Esophageal Cancer Clinical Trial

Pre-operative Adaptive Short Court Radiation Therapy in Gastric Cancer

Summary

Gastric cancer is a global health issue as the world's fifth most common malignancy and third leading cause of cancer mortality, respectively. Preoperative radiation therapy may improve overall survival (OS) but is seldom used. There is precedent for preoperative chemoradiation, as it is the standard of care for esophageal and gastroesophageal junction tumors. However, reluctance of physicians to prescribe preoperative radiation therapy in gastric cancer may be due to the large treatment fields necessary to account for stomach motion. Adaptive radiation therapy may permit decreased field sizes and more accurate dose delivery. In traditional CT based radiation delivery the same radiation plan is delivered each day without assessment of inter-fraction or intra-fraction motion. Adaptive radiation therapy permits the physician to contour the unique anatomy daily to generate a new plan to account for day to day organ motion. Real-time MR imaging is also used during the treatment so that radiation is only delivered when the tumor is within the pre-specified target area. Thus, adaptive radiation therapy may overcome traditional barriers of radiation delivery in gastric cancer and improve oncologic outcomes.

View Eligibility Criteria

Eligibility Criteria

Inclusion Criteria:

Newly diagnosed histologically or cytologically gastric adenocarcinoma. (Siewert III acceptable: the bulk of tumor should be in stomach; gastric tumors with extension to the gastroesophageal junction are permitted.) Patients with T1-3N0-2 are eligible. Patients with N3, or T4 disease are not eligible.
Known T-stage defined by EUS. Must have had CT of the chest/abdomen/pelvis with contrast.
Medically eligible to receive standard of care chemotherapy.
At least 19 years of age
ECOG performance status ≤ 2

Normal bone marrow and organ function as defined below:

Absolute neutrophil count ≥ 1,500 cells/mm3
Platelets ≥ 100,000 cells/mm3

Creatinine clearance > 50 mL/min

The effects of the various chemotherapy agents used in this study on the developing human fetus are unknown. For this reason, women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of the study, and one month after completion of the study
Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable).

Exclusion Criteria:

Prior surgery, radiation, or chemotherapy for gastric or esophageal cancer.
Prior surgery to the esophagus or stomach that would alter the radiation treatment field or stomach motion.
Siewert I-II GE junction tumor
Any active malignancy within 2 years of enrollment that may alter the course of gastric cancer. (Apparently cured localized malignancy or advanced, but indolent malignancy with significantly more favorable prognosis are allowed).
Currently receiving any other investigational agents.
A history of allergic reactions attributed to compounds of similar chemical or biologic composition to chemotherapeutic agents used in the study.
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, diabetes, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmia that are considered clinically significant as determined by the treating physician.
Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 14 days of study entry.
Patients with HIV are eligible unless their CD4+ T-cell counts are < 350 cells/mcL or they have a history of AIDS-defining opportunistic infection within the 12 months prior to registration. Concurrent treatment with effective ART according to DHHS treatment guidelines is recommended. Recommend exclusion of specific ART agents based on predicted drug-drug interactions (i.e. for sensitive CYP3A4 substrates, concurrent strong CYP3A4 inhibitors (ritonavir and cobicistat) or inducers (efavirenz) should be contraindicated).

Study is for people with:

Esophageal Cancer

Phase:

Phase 2

Estimated Enrollment:

36

Study ID:

NCT04162665

Recruitment Status:

Recruiting

Sponsor:

Washington University School of Medicine

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There are 2 Locations for this study

See Locations Near You

Dana Farber Cancer Institute
Boston Massachusetts, 02215, United States More Info
Haeseong Park, M.D., MPH
Contact
857-215-1230
Haeseong Park, M.D., MPH
Principal Investigator
Washington University School of Medicine
Saint Louis Missouri, 63110, United States More Info
Hyun Kim, M.D.
Contact
314-362-8502
[email protected]
Hyun Kim, M.D.
Principal Investigator
Ryan Fields, M.D.
Sub-Investigator
Katrina Pedersen, M.D.
Sub-Investigator
Pamela Samson, M.D.
Sub-Investigator
Carl DeSelm, M.D., Ph.D.
Sub-Investigator
Kian-Huat Lim, M.D., Ph.D.
Sub-Investigator
Rama Suresh, M.D.
Sub-Investigator
Benjamin Tan, M.D.
Sub-Investigator
Patrick Grierson, M.D.
Sub-Investigator
Dominic Sanford, M.D.
Sub-Investigator
Natasha Leigh, M.D.
Sub-Investigator
Roheena Panni, M.D., Ph.D.
Sub-Investigator
Allen Mo, M.D., Ph.D.
Sub-Investigator
Seoul National University Hospital
Seoul , , Korea, Republic of

How clear is this clinincal trial information?

Study is for people with:

Esophageal Cancer

Phase:

Phase 2

Estimated Enrollment:

36

Study ID:

NCT04162665

Recruitment Status:

Recruiting

Sponsor:


Washington University School of Medicine

How clear is this clinincal trial information?

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