Nano-SMART: An Adaptive Phase I-II Trial of AGuIX Gadolinium-based Nanoparticles With Stereotactic Magnetic Resonance-guided Adaptive Radiation Therapy for Centrally Located Lung Tumors and Locally Advanced Unresectable Pancreatic Ductal Adenocarcinoma
Summary
This research study is being done to help determine the safety and efficacy of gadolinium based nanoparticle, Activation and Guidance of Irradiation X (AGuIX), used in conjunction with MR-guided stereotactic body radiation therapy (SBRT) in the treatment of pancreatic cancer and lung tumors.
Detailed description
This is a seamless phase I/II trial with two separate disease groups/cohorts (centrally located lung tumors and locally advanced/unresectable pancreatic ductal adenocarcinoma-LAPC). The Phase I part is determining for each disease group a safe dose-level that will be evaluated in the Phase II component of the study. The phase II part of the study is a randomized controlled trial that tests, for each disease group, the treatment efficacy of stereotactic body radiation therapy (SBRT) in combination with AGuIX gadolinium-chelated polysiloxane based nanoparticles compared to treatment with stereotactic magnetic resonance (MR)-guided adaptive radiation therapy (SMART) alone The U.S. Food and Drug Administration (FDA) has not approved Activation and Guidance of Irradiation X (AGuIX) as a treatment for any disease. AGuIX is a gadolinium-based nanoparticle, gadolinium is the drug used for an MR with contrast. It is believed that the AGuIX may help the radiation received work better by making a tumor more sensitive to the radiation and allowing doctors to see the tumor more clearly. AGuIX has been tested in one previous study with humans. It was found that AGuIX did make tumor cells more sensitive to radiation therapy. The research study procedures include screening for eligibility and study treatment including evaluations and follow up visits. Participants will receive study treatment for 5 treatment days and will be followed for a year after your treatment ends. It is expected that about 100 people will take part in this research study.
Arms & interventions
- DrugAGuIX
Injected gadolinium-based nanoparticles
- RadiationRadiotherapy
Stereotactic magnetic resonance-guided adaptive radiation therapy
Outcome measures
Primary
Maximum tolerated dose (MTD) Phase 1
Evaluated by the occurrence of Dose Limiting Toxicity (DLT) over the duration of the study using the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.0
Time frame: 3 months
Compare Local Control at 12 months of Maximum tolerated dose MTD - Phase 2
Evaluate SMART + AGuIX local control at 12 months compared to SMART alone. Local control at 12 months is defined as the treated tumor is equal to or less than the tumor volume at start of SMART. Progression would be defined per RECIST criteria
Time frame: 12 months
Secondary
Progression-free survival (PFS) at Maximum tolerated dose (MTD)
Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months
Overall Response Rate (ORR) at Maximum tolerated dose (MTD)
Time frame: Enrollment through study completion, an average of 1 year
Serious Adverse Events at 90 Days
Time frame: 90 days
Serious Adverse Events at 12 months
Time frame: 12 months
Tumor Changes
Time frame: Enrollment through study completion, an average of 1 year
Compare disease-specific survival
Time frame: Enrollment through study completion, an average of 1 year
compare R0 resection rate
Time frame: Enrollment through study completion, an average of 1 year
Compare overall survival
Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months
Quality of Life (QoL)-Performance Status utilizing PROMIS Physical and Mental Health batteries
Time frame: Baseline through study completion, an average of 1 year
Quality of Life (QoL)-Completion of Daily Activities utilizing PROMIS Physical and Mental Health batteries
Time frame: Baseline through study completion, an average of 1 year
Eligibility criteria
Study locations (2)
Brigham and Women's Hospital
Boston, Massachusetts, 02115
Dana Farber Cancer Institute
Boston, Massachusetts, 02115