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NCT Number: NCT06437288

Hematoporphyrin Photodynamic Therapy for Esophageal Cancer

The objective of the present clinical trial is to assess the efficacy of photodynamic therapy (PDT) employing hematoporphyrin injection in the management of recurrent or residual superficial esophageal carcinoma. The principal objective is to determine the capability of this therapeutic modality to elicit a complete response in the patient cohort under investigation.

The central research question that this study seeks to address is as follows:

What is the rate of complete response at day 28 following treatment with photodynamic therapy utilizing hematoporphyrin injection in patients suffering from recurrent or residual superficial esophageal cancer? This study is designed as a single-arm trial, devoid of a control or comparison group.

Eligible participants will meet the following criteria:

They will be adult patients, aged between 18 and 80 years, who have experienced recurrence or retention of superficial esophageal cancer subsequent to prior therapeutic interventions.

They will receive an intravenous administration of hematoporphyrin injection at a dosage of 3mg/kg over a duration of 60 minutes.

They will undergo irradiation with a 630nm laser, which will be administered 48-72 hours post-infusion.

Their response to treatment will be evaluated at day 28 post-therapy, with assessments encompassing complete response, progression-free survival, overall survival, swallowing functionality, quality of life, and the incidence of adverse events throughout the duration of the study

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Key information

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

Endoscopic Department of Sun Yat-Sen University Cancer Center

Guangzhou, Guangdong, 510060, China

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • 1. Age between 18 and 80 years (inclusive of both 18 and 80 years), with no restrictions on gender.

2.Patients with esophageal squamous cell carcinoma who have undergone prior treatment, including radiotherapy, chemotherapy, immunotherapy, or surgical intervention (esophagectomy or endoscopic esophageal cancer surgery), with pathological confirmation of recurrence or residual disease (at least of high-grade intraepithelial neoplasia or above).

3.Patients with superficial esophageal cancer, where the primary lesion is located in the mucosal or submucosal layer, and the muscular layer is still intact, as indicated by ultrasound endoscopy and related examinations.

4.Subjects capable of tolerating general anesthesia. 5.Absence of severe hematological, coagulation, cardiac, pulmonary, hepatic, renal, or immunological abnormalities.

6.Voluntary consent to participate in the clinical trial after being fully informed about the purpose, process, potential risks, and benefits of the trial, including the subject's obligations.

Exclusion criteria

  • Known allergy to the study medication or related drugs.
  • Patients who have not recovered from the toxicities associated with prior radiotherapy or chemotherapy treatments.
  • Previous treatment with other photosensitizers that was ineffective, or subjects who have received a photosensitizer treatment within 12 months prior to enrollment.
  • Use of other photosensitizing medications within 4 weeks prior to administration, such as tetracycline antibiotics, sulfonamides, and phenothiazines.
  • Neutrophil count <1.5×10^9 /L, platelet count <100×10^9 /L, or hemoglobin <100 g/L.
  • Serum creatinine ≥3 times the upper limit of normal or creatinine clearance <60 ml/min/1.73m^2; ALT or AST >3 times the upper limit of normal; or in the case of liver metastasis, ALT or AST >5 times the upper limit of normal; serum bilirubin >3 times the upper limit of normal.
  • Presence of severe comorbid conditions, including serious heart disease, cerebrovascular disease, uncontrolled diabetes, and uncontrolled hypertension.
  • HIV, HCV, syphilis infection, or positive for both hepatitis B surface antigen and e antigen.
  • Active esophageal inflammation (especially visible active ulcers, hyperemia, necrosis, etc. under endoscopy) or clinically significant active infection symptoms.
  • Pregnant or lactating women, and sexually active subjects of childbearing potential (including males) who refuse to use appropriate contraceptive measures during the study.
  • Active bleeding or bleeding diathesis (abnormal coagulation mechanism).
  • Severe physical or mental illness that may affect treatment, assessment, or compliance with the study protocol.
  • Concurrent second primary tumor undergoing treatment.
  • Single lesion greater than 5cm in length.

Treatment and study plan

Photodynamic Therapy

Procedure

Receive an intravenous infusion of hematoporphyrin injection

Primary outcomes

  1. The complete response rate evaluated by endoscopic ultrasound (EUS)

    Time frame: 56 days after the treatment.

    The proportion of patients showing a complete disappearance of the tumor following the treatment, as assessed by EUS on day 56

Secondary outcomes

  1. Progression free survival

    Time frame: 3 years

    Length of time during and after the treatment of a disease, in which a patient lives with the disease but it does not get worse.

  2. Overall survival

    Time frame: 3 years

    length of time from the start of the treatment until the death of the patient, regardless of the cause.

  3. Adverse events

    Time frame: 1 month after the treatment

    Adverse events of the treatment.

  4. Quality of life evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30)

    Time frame: 0.5 year; 1 year; 3 year

    The Quality of life evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30) assesses cancer patients' quality of life with 30 items in functional and symptom scales scored 1-3, and a global health scale scored 1-7. Higher scores on functional/global health scales indicate better quality of life, while higher symptom scores mean worse outcomes. The scale's minimum and maximum scores vary by the number of items in each scale, with transformation to a 0-100 scale for standardization.

  5. Stooler's dysphagia grading

    Time frame: 0.5 year; 1 year; 3 year

    Stooler's dysphagia grading, in its full title, is known as the Stooler's Dysphagia Scale. This scale is used to assess the severity of dysphagia, which is difficulty or discomfort in swallowing. The Stooler's scale categorizes dysphagia into five grades, ranging from Grade 0 to Grade 4, with higher grades indicating more severe dysphagia.

    Here is a breakdown of the Stooler's Dysphagia Scale:

    Grade 0: No difficulty in swallowing. Grade 1: Occasional difficulty in swallowing solids. Grade 2: Occasional difficulty in swallowing liquids and frequent difficulty with solids.

    Grade 3: Complete inability to swallow solids and frequent difficulty with liquids.

    Grade 4: Inability to swallow any oral intake. In this scale, a lower grade indicates a better outcome, as it signifies less difficulty in swallowing. Conversely, a higher grade indicates a worse outcome, with Grade 4 being the most severe, indicating the inability to swallow anything orally.

Sponsors and collaborators

Lead sponsor

Sun Yat-sen University

Other

Registry information

Official study title

Real-World Study of Hematoporphyrin Injection-Based Photodynamic Therapy in Patients With Recurrent or Residual Superficial Esophageal Cancer

Important dates

Study start
2024
Primary completion
2027
Study completion
2030
First posted
May 31, 2024
Registry last updated
May 22, 2026

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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