This phase I trial studies the side effects of OBP-301 when given together with carboplatin, paclitaxel, and radiation therapy in treating patients with esophageal or gastroesophageal cancer that invades local or regional structures. OBP-301 is a virus that has been designed to infect and destroy tumor cells (although there is a small risk that it can also infect normal cells). Chemotherapy drugs, such as carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Giving OBP-301 with chemotherapy and radiation therapy may work better than standard chemotherapy and radiation therapy in treating patients with esophageal or gastroesophageal cancer.
PRIMARY OBJECTIVE: I. To determine if the addition of OBP-301 to chemoradiation with carboplatin/paclitaxel is safe. SECONDARY OBJECTIVES: I. To assess toxicities associated with the addition of OBP-301 to chemoradiation. II. To assess the number of clinical complete responses (cCR). III. To assess the number of patients alive/without progression (progression-free survival \[PFS\]) and the number of patients alive (overall survival \[OS\]) at 1 and 2 years. EXPLORATORY OBJECTIVE: I. To report correlate outcomes - cCR, PFS and OS - with immune and virus-based correlative assays. OUTLINE: This study will evaluate an initial dose of OBP-301 and a de-escalated dose, if needed. Patients receive OBP-301 by intratumoral injection via endoscopy on days -3, 12, and 26. Patients also receive carboplatin intravenously (IV) over 30 minutes and paclitaxel IV over 60 minutes on days 1, 8, 15, 22, and 29, and undergo radiation therapy on Monday through Friday beginning day 1 for 28 fractions over 5.5 weeks. All treatment continues in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 1 and 6-8 weeks, then every 3 months for 2 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
16
Intravenously (IV)
Intravenously (IV)
Daily fractions
Intra-tumoral injection
City of Hope Comprehensive Cancer Center
Duarte, California, United States
City of Hope South Pasadena
South Pasadena, California, United States
City of Hope Upland
Upland, California, United States
Moffitt Cancer Center
Tampa, Florida, United States
University of Kansas Clinical Research Center
Fairway, Kansas, United States
University of Kansas Cancer Center
Kansas City, Kansas, United States
University of Kansas Hospital-Westwood Cancer Center
Westwood, Kansas, United States
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, United States
Memorial Sloan Kettering Basking Ridge
Basking Ridge, New Jersey, United States
Memorial Sloan Kettering Monmouth
Middletown, New Jersey, United States
...and 7 more locations
Number of Participants Experiencing Any Dose-Limiting Toxicities (DLTs)
Adverse events are graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0, which grades adverse event severity as follows: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, 5 = death related to adverse event. A DLT is defined as the following that are definitely or probably attributed to OBP-301: * Any grade ≥3 adverse event EXCEPT for the following: * Grade 3 nausea/vomiting * Grade 3 esophagitis or dehydration * The first occurrence of grade 3/4 neutropenia * Grade 3/4 lymphopenia (since this is a known toxicity of chemoradiation and OBP-301) * Any toxicity that leads to a \>14-day cumulative delay in chemoradiation. If 0 or 1 participants of 6 participants experienced a DLT, then the treatment regimen would be considered safe (and 9 more would be accrued for secondary endpoints). Otherwise, the regimen would be deemed too toxic and a second cohort of six participants would be accrued to a lower dose of OBP-301 (1 x 10\^11 vp/mL).
Time frame: From start of protocol treatment until 30 days after the completion of chemoradiation, approximately 10 weeks.
Number of Participants by Highest Grade Adverse Event Reported
The Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 grades adverse event severity as follows: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, 5 = death related to adverse event. Summary data is provided in this outcome measure; see Adverse Events Module for specific adverse event data.
Time frame: From start of protocol treatment to last follow-up. Maximum follow-up was 28.7 months.
Number of Participants With Clinical Complete Response (cCR)
Clinical complete response is defined as grossly free of disease as determined by a visual inspection or if the visual inspection was not certain, then a negative biopsy. The number of participants is determined for two populations: * Complete case analysis only includes eligible participants who started protocol treatment and were assessed for cCR; * Sensitivity analysis includes all eligible participants who started protocol treatment and counts participants without an assessment as not achieving a cCR.
Time frame: 6-8 weeks after completion of chemoradiation, approximately 11.5-13.5 weeks from baseline.
Number of Participants Alive Without Progression at 1 and 2 Years
Progression is defined as pathologically confirmed recurrence of local disease or clinical evidence of distant disease.
Time frame: At 1 and 2 years
Number of Participants Alive at 1 and 2 Years
Time frame: At 1 and 2 years
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