Using hypoxia imaging to personalize radiation therapy for esophageal cancer
Hypoxia Imaging for Esophageal Cancer to Guide Personalized Radiation Therapy
This study is testing if using special imaging to find low oxygen levels in esophageal cancer tumors can help doctors give personalized radiation treatment that works better for patients.
Quick facts
| Phase | Phase 1 |
|---|---|
| Study type | Interventional |
| Enrollment | 16 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Utah Academic / other |
| Drugs / interventions | chemotherapy, radiation |
| Locations | 1 site (Salt Lake City, Utah) |
| Trial ID | NCT04846309 on ClinicalTrials.gov |
What this trial studies
This Phase I trial evaluates the safety of personalized radiation therapy based on hypoxia levels identified through FMISO-PET and MRI in patients with esophageal cancer. Initially, all participants will undergo baseline imaging to assess tumor hypoxia. Those with hypoxic tumors will receive a higher radiation dose, while others will follow standard treatment. An interim MRI after 10 radiation fractions will help determine if additional radiation boosts are necessary based on treatment response.
Who should consider this trial
Good fit: Ideal candidates include adults aged 18 and older with esophageal cancer who are eligible for chemoradiation therapy.
Not a fit: Patients with advanced esophageal cancer not recommended for chemoradiation therapy or those with an ECOG performance status greater than 2 may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could lead to more effective radiation therapy tailored to individual tumor characteristics, improving outcomes for esophageal cancer patients.
How similar studies have performed: While personalized radiation therapy approaches are being explored, this specific method using hypoxia imaging is relatively novel and has not been extensively tested in prior studies.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
* Male or female subject aged ≥ 18 years.
* Esophageal cancer patient eligible to undergo either neoadjuvant or definitive chemoradiation therapy (CRT).
Note: Stage IV patients with limited metastatic disease burden may be eligible if CRT is recommended by the multidisciplinary team.
* Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2.
* For female subjects: Negative pregnancy test or evidence of post-menopausal status. The post-menopausal status will be defined as having been amenorrheic for 12 months without an alternative medical cause. The following age-specific requirements apply:
* Women \< 50 years of age:
* Amenorrheic for ≥ 12 months following cessation of exogenous hormonal treatments; and
* Luteinizing hormone and follicle-stimulating hormone levels in the post-menopausal range for the institution; or
* Underwent surgical sterilization (bilateral oophorectomy or hysterectomy).
* Women ≥ 50 years of age:
* Amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments; or
* Had radiation-induced menopause with last menses \>1 year ago; or
* Had chemotherapy-induced menopause with last menses \>1 year ago; or
* Underwent surgical sterilization (bilateral oophorectomy, bilateral salpingectomy, or hysterectomy).
* Recovery to baseline or ≤ Grade 2 CTCAE v5 from toxicities related to any prior treatments, unless AE(s) are clinically non-significant and/or stable on supportive therapy.
* Able to provide informed consent and willing to sign an approved consent form that conforms to federal and institutional guidelines.
Exclusion Criteria:
* Unable to undergo an MRI for any reason, including:
* Severe claustrophobia not amenable to pre-medication
* Presence of metallic objects or implanted medical devices in the body that are not MRI-compatible (e.g., non-MRI-compatible cardiac pacemaker, deep brain stimulator, neurostimulator, aneurysm clips, surgical clips, prostheses, artificial hearts, valves with steel parts, metal fragments, shrapnel, tattoos near the eye, or steel implants)
* Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the radiation therapy are eligible for this trial.
* The subject has severe, uncontrolled, significant intercurrent or recent illness that would exclude them from being a candidate for chemoradiation therapy.
--Any other condition that would, in the Investigator's judgment, contraindicate the subject's participation in the clinical study due to safety concerns or compliance with clinical study procedures.
* Known HIV infection with a detectable viral load at the time of screening. Note: Patients on effective antiretroviral therapy or who will plan on going on antiretroviral therapy at the time of screening are eligible for this trial. HIV testing is not required for eligibility.
* Known prior severe hypersensitivity to gadolinium, FMISO or any component in its formulations (NCI CTCAE v5.0 Grade ≥ 3).
Where this trial is running
Salt Lake City, Utah
- Huntsman Cancer Institute — Salt Lake City, Utah, United States (Recruiting)
Study contacts
- Principal investigator: Shane Lloyd, MD — Huntsman Cancer Institute
- Study coordinator: Rachel Kingsford
- Email: rachel.kingsford@hci.utah.edu
- Phone: 801-585-0115
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.