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Anal Canal Cancer Stage IIIPhase 3NCT05374252

Chemoradiotherapy Combined With or Without PD-1 Blockade in Anal Canal Squamous Carcinoma Patients

A Phase 3 study testing PD-1 inhibitor and concurrent chemoradiotherapy in people with Anal Canal Cancer Stage III and Anal Squamous Cell Carcinoma, run by Sixth Affiliated Hospital, Sun Yat-sen University at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a phase III, multi-center, double-blind randomized controlled trial assessing the efficacy and safety of concurrent mitomycin C/5-Fu chemotherapy and long-course IMRT combined with PD-1 antibody Sintilimab for locally advanced anal canal squamous carcinoma patients, by comparing an experiment group… Read more about this study

Who is it for?
Ages 18 to 75 years
What is being tested?
PD-1 inhibitor and concurrent chemoradiotherapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
102 participants
Where
1 siteChina
Study dates
7 May 2022to 31 Dec 2025
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histology identified anal canal squamous carcinoma,
  • Aged 18 to 75,
  • Clinical staging III, Eastern Cooperative Oncology Group 0-2 score,
  • The Staging method: All patients undergoing rectal anus palpation, high resolution MRI and chest-abdominal enhanced CT, clinical data should be re-evaluated and inclusive by center evaluation group when there is contradictory staging, distant metastasis were excluded by chest-abdominal enhanced CT and pelvic enhanced MRI,
  • No previous anal canal surgery or anal tumor resection (except for biopsy),
  • No previous chemotherapy or pelvic radiotherapy history,
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  • No biopharmaceutical treatment history (such as monoclonal antibody), immunotherapy (such as anti PD-1antibody, anti PD-L1 antibody, anti PD-L2 antibody or anti CTLA-4), or other research drug treatment in the previous 5 years,
  • Adequate bone marrow, liver, and kidney function,
  • Clinical complete response (cCR) (Chest, abdominal and pelvic enhanced CT or pelvic enhanced MRI or PET/CT),
  • Informed consent assigned, Final inclusion criteria,
  • Non-pregnant or breast-feeding women,
  • No other malignant disease within 5 years before diagnosis of anal cancer squamous carcinoma (except endocervical cancer in situ or skin basal cell carcinoma which had been cured); no other malignant disease beside anal cancer squamous carcinoma,
  • No other serious disease leading to shortened survival.

Who cannot join

  • Diagnosed as stage I-II and well differentiated squamous cell carcinoma,
  • Distant metastasis,
  • Received radiation therapy in abdominal or pelvic regions,
  • Pregnant, lactating woman patient or fertile but lacks adequate contraceptives,
  • Arrhythmia need anti-arrhythmia treatment (except β-blocking agent or Digoxin), symptomatic coronary heart disease or myocardial ischemia (myocardial infarction within 6 months) or congestive heart-failure (CHF) > New York Heart Association grade II,
  • Severe hypertension not well controlled by drugs,
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  • Active phase of chronic hepatitis B or hepatitis C (high copies of virus DNA),
  • Patients with active tuberculosis (TB) are receiving anti-tuberculosis treatment or have received anti-tuberculosis treatment within 1 year before screening,
  • Other active clinical severe infection (NCI-CTCAE (version 4.0) ),
  • Dyscrasia, organ dysfunction,
  • Known or suspicious allergy to any research-related drugs,
  • Epilepsy needs treatments (Steroid or anti-epilepsy therapy),
  • Other malignant tumor history within 5 years,
  • Drug abuse and medical, psychological, or social factors that may interfere with patients' participation in the study or affect the evaluation of the study,
  • Patients have any active autoimmune diseases or a history of autoimmune diseases (including but not restricted: interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, nephritis, hyperthyroidism and decreased thyroid function; patients with vitiligo or with complete remission of asthma in childhood and without any intervention in adulthood may be included; patients with asthma requiring bronchodilators intervention are not included,
  • Any anti-infection vaccine 4 weeks before inclusion,
  • Long-term exposure to immune-suppressor, combination of systemic or topical use of corticosteroids (dose>10mg/day prednisolone or equivalent hormone),
  • Any unstable state might endanger the patients' safety and compliance,
  • Refuses to sign informed consent.

