Esophageal Squamous Cell Carcinoma
Conditions
Brief summary
To evaluate the efficacy and safety of paclitaxel and DDP combined with Anlotinib in the treatment of advanced esophageal squamous cell carcinoma.
Interventions
* anlotinib: 1 capsule (10mg) once a day, d1-d14 per cycle, 3 weeks for a treatment cycle. * Paclitaxel: intravenously infused at 135mg/ m2, administered d1 per cycle, 3 weeks for a treatment cycle. * Cisplatin: administered after paclitaxel, intravenously infused at 60-75 mg/m2, divided into d1-d3 medications per cycle; 3 weeks for one treatment cycle.
Sponsors
Study design
Eligibility
Inclusion criteria
* histopathology confirmed unresectable, locally recurrent or metastatic advanced esophageal squamous cell carcinoma (excluding mixed type adenosquamous carcinoma ); * Those who have not received systemic treatment before, or who relapsed after (new) adjuvant therapy/radical surgery more than 6 months ; Note: Including advanced or recurrent Patients who ever received only radiotherapy on non-target lesions. The duration from the end of palliative treatment for local lesions (non-target lesions) to enrollment should \> 2 weeks; * According to RECIST 1.1, at least one measurable lesion; the measurable lesions should not have received local treatment such as radiotherapy (for the lesions in the area where received local radiotherapy, it can also be regarded as a target lesion if confirmed to progress according to the recist1.1); * Age from 18-75 years old; * ECOG PS score: 0-1; expected survival time more than 3 months; * Main organs function is normal; * Women of childbearing potential should agree to use and utilize an adequate method of contraception (such as intrauterine device,contraceptive and condom) throughout treatment and for at least 3 months after study is stopped;the result of serum or urine pregnancy test should be negative before enrollment;Man participants should agree to use and utilize an adequate method of contraception throughout treatment and for at least 2 months after study is stopped. * Patients should participate in the study voluntarily and sign informed consent
Exclusion criteria
* Patients tends to have complete obstruction or patients requiring interventional treatment for obstruction; * ulcerated esophageal squamous cell carcinoma patients; * after esophageal or endotracheal stent implantation; * Patients with a high risk of bleeding or perforation due to the apparent invasion of adjacent organs (aorta or trachea) of the esophageal lesion, or patients who have formed fistulas; * patients with ESCC who have not undergone surgical resection but have not reduced esophageal lesions after radiotherapy; * allergic to paclitaxel and cisplatin preparations or excipients; * Adjuvant chemotherapy patients who have used paclitaxel or cisplatin, and relapse or metastasize within one year; * A variety of factors affecting oral medications (such as inability to swallow, chronic diarrhea, and intestinal obstruction); * The of liver metastases accounts for more than 50% of the total liver volume; * patients with any severe and / or uncontrolled disease, including:Unsatisfactory blood pressure control using antihypertensive drugs (systolic blood pressure ≥150 mmhg or diastolic blood pressure ≥100) Mmhg) patients; patients with grade ≥ myocardial ischemia or myocardial infarction, arrhythmia (including qt interval ≥ 480ms); according to nyha criteria, iii-iv cardiac dysfunction, or cardiac ultrasonography prompted left ventricular ejection fraction (lvef) \<50% of patients;live Severe infection that is sexual or uncontrolled;Liver diseases such as cirrhosis, decompensated liver disease, chronic active hepatitis;poor diabetes control (fasting blood glucose (fbg)\>10mmol/l);Urine routine indicates that urine protein ≥ ++, and confirmed 24-hour urine protein quantitation \> 1.0 g; * long-term unhealed wounds or fractures; * Patients with active hemorrhage within 2 months of primary lesions; pulmonary hemorrhage with NCI CTC AE grade \>1, 4 weeks before of enrollment; other sites of bleeding NCI CTC AE grade \>2, 4 weeks before of enrollment; patients with bleeding tendency (such as active gastrointestinal ulcers) or patients undergoing thrombolytic or anticoagulant therapy such as warfarin, heparin or its analogues; * Have undergone major surgery (craniotomy, thoracotomy or open surgery) within 4 weeks prior to the first dose study or Major surgery is required during the study period. * A history of gastrointestinal perforation and/or fistula occurred within 6 months prior to treatment; or an overactive/venous thrombosis event such as a cerebrovascular accident (including transient ischemic attack), deep vein thrombosis, and lung Embolism. * Symptomatic central nervous system metastasis and/or cancerous meningitis are known to exist; * Clinically significant ascites, including any ascites that can be found on a physical examination, ascites that has been treated or currently in need of treatment, and only those with a small amount of ascites but no symptoms can be selected; * A moderate amount of fluid in both sides of the chest, or a large amount of fluid in one side of the chest, or has caused respiratory dysfunction Patient to be drained; * known to have active tuberculosis; * suffering from interstitial lung disease requiring steroid therapy; * Uncontrolled metabolic disorders or other non-malignant tumors or systemic diseases or cancer secondary reactions that can lead to higher medical risks and/or survival Evaluation of uncertainty; * Significantly malnourished patients; * those who have a history of psychotropic substance abuse and are unable to quit or have a mental disorder; * A history of immunodeficiency, including a positive HIV test or other acquired, congenital immunodeficiency disease, or a history of organ transplantation; * History of other primary malignancies, but the following : 1) complete remission of malignant tumors for at least 2 years prior to enrollment and no additional treatment during the study; 2) non-melanoma skin cancer or malignant freckle-like sputum with adequate treatment and no evidence of disease recurrence; 3) adequately treated and In situ carcinoma without evidence of disease recurrence; * Female patients who are pregnant or breastfeeding * According to the investigator's judgment, there are serious concomitant diseases that endanger the safety of the patient or affect the patient's completion of the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Progress free survival (PFS) | From first treatment,each 42 or 63 days until PD or death(up to 24 months) |
Secondary
| Measure | Time frame |
|---|---|
| Objective Response Rate (ORR) | each 42 or 63 days until intolerant the toxicity or PD (up to 24 months) ] |
| Disease Control Rate (DCR) | each 42 or 63 days until intolerant the toxicity or PD (up to 24 months) ] |
| Duration of Response(DOR) | each 42 or 63 days until intolerant the toxicity or PD (up to 24 months) |
Countries
China