NBTXR3, Chemotherapy, and Radiation Therapy for the Treatment of Esophageal Cancer

Inclusion Criteria:

Biopsy proven adenocarcinoma of the cervical or thoracic esophagus or gastroesophageal junction
Adenocarcinoma of the esophagus stages II-III allowed

Medically able to receive chemoradiation. Following chemotherapy regimens are allowed:

Oxaliplatin and fluorouracil (5-FU) or capecitabine
Docetaxel and/or 5-FU or paclitaxel
Carboplatin and paclitaxel

Amenable to undergo the endoscopic ultrasound (EUS) guided injection of NBTXR3 as determined by the investigator or treating physician

Patients with lesions for which the EUS scope is not able to traverse the tumor are allowed on this trial as long as an injection can be performed as per treating physician's discretion

Has at least 1 and up to 4 target lesion(s) in the esophagus that are measurable on cross sectional imaging and repeated measurements (via Response Evaluation Criteria in Solid Tumors [RECIST] version [v] 1.1) at the same anatomical location should be achievable

Local nodal disease around the esophagus allowed
Nodal target lesions must be >= 15 mm (short axis) based on computed tomography (CT) (slice thickness of 5 mm or less) or magnetic resonance imaging (MRI)
Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Hemoglobin >= 8.0 g/dL
Absolute neutrophil count (ANC) >= 1,500/mm^3
Platelet count >= 100,000/mm^3
Creatinine =< 1.5 x upper limit of normal (ULN)
Calculated (Calc.) creatinine clearance > 30 mL/min
Glomerular filtration ratio > 40 mL/min per 1.73 m^2
Total bilirubin =< 2.0 mg/dL
Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.5 x upper limit of normal (ULN)
Negative urine or serum pregnancy test =< 7 days of NBTXR3 injection in all female participants of child-bearing potential
Signed informed consent form (ICF) indicating that participant understands the purpose of, and procedures required for, the study and is willing to participate in the study

Exclusion Criteria:

Prior radiation or any therapy for the treatment of esophageal cancer
Prior surgical resection of esophageal tumor
Esophageal cancer with radiographic evidence of metastases at screening

At screening, past medical history of:

Esophageal fistula
Tracheoesophageal fistula
Siewert type III tumors

Evidence of bulky disease and/or abutment of tumor above the carina that may result in tracheoesophageal fistulas as determined by the investigator or treating physician

Tumors above the carina without defacement of the fat plane between tumor and the airway are allowed
Known uncontrolled (grade >= 2) or active esophageal or gastric ulcer disease within 28 days of enrollment
Known contraindication to iodine-based or gadolinium-based intravenous (IV) contrast
Active malignancy, in addition to esophageal cancer except for basal cell carcinoma of the skin or non-metastatic low risk prostate cancer definitively treated and relapse free within at least 3 months from time of screening
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, renal failure, cardiac arrhythmia, or psychiatric illness that would limit compliance with treatment
Known active, uncontrolled (high viral load) human immunodeficiency virus (HIV) or hepatitis B or hepatitis C infection
Female patients who are pregnant or breastfeeding
Women of child-bearing potential and their male partners who are unwilling or unable to use an acceptable method of birth control to avoid pregnancy for the entire study period. Acceptable methods of contraception are those that, alone or in combination, result in a failure rate of < 1% per year when used consistently and correctly
Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (e.g., compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments