Adaptive Radiation for Abdominopelvic Metastases

Trial Title: Adaptive Radiation for Abdominopelvic Metastases

NCT ID: NCT05880667

Condition: Neoplasm - Soft Tissue Pelvis Malignant Secondary
Malignant Neoplasm of Stomach

Conditions: Official terms:
Neoplasms
Stomach Neoplasms

Study type: Interventional

Study phase: Phase 1

Overall status: Recruiting

Study design:

Allocation: N/A

Intervention model: Single Group Assignment

Primary purpose: Treatment

Masking: None (Open Label)

Intervention:

Intervention type: Radiation
Intervention name: Adaptive Stereotactic Body Radiation
Description: Radiation therapy is given following generation of planning imaging at the time of simulation. A recent development has been diagnostic quality onboard imaging incorporated within radiation treatment machines. The incorporation of onboard imaging into standard practice has allowed the use Stereotactic Body Radiation (SBRT), which is a precise radiation technique that allows safe delivery of ablative radiation doses. More recently, the development of improved technologies and software have allowed radiation plans to be generated and delivered that are specific to the anatomy of the very moment the patient is being treated. This novel ability to adjust the radiation treatment plan based upon real time imaging is termed adaptive radiation therapy. This study will utilize the novel adaptive radiation therapy technology in a patient population with technically challenging disease to deliver ablative radiation with an appropriately low toxicity rate.
Arm group label: Adaptive Stereotactic Body Radiation

Summary: Single arm Phase I trial of adaptive stereotactic body radiation (SBRT) for abdominopelvic metastases. Adaptive SBRT will allow for escalation of the prescription dose and target coverage while maintaining grade 3+ toxicity no greater than 10%. Subjects with metastatic cancer to the abdomen or pelvis requiring local control or palliation will be enrolled.

Detailed description: This is a dose-escalation study where the objective is to find the Maximum Tolerated Dose (MTD) and Recommended Phase 2 Dose (RP2D) of adaptive SBRT for abdominopelvic SBRT. There are 3 doses of interest 8Gy/fraction (level 1), 9Gy/fraction (level 2), and 10Gy/fraction (level 3). The starting dose will be level 2. We will use a Bayesian Optimal Interval Design (BOIN) to define dose escalation and de-escalation rules based on the proportion of patients experiencing a dose-limiting toxicity (DLT). DLT events are Grade 3 events possibly, probably, or definitely related to the study intervention.

Criteria for eligibility:
Criteria:
Inclusion Criteria: 1. Subjects must have histologically or cytologically confirmed cancer that is metastatic (all solid tumor types accepted), with at least one target lesion untreated by radiation, IR techniques, or growing in the abdomen or pelvis. Adjacent lymph nodes in the same region (5 cm or closer) constitute one active lesion. Target lesion must be measurable according to RECIST v 1.1. Previous systemic therapies are allowed. 2. Age > 18 years. 3. ECOG performance status 0 or 1 4. Estimated survival of >/= 12 months 5. Subjects must have normal organ and marrow function as defined below - Absolute neutrophil count > 1,500/mcL - Platelets > 100,000/mcL - Total bilirubin < 2 mg/dL - AST/ALT (SGOT/SGPT) < 5X ULN - Creatinine < 1.5X ULN OR - Creatinine clearance ≥ 50 ml/min/1.73 m2 for subjects with creatinine levels above institutional normal 6. Subjects must possess the ability to understand and willingness to sign a written informed consent and HIPAA consent document. Translation services including translation of informed consent documents will be provided, as feasible, to encourage diversity of inclusion of eligible patients. Exclusion Criteria: 1. Subjects must not be experiencing toxicity due to prior therapy that has not resolved to ≤Grade 1 by study registration, with the exception of sensory neuropathy related to previous systemic therapy exposure, alopecia and fatigue. 2. Subjects must not be receiving any other investigational agents. 3. Subjects must not have known peritoneal carcinomatosis visible on imaging. 4. Subjects must not have known active solid tumors on imaging outside of abdomen/pelvis noted on screening imaging 5. Subjects must not have 6 or more active metastatic sites. 6. Subjects must not have had prior radiotherapy to any target metastatic lesion. Prior radiotherapy to non-target sites is allowed. 7. Subjects must not have uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. 8. Any condition or significant co-morbidity that prevents safe delivery of SBRT per the discretion of the treating physician(s). 9. Subjects must not be pregnant or breast-feeding. Refer to section 4.4 for further detail.

Gender: All

Minimum age: 18 Years

Maximum age: N/A

Healthy volunteers: No

Locations:

Facility:
Name: Fox Chase Cancer Center

Address:
City: Philadelphia
Zip: 19111
Country: United States

Status: Recruiting

Contact:
Last name: Joshua E. Meyer, MD

Phone: 215-728-2667
Email: joshua.meyer@fccc.edu

Investigator:
Last name: Joshua E. Meyer
Email: Principal Investigator

Start date: August 1, 2023

Completion date: June 1, 2029

Lead sponsor:
Agency: Fox Chase Cancer Center
Agency class: Other

Source: Fox Chase Cancer Center

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT05880667