Chemoradiotherapy, Esophageal Cancer, Immunotherapy, Induction Therapy, Surgery
Conditions
Brief summary
Although unprecedented advances have been made in the field of esophageal cancer in recent decades, the prognosis for patients with locally advanced esophageal squamous cell carcinoma (ESCC) remains extremely poor, accounting for 30-40% of overall survival at 5 year. In recent years, multimodal treatments have proven to be an appropriate therapeutic approach for locally advanced ESCC. Recently, immunotherapy developed rapidly. The purpose of this study was to observe the efficacy and safety of cardonilizumab combined with chemoradiotherapy in the treatment of locally advanced ESCC.
Interventions
DRUGCardonilizumab
Two cycles of Inductive therapy： nab-paclitaxel 250mg/ m2+cisplatin 75mg/ m2+Cardonilizumab 10mg/kg，ivgtt，3 weeks per cycle for 2 cycles
RADIATIONChemoradiotherapy ±immunotherapy
Chemoradiotherapy ± immunotherapy： * PTV: 50-50.4Gy/1.8-2Gy/25-28fractions ②nab-paclitaxel 100mg+cisplatin 25mg/ m2, d1, every 7 days for 3-5 weeks ③Cardonilizumab 10mg/kg，ivgtt，3 weeks per cycle for 2 cycles
PROCEDURERadical surgery
Surgery was evaluated after concurrent chemoradiotherapy according to patients willing and the surgeons' assessment. If patients were accessed with unresectable disease after radiotherapy or refused to receive surgery, Cardonilizumab would be administered for 2 years or until disease progression.
Sponsors
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* 18-80 years old； * Eligible patients were histologically confirmed esophageal squamous cell carcinoma; * Eligible patients were proven locally advanced ESCC (cT1-2N1-3M0-1, cT3/T4N0-3M0-1, M1 was limited to supraclavicular lymph node metastasis）diagnosed by computed tomography \[CT\] and/or endoscopic ultrasonography \[EUS\] according to the American Joint Committee on Cancer (AJCC) 8th edition staging system； * ECOG PS score: 0\ 1； * Main organs and bone marrow function are normal: routine blood tests: hemoglobin (Hb) ≥100g/L ; absolute neutrophil count (NEUT)≥1.5×109/L; platelets (PLT) ≥100×109/L; white blood cell (WBC)≥3.5×109/L,biochemical examination: alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤1.5×UNL; serum total bilirubin (TBIL) ≤1.5×UNL; serum creatinine ( Cr) 1.0×1.5UNL, and BUN≤1.0×UNL;
Exclusion criteria
* Those combined with other primary malignant tumors other than esophageal cancer (except cured basal cell carcinoma of the skin and carcinoma in situ of the cervix); * patients who had previously received other treatments * At the time of diagnosis, there were distant and hematogenous metastases beyond the supraclavicular lymph node region, including retroperitoneal multiple lymph node metastasis, bone metastasis, brain metastasis, lung metastasis, liver metastasis, malignant pleural effusion and ascites * Those who already have esophageal perforation or are at high risk of esophageal perforation * Patients whose tumors invade close to large blood vessels and are at risk of bleeding in the * there are active infections, such as active tuberculosis and hepatitis * There are contraindications to immunotherapy. * Pregnant or lactating women and women of childbearing age do not take reliable contraceptive measures * Combined with serious cardiovascular diseases, such as uncontrolled heart failure, coronary heart disease, cardiomyopathy, uncontrolled arrhythmia, uncontrolled hypertension, or a history of myocardial infarction within the past 6 months; and those combined with other uncontrolled acute and chronic diseases such as hypertension and diabetes. * Violation of inclusion and
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Event-free survival | 1-year | Time from treatment initiation to locoregional or distant recurrence, or death from any cause. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adverse events | 1-year | In terms of adverse events of radiation, chemotherapy and immunotherapy |
| Overall survival | 1-year | The 1-year OS rate was defined as the proportion of patients who still alive within one year from treatment initiation. |
| Locoregional recurrence free survival | 1-year | The 1-year rate was defined as the proportion of patients who did not have any locoregional recurrence from treatment initiation. |
| Distant metastasis free survival | 1-year | The 1-year rate was defined as the proportion of patients who did not have any distant metastasis from treatment initiation. |
Countries
China
Contacts
Primary ContactXin Wang, M.D.
Outcome results
None listed