Radio-immuno-chemotherapy for Esophageal Cancer

(OPERARADIO Trial)

AD
KD
BK
JB
Overseen ByJennifer Basa
Stay on Your Current MedsYou can continue your current medications while participating
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test the safety of different treatments for early-stage esophageal cancer. Researchers are examining how well patients tolerate combined treatments that include chemotherapy, radiation, and immunotherapy. The trial targets individuals with early-stage esophageal cancer who have undergone a procedure to remove the tumor but are not candidates for major surgery. Those who have this type of cancer and have completed certain treatments without surgery might find this trial suitable. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive potentially groundbreaking therapies.

Do I need to stop my current medications to join the trial?

The trial protocol does not specify if you need to stop taking your current medications. However, you cannot participate if you have received anticancer therapy within 15 days before the trial or if you are on certain immunosuppressive medications. It's best to discuss your specific medications with the study team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that treatments like chemoradiotherapy and immunoradiotherapy are generally well-tolerated by patients. Studies indicate that chemoradiotherapy can be safe even with long-term use, though some patients do experience side effects, which are common in cancer treatments. Research has found immunoradiotherapy promising in terms of safety, with only a few patients experiencing severe side effects.

Regarding immunotherapy alone, research has shown it to be quite safe when used after surgery. In one study, most patients completed their treatment without major issues, and only a few had serious side effects.

Overall, these treatments have demonstrated manageable safety in previous studies. This suggests that while side effects can occur, they are usually not severe for most people.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for esophageal cancer because they combine traditional and cutting-edge therapies in new ways. Unlike standard treatments, which often involve chemoradiotherapy, these options explore the use of immunotherapy alongside radiation. Immunoradiotherapy, for instance, leverages the body's immune system to target cancer cells more effectively, potentially improving outcomes for patients who can handle this approach. For patients with severe autoimmune conditions, the trial offers chemoradiotherapy, providing a tailored option that avoids the risks of immunotherapy. These innovative combinations aim to enhance the effectiveness of treatment and provide safer alternatives for diverse patient needs.

What evidence suggests that this trial's treatments could be effective for esophageal cancer?

Research has shown that combining chemotherapy and radiation after surgery, known as adjuvant chemoradiotherapy, can extend the lives of people with esophageal cancer. In this trial, some participants will receive this combination as part of the adjuvant chemoradiotherapy arm. Studies suggest this approach often outperforms surgery alone, particularly in older patients.

Another group in this trial will receive adjuvant immunoradiotherapy, which combines immunotherapy with chemotherapy and radiation. This method can shrink tumors and may increase survival chances. Additionally, some participants may receive immunotherapy alone, as demonstrated in the CheckMate 577 trial, which showed improved cancer-free survival time after surgery. These treatments attack cancer cells and boost the body's immune system, potentially leading to longer and healthier lives for patients.36789

Who Is on the Research Team?

BK

Biniam Kidane

Principal Investigator

University of Manitoba

Are You a Good Fit for This Trial?

This trial is for adults over 18 with early-stage esophageal cancer (T1b/T2N0) who have completed a specific type of surgery (EMR/ESD), can't or won't get their esophagus removed, and meet certain health requirements like body weight and blood counts.

Inclusion Criteria

I have completed a procedure to remove part of the inner layers of my stomach or esophagus.
I am older than 18 years.
Able to provide informed consent
See 4 more

Exclusion Criteria

I have or had an autoimmune or inflammatory disorder.
Participation in another clinical study with an investigational product during the last 4 weeks
History of allogenic organ transplantation
See 16 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Endoscopic Resection

Participants undergo endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) as a diagnostic and potentially curative procedure

1 week
1 visit (in-person)

Adjuvant Treatment

Participants receive adjuvant immunoradiation therapy or chemoradiation therapy based on eligibility

6-8 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

2 years
Regular visits (in-person and virtual)

What Are the Treatments Tested in This Trial?

Interventions

  • Adjuvant Chemoradiotherapy
  • Adjuvant Immunoradiotherapy
  • Adjuvant Immunotherapy
  • Adjuvant Radiotherapy
Trial Overview The study tests the safety of two additional treatments after surgery: one group gets chemo plus radiation (chemoradiation), while another gets immune therapy plus radiation. The goal is to enroll 10 patients to see if these approaches are safe.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Adjuvant chemoradiotherapyExperimental Treatment1 Intervention
Group II: Adjuvant Immunoradiotherapy (ARM1) and Adjuvant Immunotherapy (ARM1B)Experimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Manitoba

Lead Sponsor

Trials
628
Recruited
209,000+

AstraZeneca

Industry Sponsor

Trials
4,491
Recruited
290,540,000+

Sir Pascal Soriot

AstraZeneca

Chief Executive Officer since 2012

Veterinary Medicine from École nationale vétérinaire d'Alfort, MBA from HEC Paris

Dr. Cristian Massacesi

AstraZeneca

Chief Medical Officer since 2021

MD from Marche Polytechnic University, Oncology training at Royal Marsden Hospital, Kaplan Comprehensive Cancer Center, and European Institute of Oncology

Pascal Soriot

AstraZeneca

Chief Executive Officer since 2012

Veterinary Medicine from École nationale vétérinaire d'Alfort, MBA from HEC Paris

Cristian Massacesi

AstraZeneca

Chief Medical Officer since 2021

MD from Marche Polytechnic University, Medical Oncology training at Royal Marsden Hospital, Kaplan Comprehensive Cancer Center, and European Institute of Oncology

Manitoba Medical Service Foundation

Collaborator

Trials
19
Recruited
1,100+

CancerCare Manitoba

Collaborator

Trials
29
Recruited
5,600+

Citations

Adjuvant treatment after neoadjuvant chemoradiotherapy ...Surgery is widely recognized as the primary treatment for locally advanced resectable ESCC; however, the prognosis remains poor, with a 5-year ...
A Retrospective Study from TaiwanThe primary oncological outcomes were overall survival (OS) and recurrence-free survival (RFS). OS was defined as the time from diagnosis until ...
Outcomes of adjuvant chemotherapy after neoadjuvant ...The purpose of this study is determine if AC is associated with an overall survival (OS) benefit after NCR. Methods: The National Cancer Database was queried to ...
Efficacy of Concurrent Chemoradiotherapy With S-1 vs ...Our phase 1 and 2 trials have suggested that CCRT with S-1 provides promising outcomes and mild toxic effects in older patients with esophageal ...
a systematic review and meta-analysis - Annals of EsophagusNeoadjuvant chemotherapy or chemoradiotherapy followed by surgery was associated with a survival benefit compared to surgery alone (27-29), and NCRT + S seemed ...
Adjuvant chemotherapy and outcomes in esophageal ...We found no survival benefit associated with adjuvant chemotherapy in our own analysis of patients treated with neoadjuvant chemoradiation followed by surgery ...
Long-Term Clinical Outcomes and Safety Analysis ...Long-term clinical outcomes and safety analysis of superficial esophageal cancer patients treated with definitive or adjuvant radiotherapy.
Full article: Survival rates and safety associated with ...The incidence of esophageal cancer is 3.1% among all new cancer cases with five-year survival of up to 30% (AJCC) [1,2]. The incidence of T4 tumors is ...
Efficacy and safety of definitive chemoradiotherapy in ...Previous clinical trials have indicated a clinical complete response (cCR) rate of 11%-25% and median overall survival (OS) of 9-10 months. The ...
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