250 Participants Needed

Ablative Therapy for Oligoprogressive Cancer

(VALOROUS Trial)

Selina Laqui, MD, PhD profile photo
Overseen BySelina Laqui, MD, PhD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of California, Davis
Must be taking: Systemic therapy
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the benefits of combining local treatments with ongoing medication for individuals with certain cancers that have spread moderately. The focus includes breast, gynecological, head and neck, and other solid tumors. Local treatments, such as targeted radiation or ablation (locally ablative therapy), aim to halt or slow new tumor growth. This trial suits those whose treatment has mostly stabilized their cancer but who have developed a few new spots. Participants should have no more than five new or growing spots that can be safely treated with these local therapies. As an unphased trial, this study provides a unique opportunity to explore innovative treatment combinations that might better control cancer.

Will I have to stop taking my current medications?

The trial does not require you to stop your current medications. You can continue your current systemic therapy, with a possible break of up to 30 days for the local ablative therapy.

What prior data suggests that locally ablative therapy is safe for treating oligo-progressive solid tumors?

Research has shown that treatments like stereotactic ablative radiotherapy (SABR) are generally safe and well-tolerated. Studies have found that SABR effectively treats certain cancers, particularly those with limited spread or slow growth. For instance, some studies indicate that patients can safely undergo multiple rounds of SABR, suggesting it is not only effective but also manageable over time. While some side effects might occur, many patients consider these treatments safe.12345

Why are researchers excited about this trial?

Researchers are excited about locally ablative therapy for oligoprogressive cancer because it offers a targeted approach that directly attacks cancer cells in specific areas, unlike traditional therapies that often affect the whole body. This method uses stereotactic ablative radiotherapy (SABR) or interventional radiology (IR) ablation to precisely focus on tumors, minimizing damage to surrounding healthy tissue. By concentrating treatment on progression spots, it can potentially control the disease more effectively and with fewer side effects than systemic treatments like chemotherapy or broad radiation therapy. This specificity might allow for better quality of life and faster recovery for patients.

What evidence suggests that locally ablative therapy is effective for oligoprogressive cancer?

Research has shown that treatments like Stereotactic Ablative Radiotherapy (SABR), studied in this trial as part of the ablative local therapy arm, can effectively treat oligoprogressive cancer. Studies have found that SABR can extend patient survival and delay the need to alter overall cancer treatment. For certain cancer types, this method proves both effective and manageable. The therapy targets and destroys specific cancer areas, helping control the disease without immediately requiring new medications. Overall, evidence supports this treatment as a valuable option for managing cancer progression.26789

Who Is on the Research Team?

XZ

Xiao Zhao, MD

Principal Investigator

University of California, Davis

Are You a Good Fit for This Trial?

Adults over 18 with certain cancers (like breast, gynecological, head and neck, sarcomas) who have up to 5 new or worsening metastatic lesions. They must be on systemic therapy they can continue post-treatment and have seen benefits from it for at least 3 months. Not eligible if they have progressing brain tumors or health issues that rule out local therapies.

Inclusion Criteria

I've had at least one treatment for my cancer that spread, and it worked for 3 months before the cancer grew.
My cancer spread can be targeted with specific local treatments.
I have 5 or fewer new or growing cancer spots.
See 9 more

Exclusion Criteria

I have side effects from past treatments that prevent me from getting certain local therapies.
My brain tumor is getting worse.
I have health conditions that prevent me from undergoing treatments targeting specific areas.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive systemic therapy with the addition of locally ablative therapies such as stereotactic ablative radiotherapy (SABR) or interventional radiology (IR) ablation therapy

3 months
Visits as per standard practices

Follow-up

Participants are monitored for disease control and adverse events after treatment

Up to 5 years
Regular follow-up visits

What Are the Treatments Tested in This Trial?

