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NCT Number: NCT05478876

Carbon Ion Radiation Therapy in the Treatment of Mucous Melanomas of the Female Lower Genital Tract

The present monocentric prospective phase 2 study aims to reproduce the results obtained at NIRS thus offering the possibility of obtaining a promising rate of progression-free survival (PFS) and local control (LC) in patients diagnosed with mucosal melanoma of lower genital tract. Systemic treatment with immunotherapy is not the subject of this study but is allowed both in the neoadjuvant and sequential regimens.

Melanomas have always been considered poorly radiosensitive. It is now accepted that high LET (Linear Energy Transfer) particle beams, such as carbon ions, can offer a biological advantage, compared to photons treatment, in radio-resistant neoplasms treatment, thanks to their higher biological efficacy (RBE) against tumours with a low α/ ß ratio. In addition, carbon ions have the physical advantage of an inverted depth deposition profile compared to photons, allowing then a steep dose gradients that ensure increased sparing of adjacent healthy organs at risk (OARs).

Recruiting

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Key information

Age range

20 year–80 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Patients with primary gynaecological melanoma, non-metastatic, non-suitable for surgery, and not previously subjected to conventional radiotherapy can be enrolled in the trial, according to selection criteria. After requested baseline exams, the patient undergoes to simulation phase for the carbon ion radiation therapy, according to study constraints. The patient will then receive immunotherapy not concomitant to CIRT. The response is evaluated through RECIST criteria.

PFS is the primary endpoint, calculated from the end of CIRT to date of disease progression or death or last follow up.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Histological diagnosis
  • Absence of skin extension
  • N + (only if confined to the groin and pelvis)
  • Age between 20-80 years
  • ECOG 0-2
  • No evidence of metastasis
  • At least 5 mm away with rectum and bladder wall
  • No previous RT
  • Written informed consent
  • Patient's ability to understand the characteristics and consequences of the clinical trial
  • Molecular characterization/ mutational state
  • Disease staging (baseline exams)

Exclusion criteria

  • Hip prosthesis, or metal prostheses or any other condition that prevents adequate imaging to identify the target volume and calculate the dose in the treatment plan
  • Psychic or other disorders that may prevent informed consent
  • Previous invasive tumor unless patient has been disease free for at least 3 years
  • Contraindication to MRI
  • Pregnancy or breastfeeding in progress

Treatment and study plan

carbon ion radiation therapy CIRT

Radiation

CIRT: The low-dose CTV (clinical target volume) will receive a total dose of 43 GyRBE in 10 fractions, 4 fractions per week. The high-dose CTV will receive a total dose of 68.8 GyRBE in 16 fractions, 4 fractions per week.

The expected duration of treatment is 4 weeks, 4 fractions per week. Treatments lasting longer than 6 weeks, or with less than 6 fractions administered on 14 consecutive days, will not be considered acceptable.

Immunotherapy: Patients will undergo immunotherapy after carbon ion radiation therapy (CIRT) up to maximum response and/or up to tolerance. The concomitant association of immunotherapy is not envisaged in this protocol.

Other names: immunotherapy

Primary outcomes

  1. progression free survival

    Time frame: 2 years

    estimate 2-year PFS in patients diagnosed with mucosal melanoma of the lower genital tract, treated with carbon ion radiation therapy.

Secondary outcomes

  1. Overall survival (OS)

    Time frame: 3 years

    The OS will be calculated from the end date of therapy with carbon ion radiation

  2. Toxicity according to Common Terminology Criteria for Adverse Events (CTCAE version 5.0)

    Time frame: within 3 months, 3-6 months, over 6 months from CIRT

    acute, medium term and late toxicity

  3. local response

    Time frame: 3 years

    according to Response Evaluation Criteria in Solid Tumours RECIST 1.1

  4. assessment of quality of life

    Time frame: 3 years

    assessed through questionarie Portec 3 administered on each follow up

  5. assessment of quality of life for >= 75 years old patients

    Time frame: 3 years

    assessed through questionnaire G8 Geriatric questionnaire administered on each follow up

Study contacts

Contact information is provided by the study sponsor or research team.

Amelia Barcellini, MD

CONTACT

[email protected]

0039 0382078501

Cristina Bono, MSc

CONTACT

[email protected]

0382078613

Sponsors and collaborators

Lead sponsor

CNAO National Center of Oncological Hadrontherapy

Other

Registry information

Official study title

CNAO 40-2020 C CYCLE "Carbon Ion Radiation Therapy in the Treatment of Mucous Melanomas of the Female Lower Genital Tract" "Radioterapia Con Ioni Carbonio Per il Trattamento Dei Melanomi Mucosi Ginecologici"

Acronym: CYCLE

Important dates

Study start
2020
Primary completion
2027
Study completion
2027
First posted
Jul 28, 2022
Registry last updated
Aug 21, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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