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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
100
Injected gadolinium-based nanoparticles
Stereotactic magnetic resonance-guided adaptive radiation therapy
Brigham and Women's Hospital
Boston, Massachusetts, United States
RECRUITINGDana Farber Cancer Institute
Boston, Massachusetts, United States
RECRUITINGMaximum 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
Progression-free survival (PFS) at Maximum tolerated dose (MTD)
Assessed by RECIST criteria
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)
Assessed by RECIST criteria
Time frame: Enrollment through study completion, an average of 1 year
Serious Adverse Events at 90 Days
NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 will be used.
Time frame: 90 days
Serious Adverse Events at 12 months
NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 will be used.
Time frame: 12 months
Tumor Changes
Changes in the largest diameter (unidimensional measurement) of the tumor lesions and the shortest diameter in the case of malignant lymph nodes are used in the RECIST criteria.
Time frame: Enrollment through study completion, an average of 1 year
Compare disease-specific survival
Bayesian hierarchical two-sample test for binary outcomes
Time frame: Enrollment through study completion, an average of 1 year
compare R0 resection rate
Bayesian hierarchical two-sample test for binary outcomes
Time frame: Enrollment through study completion, an average of 1 year
Compare overall survival
Bayesian hierarchical two-sample test for binary outcomes
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
Described using descriptive statistics and longitudinal analyses
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
Described using descriptive statistics and longitudinal analyses
Time frame: Baseline through study completion, an average of 1 year
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