Interventions

  • Locally ablative therapy
Trial Overview The VALOROUS trial is testing whether adding local ablative treatments (like radiation) to ongoing systemic cancer therapy helps control the disease better in patients whose cancer has started to progress again but only in a limited number of spots.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Ablative local therapyExperimental Treatment1 Intervention

Locally ablative therapy is already approved in European Union, United States for the following indications:

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Approved in European Union as SAbR/SBRT for:
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Approved in United States as SAbR/SBRT for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, Davis

Lead Sponsor

Trials
958
Recruited
4,816,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Published Research Related to This Trial

This phase II study will evaluate the effectiveness of Stereotactic Ablative Radiotherapy (SABR) combined with ongoing systemic treatment in 68 patients with oligoprogressive Non-Small Cell Lung Cancer (NSCLC), aiming to provide clearer evidence on its benefits compared to standard care.
The study will focus on key outcomes such as progression-free survival and overall survival, while also assessing quality of life and the safety of SABR, addressing a significant gap in current treatment strategies for oligoprogressive NSCLC.
Stereotactic Ablative Radiotherapy for oligo-progressive disease refractory to systemic therapy in Non-Small Cell Lung Cancer: A registry-based phase II randomized trial (SUPPRESS-NSCLC).Bahig, H., Tonneau, M., Blais, N., et al.[2022]
Stereotactic ablative radiotherapy (SABR) is a promising noninvasive treatment for oligometastatic and oligoprogressive cancer, showing improved progression-free and overall survival in recent randomized trials.
While SABR is generally safe and minimally toxic, there have been rare reports of severe adverse events, highlighting the need for careful patient selection and ongoing research to optimize its use.
Radiation in the Treatment of Oligometastatic and Oligoprogressive Disease: Rationale, Recent Data, and Research Questions.Zayed, S., Correa, RJM., Palma, DA.[2021]
Stereotactic ablative radiotherapy (SABR) is a highly effective and low-toxicity treatment for metastatic tumors, achieving local control rates of about 80%.
SABR shows promise in treating oligometastatic patients, with pilot studies suggesting it may be 'curative' in 20-25% of cases, especially when combined with systemic therapies.
New concepts and insights into the role of radiation therapy in extracranial metastatic disease.Ricardi, U., Filippi, AR., Franco, P.[2013]

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/38648995/
Systematic review of the efficacy of stereotactic ablative ...Stereotactic Ablative Radiotherapy (SABR) for the treatment of oligometastatic disease can improve survival and delay the requirement for systemic therapy.
A Phase II Prospective Multicenter TrialThis study suggests that SABR can help delay the need to change systemic therapy in patients with estrogen receptorโ€“positive, human epidermal ...
Study Details | NCT06882499 | Stereotactic Ablative Body ...The goal of this clinical trial is to assess Stereotactic Ablative Radiotherapy (SABR) as a method to delay a change in systemic therapy in patients with ...
Stereotactic Ablative Radiotherapy for Gynecological ...This cohort study evaluates the outcomes of stereotactic ablative radiotherapy in patients with oligometastatic and oligoprogressive ...
Stereotactic ablative body radiation for oligometastatic and ...SABR is an effective and tolerable treatment modality for ablation of metastatic sites and should be considered a feasible tool in the management of ...
Safety and Survival Rates Associated With Ablative ...The findings of this study suggest that stereotactic ablative radiotherapy is generally safe and well tolerated in the oligometastatic setting.
Local treatment for oligoprogressive metastatic sites of breast ...While in NSCLC patients SBRT led to a reduction in allelic fraction, no change in ctDNA was observed in BC patients after ablative therapy. This ...
Clinical Outcomes for Stereotactic AblativeRadiotherapy in ...Conclusions: The SABR is a safe and effective local treatment modality in patients with oligometastatic gynecological disease. Distant progression remains the ...
Treatment Outcomes of Stereotactic Ablative Body ...This study reported SABR treatment outcomes for multisite OM and OP diseases originating from metastatic breast cancer.
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