NCT04135664

Brief Summary

The ad-ESD trial is phase III randomized trial to compare adjuvant esophagectomy and chemoradiation for patients with clinical stage N0 and pathological stage T1b squamous cell carcinoma (after endoscopic submucosal dissection).

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
176

participants targeted

Target at P25-P50 for phase_3

Timeline
18mo left

Started Sep 2019

Longer than P75 for phase_3

Geographic Reach
1 country

6 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress82%
Sep 2019Dec 2027

Study Start

First participant enrolled

September 1, 2019

Completed
1 month until next milestone

First Submitted

Initial submission to the registry

October 9, 2019

Completed
13 days until next milestone

First Posted

Study publicly available on registry

October 22, 2019

Completed
8.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2027

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2027

Last Updated

October 22, 2019

Status Verified

August 1, 2019

Enrollment Period

8.3 years

First QC Date

October 9, 2019

Last Update Submit

October 20, 2019

Conditions

Keywords

esophagectomychemoradiationesophageal cancerendoscopic submucosal dissection

Outcome Measures

Primary Outcomes (1)

  • 5-year overall survival rate

    The overall survival is defined as days from date of randomization to death from any cause, and cencored at the last day of follow up when patients are alive.

    5 years after enrollment day

Secondary Outcomes (5)

  • 3-year overall survival rate

    3 years after enrollment day

  • 3-year relapse free survival rate

    3 years after enrollment day

  • 5-year relapse free survival rate

    5 years after enrollment day

  • Quality of life differences (EORTC QLQ-C30)

    1st, 3rd, 6th, 12th and 24th month after enrollment

  • Quality of life differences (EORTC QLQ-OES18)

    1st, 3rd, 6th, 12th and 24th month after enrollment

Study Arms (3)

Patients undergoing adjuvant esophagectomy

ACTIVE COMPARATOR

Patients underwent endoscopic submucosal dissection and diagnosed with pathological-T1b and clinical-N0 squamous cell carcinoma. Patients randomized into undergoing adjvant esophagectomy.

Procedure: esophagectomy

Patients undergoing adjuvant chemoradiation

EXPERIMENTAL

Patients underwent endoscopic submucosal dissection and diagnosed with pathological-T1b and clinical-N0 squamous cell carcinoma. Patients randomized into undergoing adjvant chemoradiation.

Combination Product: chemoradiation

Prospective registry of patients that cannot be randomized

ACTIVE COMPARATOR

Patients underwent endoscopic submucosal dissection and diagnosed with pathological-T1b and clinical-N0 squamous cell carcinoma. Patients cannot be randomized into undergoing adjvant esophagectomy or chemoradiaton. This arm includes patients undergoing adjuvant esophagectomy; adjuvant chemoradiation and active surveillance.

Procedure: esophagectomyCombination Product: chemoradiationOther: active surveillance

Interventions

esophagectomyPROCEDURE

esophagectomy with at least two-field (thoracic-abdominal) lymphadenectomy

Patients undergoing adjuvant esophagectomyProspective registry of patients that cannot be randomized
chemoradiationCOMBINATION_PRODUCT

concurrent chemotherapy and radiotherapy

Patients undergoing adjuvant chemoradiationProspective registry of patients that cannot be randomized

No further adjuvant therapy

Prospective registry of patients that cannot be randomized

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Biopsy proven with esophageal squamous cell cancer.
  • Clinical N0 stage diagnosed by imaging examinations.
  • Pathological T1b stage confirmed by endoscopic submucosal dissection.
  • Age: 18-75.
  • Tumor located at the thorax.
  • Performance status Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
  • Written informed consent.

You may not qualify if:

  • Prior intervention treatment before endoscopic submucosal resection.
  • Inability to accept any treatment component.
  • Prior intervention (surgery, chemoradiation, et al.) for other primary tumor disease.
  • Distant metastasis.
  • The circumference of the lumen over 3/4
  • Main tumor size \> 5cm assessed by endoscopy
  • Inability to understand the informed consent.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (6)

The First Affiliated Hospital of Nanchang University

Nanchang, Jiangxi, JX 791, China

ACTIVE NOT RECRUITING

Changhai Hospital, The Second Military Medical University

Shanghai, SH 21, China

ACTIVE NOT RECRUITING

Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine

Shanghai, SH 21, China

ACTIVE NOT RECRUITING

Shanghai Chest Hospital, Shanghai Jiao Tong University

Shanghai, SH 21, China

RECRUITING

Zhongshan Hospital, Fudan University

Shanghai, SH 21, China

ACTIVE NOT RECRUITING

Tianjin Medical University Cancer Institute and Hospital

Tianjin, China

ACTIVE NOT RECRUITING

Related Publications (2)

  • Al-Batran SE, Koch C. Neoadjuvant therapy for oesophageal cancer: refining the armamentarium. Lancet. 2024 Jul 6;404(10447):5-7. doi: 10.1016/S0140-6736(24)01084-5. Epub 2024 Jun 11. No abstract available.

  • Yang Y, Su Y, Zhang X, Liu J, Zhang H, Li B, Hua R, Tan L, Chen H, Li Z. Esophagectomy versus definitive chemoradiotherapy for patients with clinical stage N0 and pathological stage T1b esophageal squamous cell carcinoma after endoscopic submucosal dissection: study protocol for a multicenter randomized controlled trial (Ad-ESD Trial). Trials. 2020 Jul 1;21(1):603. doi: 10.1186/s13063-020-04461-5.

MeSH Terms

Conditions

Esophageal Neoplasms

Interventions

EsophagectomyChemoradiotherapyWatchful Waiting

Condition Hierarchy (Ancestors)

Gastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsHead and Neck NeoplasmsDigestive System DiseasesEsophageal DiseasesGastrointestinal Diseases

Intervention Hierarchy (Ancestors)

Digestive System Surgical ProceduresSurgical Procedures, OperativeCombined Modality TherapyTherapeuticsDrug TherapyRadiotherapyOutcome Assessment, Health CareOutcome and Process Assessment, Health CareQuality of Health CareHealth Services Administration

Study Officials

  • Zhigang Li, MD, PhD

    Shanghai Chest Hospital of Shanghai Jiao Tong University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Zhigang Li, MD

CONTACT

Xiaobin Zhang, MD

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Chief of Department of Esophageal Surgery, Deputy of Department of Thoracic Surgery

Study Record Dates

First Submitted

October 9, 2019

First Posted

October 22, 2019

Study Start

September 1, 2019

Primary Completion (Estimated)

December 1, 2027

Study Completion (Estimated)

December 1, 2027

Last Updated

October 22, 2019

Record last verified: 2019-08

Locations