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • The Sixth Affiliated Hospital of Sun Yat-sen University

    Guangzhou, Guangdong, 510630

    Xiang-bo Wan, PhD, +86-13826017157, wanxbo@mail.sysu.edu.cn

    Fang He, MD, +86-20-85655905, hefang23@mail.sysu.edu.cn

    Recruiting

Other trials in China

About this study

Official title: A Phase 3, Multicenter, Double-Blind Randomized Study of Mitomycin, 5-Fluorouracil and IMRT Combined With or Without Anti-PD-1 in Patients With Locally Advanced Anal Canal Squamous Carcinoma

This is a phase III, multi-center, double-blind randomized controlled trial assessing the efficacy and safety of concurrent mitomycin C/5-Fu chemotherapy and long-course IMRT combined with PD-1 antibody Sintilimab for locally advanced anal canal squamous carcinoma patients, by comparing an experiment group (traditional chemoradiotherapy with PD-1 antibody Sintilimab) with a control group (traditional treatment without Sintilimab).

Being tested
PD-1 inhibitor, concurrent chemoradiotherapy
Keywords
Anal Squamous Cell Carcinoma, Radiochemotherapy, PD-1
Medical subject headings
Anal Canal Carcinoma, Anus Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PD-1 inhibitorDrug

    Also called radiation, concurrent chemotherapy

    Two cycles of concurrent PD-1 antibody sintilimab combined with mytomicin C, 5-fluorouracil and IMRT, followed by adjuvant sintilimab for six months

  • concurrent chemoradiotherapyRadiation

    Also called radiation, concurrent chemotherapy

    Two cycles of concurrent mytomicin C and 5-fluorouracil combined with IMRT

Study groups in NCT05374252
Study groupRoleWhat they receive
Experimental GroupExperimentalConcurrent PD-1 antibody sintilimab combined with mytomicin C, 5-fluorouracil, and IMRT, followed by adjuvant sintilimab
Receives: Drug: PD-1 inhibitor
Control GroupActive comparatorConcurrent mytomicin C and 5-fluorouracil combined with IMRT
Receives: Radiation: concurrent chemoradiotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression free survival

    progression free survival

    Measured: from the end of treatment to 3 years after treatment

  2. Overall survival

    overall survival

    Measured: from the end of treatment to 3 years after treatment

  3. cCR rate

    cCR rate 6 months after treatment

    Measured: 6 months after treatment

Secondary outcomes (7)
  1. Acute toxicities

    acute toxicities according to the NCI CTCAE (version 4.0)

    Measured: from the start of treatment to 3 months after treatment

  2. cCR rate

    cCR rate 3 months after treatment

    Measured: 3 months after treatment

  3. The rate of late toxicity according to the RTOG/EORTC scale

    The rate of late toxicity according to the RTOG/EORTC scale

    Measured: 3 years

  4. Colostomy rate

    colostomy rate

    Measured: 2 year

  5. Local recurrence rate

    local recurrence rate

    Measured: from the end of treatment to 3 years after treatment

  6. Distant metastasis rate

    distant metastasis rate

    Measured: from the end of treatment to 3 years after treatment

  7. Incidence rate of Grade ≥3 PD-1monoclonal antibody-related adverse events

    Incidence rate of Grade ≥3 PD-1monoclonal antibody-related adverse events

    Measured: 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 May 2022
  2. Study start7 May 2022
  3. Primary completion31 May 2025 (estimated)
  4. Study completion31 Dec 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
102 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05374252
Sponsor's protocol ID
E2021144
Status last verified
May 2022
First submitted
10 May 2022
Last updated
16 May 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Bartelink H, Roelofsen F, Eschwege F, Rougier P, Bosset JF, Gonzalez DG, Peiffert D, van Glabbeke M, Pierart M. Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J Clin Oncol. 1997 May;15(5):2040-9. doi: 10.1200/JCO.1997.15.5.2040.

