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Postoperative Concurrent Chemoradiotherapy Combined With Endostar for High-risk Early Stage Cervical Cancer (ChESS)

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ClinicalTrials.gov Identifier: NCT03622827
Recruitment Status : Recruiting
First Posted : August 9, 2018
Last Update Posted : August 14, 2018
Sponsor:
Collaborator:
Second Affiliated Hospital of Soochow University
Information provided by (Responsible Party):
Ke Gu, Nanjing Medical University

Brief Summary:
To assess the efficacy and safety of postoperative concurrent chemoradiotherapy combined with recombinant human endostatin (Endostar) in patients with high-risk early stage cervical cancer.

Condition or disease Intervention/treatment Phase
Uterine Cervical Neoplasms Combination Product: Chemoradiotherapy+ Endostar Phase 2

Detailed Description:

This is a pilot phase 2, single arm study to assess the efficacy and safety of concurrent chemoradiotherapy combined with recombinant human endostatin (Endostar) in early stage cervical cancer patients with high risk factor(s).

Postoperative pelvic radiotherapy starts 2-3 weeks after surgery. Intensity modulated radiotherapy (IMRT) is given five fractions per week at 1.8-2 Gy/fraction/day with total prescription dose of 45-50Gy to PTV region. The external beam radiotherapy should be completed within 6 weeks. Concurrent chemotherapy consists of cisplatin (75 mg/m2, day 1-3) and 5-fluorouracil (5-FU; 1000mg/m2/day, civ, day 1-4) for 2 cycles every 3 weeks. Recombinant human endostatin (Endostar,15mg/m2/d, civ, d1-7) is applied 3 days before the concurrent chemoradiotherapy for 2 cycles every 3 weeks.

Aimed to recruit total of 120 cases in this single arm study. The primary endpoint is 3-year disease-free survival and acute toxicity. Secondary endpoints include time to distant metastasis survival, local-regional recurrence free survival, 3 and 5-year overall survival, and safety and tolerability. Quality of life will be evaluated with EORTC-Q30.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 120 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Postoperative Concurrent Chemoradiotherapy Combined With Recombinant Human Endostatin for High-risk Early Stage Cervical Cancer: A Phase II Pilot Study (ChESS).
Actual Study Start Date : July 31, 2018
Estimated Primary Completion Date : July 30, 2023
Estimated Study Completion Date : July 30, 2025

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Cervical Cancer

Arm Intervention/treatment
Experimental: Chemoradiotherapy + Endostar

Chemoradiotherapy with Endostar:

  • Chemoradiotherapy: pelvic radiotherapy with concurrent chemotherapy that consisted of cisplatin (75 mg/m2, day 1-3) and 5-fluorouracil (5-FU; 1000mg/m2/day,civ, day 1-4) for 2 cycles every 3 weeks.
  • Endostar: recombinant human endostatin (15mg/m2/d, civ, d1-7) is given 3 days before the chemotherapy every 3 weeks, total of two cycles during chemoradiotherapy course.
Combination Product: Chemoradiotherapy+ Endostar

Chemoradiotherapy with Endostar:

  • Chemoradiotherapy: pelvic radiotherapy starts 2-3 weeks after surgery. Intensity modulated radiotherapy (IMRT) is given five fractions per week at 1.8-2 Gy/fraction/day with total dose summed up to 45-50Gy. The external beam radiotherapy should be completed within 6 weeks.
  • Concurrent chemotherapy is consisted of cisplatin (75 mg/m2, day 1-3) and 5-fluorouracil (5-FU; 1000mg/m2/day, civ, day 1-4) for 2 cycles every 3 weeks.
  • Endostar: recombinant human endostatin (15mg/m2/d, civ, d1-7) is given 3 days before the concurrent chemoradiotherapy for 2 cycles every 3 weeks.




Primary Outcome Measures :
  1. 3-year Disease-free survival [ Time Frame: 3 years ]
    From date of surgery until the date of first documented local-regional progression or distant metastasis (determined by CT or MRI scan and/or biopsy) or death (from any cause) assessed up to three years.

  2. Acute toxicity [ Time Frame: 3 months ]
    Evaluate the treatment induced toxicity according to CTCAE 4.0 during the time of chemoradiotherapy and Endostar which starts from the first day of Endostar and lasts three months.


Secondary Outcome Measures :
  1. Time to distant metastasis survival [ Time Frame: 3 years ]
    Determine the non-distant metastasis survival in early-stage cervical cancer patients with high risk factors, defined as time from the date of surgery to first distant metastasis event (determined by CT or MRI scan and/or pathologic disease on biopsy).

  2. Local-regional recurrence free survival [ Time Frame: 3 years ]
    Determine the local-regional recurrence free survival in early-stage cervical cancer patients with high risk factors, defined as time from the date of surgery to first local-regional recurrence event (determined by CT or MRI scan and/or pathologic disease on biopsy).

