Stereotactic Adaptive Radiation Therapy of Borderline Resectable Pancreatic Cancer an Individualized Approach

Launched by VARIAN, A SIEMENS HEALTHINEERS COMPANY · Mar 7, 2023

Keywords

ClinConnect Summary

This clinical trial is looking at a new way to treat patients with borderline-resectable pancreatic cancer using a method called stereotactic adaptive radiation therapy. This approach aims to deliver a high dose of radiation while minimizing side effects. The trial will measure how well this treatment works in terms of controlling the cancer, improving survival rates, and maintaining a good quality of life for participants.

To be eligible for this trial, patients should have a confirmed diagnosis of pancreatic cancer that is either not easily operable or has advanced locally. They should be between 18 and 74 years old, have received at least two months of chemotherapy before starting the trial, and be in reasonably good health (as measured by their ability to perform daily activities). Participants will need to be able to hold their breath for short periods during treatment and will be closely monitored throughout the study. The trial is currently recruiting participants, and those who join can expect to receive careful care and follow-up during this innovative treatment process.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Histologically or cytologically confirmed borderline-resectable (based on NCCN criteria), locally-advanced (based on NCCN criteria), or medically inoperable pancreatic adenocarcinoma.
• • 2. ECOG performance status 0-1
• • 3. Receipt of at least two months of lead-in chemotherapy (regimen at the discretion of the treating physician) prior to planned initiation of CT-STAR.
• • 4. Limited regional lymphadenopathy permitted. Node positive patients are restricted to those with up to 3 clinically involved (greater than 1cm on cross-sectional imaging or pathologically proven) nodes provided that the lymph nodes are adjacent to the primary tumor.
• • 5. At least 18 years of age.
• • 6. Must be able to take an interruption in systemic therapy at least one week prior to planned start of CT-STAR (two weeks preferred) lasting for the duration of CT-STAR and continuing for at least one week following end of CT-STAR (two weeks preferred).
• • 7. Capable of a single end-exhale breath-hold of at least 20 seconds in duration and of repeated end-exhale or deep inspiratory breath-hold of at least 10 seconds in duration upon verbal instruction.
• • 8. Anatomy of target and adjacent OARs adequately visualized on ETHOS simulation imaging, as determined by treating and study physicians.
• • Note: central review of simulation imaging and initial plan target/OAR contours by the Principal Investigator and Physics lead is required for the first two patients at each participating institution prior to study treatment delivery. Patients with inadequate anatomic visualization at simulation will be considered screen-failures and treated off-protocol as per institutional standard-of-care.
• • 9. Able to understand and willing to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable).
• Exclusion Criteria:
• • 1. Past history of radiotherapy within the projected treatment field
• • 2. Prior, intercurrent, or planned receipt (within 90 days prior to or following SBRT) of any investigational agents related to pancreatic cancer diagnosis.
• • 3. Competing, active cancer diagnosis within the preceding one year.
• • 4. 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.
• • 5. Gross tumor invasion of the stomach or duodenum (defined either radiographically or endoscopically).
• • 6. Pregnant and/or breastfeeding. Patients of childbearing potential must have a negative pregnancy test within 14 days of study entry.