    PubMed 9164216
  • Gunderson LL, Moughan J, Ajani JA, Pedersen JE, Winter KA, Benson AB 3rd, Thomas CR Jr, Mayer RJ, Haddock MG, Rich TA, Willett CG. Anal carcinoma: impact of TN category of disease on survival, disease relapse, and colostomy failure in US Gastrointestinal Intergroup RTOG 98-11 phase 3 trial. Int J Radiat Oncol Biol Phys. 2013 Nov 15;87(4):638-45. doi: 10.1016/j.ijrobp.2013.07.035. Epub 2013 Sep 10.

    PubMed 24035327
  • James RD, Glynne-Jones R, Meadows HM, Cunningham D, Myint AS, Saunders MP, Maughan T, McDonald A, Essapen S, Leslie M, Falk S, Wilson C, Gollins S, Begum R, Ledermann J, Kadalayil L, Sebag-Montefiore D. Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2 x 2 factorial trial. Lancet Oncol. 2013 May;14(6):516-24. doi: 10.1016/S1470-2045(13)70086-X. Epub 2013 Apr 9.

    PubMed 23578724
  • Ben-Josef E, Moughan J, Ajani JA, Flam M, Gunderson L, Pollock J, Myerson R, Anne R, Rosenthal SA, Willett C. Impact of overall treatment time on survival and local control in patients with anal cancer: a pooled data analysis of Radiation Therapy Oncology Group trials 87-04 and 98-11. J Clin Oncol. 2010 Dec 1;28(34):5061-6. doi: 10.1200/JCO.2010.29.1351. Epub 2010 Oct 18.

    PubMed 20956625
  • Ott PA, Piha-Paul SA, Munster P, Pishvaian MJ, van Brummelen EMJ, Cohen RB, Gomez-Roca C, Ejadi S, Stein M, Chan E, Simonelli M, Morosky A, Saraf S, Emancipator K, Koshiji M, Bennouna J. Safety and antitumor activity of the anti-PD-1 antibody pembrolizumab in patients with recurrent carcinoma of the anal canal. Ann Oncol. 2017 May 1;28(5):1036-1041. doi: 10.1093/annonc/mdx029.

    PubMed 28453692
  • Shahjehan F, Kamatham S, Ritter A, Kasi PM. Dramatic response to modified docetaxel, cisplatin, and fluorouracil chemotherapy after immunotherapy in a patient with refractory metastatic anal cancer. Clin Case Rep. 2019 Aug 6;7(9):1729-1734. doi: 10.1002/ccr3.2333. eCollection 2019 Sep.

    PubMed 31534737
  • Nigro ND, Vaitkevicius VK, Considine B Jr. Combined therapy for cancer of the anal canal: a preliminary report. Dis Colon Rectum. 1974 May-Jun;17(3):354-6. doi: 10.1007/BF02586980. No abstract available.

    PubMed 4830803
  • Northover J, Glynne-Jones R, Sebag-Montefiore D, James R, Meadows H, Wan S, Jitlal M, Ledermann J. Chemoradiation for the treatment of epidermoid anal cancer: 13-year follow-up of the first randomised UKCCCR Anal Cancer Trial (ACT I). Br J Cancer. 2010 Mar 30;102(7):1123-8. doi: 10.1038/sj.bjc.6605605. Epub 2010 Mar 16.

    PubMed 20354531
  • Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. UK Co-ordinating Committee on Cancer Research. Lancet. 1996 Oct 19;348(9034):1049-54.

    PubMed 8874455

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing PD-1 inhibitor and concurrent chemoradiotherapy in people with Anal Canal Cancer Stage III and Anal Squamous Cell Carcinoma, run by Sixth Affiliated Hospital, Sun Yat-sen University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 16 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Xiang-bo Wan, PhD (+86-13826017157, wanxbo@mail.sysu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression free survival (time frame: from the end of treatment to 3 years after treatment). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05374252, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 May 2022.

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