  3. 3-year overall survival rate [ Time Frame: 3 years ]
    Determine the 3-year overall survival rate in early-stage cervical cancer patients with high risk factors, defined as time from the date of surgery to death of all cause at time of 3 years after operation.

  4. 5-year overall survival rate [ Time Frame: 5 years ]
    Determine the 5-year overall survival rate in early-stage cervical cancer patients with high risk factors, defined as time from the date of surgery to death of all cause at time of 5 years after operation.

  5. Quality of Life (QoL) [ Time Frame: 3 years ]
    Collect QoL data on early-stage cervical cancer patients with high risk factors. The data is measured by EORTC QLQ-C30 (Version 3.0) according to investigator collection at the starting and ending time of the adjuvant treatment. EORTC QLQ-C30 is a questionnaire developed to assess the quality of life of cancer patients. The core and disease-specific for cervix modules are selected to estimate treatment related influence on patients' life. The final score of the questionnaire is collected and analyzed according to detailed scoring procedures from manuals.



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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Aged between 18 and 70 years.
  • Histologically confirmed adenocarcinoma or squamous cervical carcinomas.
  • Chest CT scan and ultrasound must be done prior to surgery as to rule out distant metastasis.
  • Operable patients with clinical diagnosis of FIGO stage IB-IIA cervical cancer.
  • Complete radical hysterectomy of cervical cancer is mandatory. All gross diseases must have been removed at the end of surgery. All surgical margins of resection must be negative for tumor. Para-aortic lymph node sampling is performed according to gynaecologist decision.
  • Patients with one of these risk factors:positive pelvic nodes, parametrial invasion, positive surgical margin.OR patients with at least two of following risk factors: tumor size≥4cm,lymphovascular space invasion,stromal invasion≥1/2.
  • Performance status 0-2 (ECOG, Eastern Cooperative Oncology Group).
  • Adequate organ function is needed, including cardio-respiratory, hepato-renal and hematological reserves: Absolute neutrophil count (ANC)≥1.5×109/L;Platelet count≥100×109/L; ASAT&ALST<1.5 times upper limit of normal (ULN) (With hepatic metastases, ASAT&ALST<5.0 times upper limit of normal);Bilirubin <1.5 times ULN;Creatinine≤1.25×ULN or Creatinine clearance≥50 mL/min.
  • Signed written informed consent prior to study entry.

Exclusion Criteria:

  • Previous radiation or chemotherapy treatment or major pelvic surgery.
  • Patients with distant metastasis confirmed by imaging or pathology.
  • Other uncured malignant tumors in the past five years, except the cured skin basal cell carcinoma and breast carcinoma in situ.
  • Any prior anticancer therapy.
  • Unable to tolerate postoperative concurrent chemoradiotherapy.
  • Patients with evidence of being allergic to fluorouracil, cisplatin or Endostar.
  • Patients with serious comorbidity that might potentially influence the practice of protocol, including severe infection, myocardial infarction, severe arrhythmia, severe cerebrovascular disease, severe mental disorder, etc.
  • Patients with Heart related adverse events or thrombotic events in the past 6 months.
  • Patients with hepatitis B, hepatitis C and human immunodeficiency virus (HIV) or any other active viral infections.
  • Participate in other clinical researchers.
  • The estimated survival<3 months;

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03622827


Contacts
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Contact: Ke Gu, M.D., Ph.D 86-13405070898 dr.guke@hotmail.com
Contact: Zhiliang Ding, M.D. 86-18913535515

Locations
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China, Jiangsu
The Affiliated Suzhou Hospital of Nanjing Medical University Recruiting
Suzhou, Jiangsu, China, 215001
Contact: Ke Gu, M.D., Ph.D    86-13405070898    dr.guke@hotmail.com   
Contact: Zhiliang Ding, M.D.    86-18913535515      
Sponsors and Collaborators
Nanjing Medical University
Second Affiliated Hospital of Soochow University
Investigators
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Principal Investigator: Ke Gu, M.D., Ph.D The Affiliated Suzhou Hospital of Nanjing Medical University
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Responsible Party: Ke Gu, Associate professor, Nanjing Medical University
ClinicalTrials.gov Identifier: NCT03622827    
Other Study ID Numbers: K2018009
First Posted: August 9, 2018    Key Record Dates
Last Update Posted: August 14, 2018
Last Verified: August 2018

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Ke Gu, Nanjing Medical University:
Adjuvant therapy
chemoradiotherapy
Uterine Cervical Neoplasms
high risk
Endostar
Additional relevant MeSH terms:
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Uterine Cervical Neoplasms
Neoplasms
Uterine Neoplasms
Genital Neoplasms, Female
Urogenital Neoplasms
Neoplasms by Site
Uterine Cervical Diseases
Uterine Diseases
Endostar protein
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors
Antineoplastic Agents