiting

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Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT06187597 on ClinicalTrials.gov ↗ ← All trials in China