Tislelizumab in Combination With Chemotherapy for Conversion Therapy of Locally Nonresectable ESCC

Study Overview
=================
Brief Summary
-----------------
This is a single-arm，open-label study to evaluate the efficacy and safety of tislelizumab plus chemotherapy for conversion therapy of patients with locally nonresectable ESCC.

Official Title
-----------------
The Safety and Efficacy of Tislelizumab in Combination With Chemotherapy for Conversion Therapy of Locally Nonresectable ESCC，A Single-arm Study

Conditions
-----------------
Esophageal Squamous Cell Carcinoma, Locally Advanced Carcinoma

Intervention / Treatment
-----------------
* Drug: Tislelizumab
* Drug: 5-FU
* Drug: cis Platinum


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Aged between 18 and 75 years; Understand the research procedure and content, and voluntarily sign written informed consent; Patients with clinical stage IIA-IIIB esophageal cancer were assessed by endoscopic ultrasonography, CT/MRI and other imaging. Esophageal surgery experts believe that patients with potentially resectable esophageal cancer No blood transfusion was received 3 months before enrollment; ECOG PS score: 0-1. Exclusion Criteria: Patients meeting any of the following criteria are not eligible for inclusion: Women who are pregnant or breastfeeding; previous or concurrent malignancy; Participated in clinical trials of other drugs within four weeks; Have a history of immune deficiency, or other acquired or congenital immune deficiency diseases, or have a history of organ transplantation, or have a history of serious chronic autoimmune diseases, such as systemic lupus erythematosus, etc. Patients with hypersensitivity to human or mouse monoclonal antibodies; Those who have a history of psychotropic drug abuse and cannot get rid of it or have mental disorders; According to the judgment of the researcher, there are serious concomitant diseases that endanger the patient's safety or affect the patient's ability to complete the study.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Tislelizumab plus Chemotherapy<br>In the single experimental arm, patients with locally nonresectable disease were subjected to receive neoadjuvant tislelizumab (200mg) plus chemotherapy (FP regimen) for conversion therapy. If conversion therapy succeeds, patients would proceed to surgery and adjuvant therapy. Otherwise, if patients were still not resectable after the conversion therapy, they will be treated by tislelizumab plus chemotherapy with or without palliative radiotherapy . | Drug: Tislelizumab<br>* The 1st to 3rd doses were administered concurrently with FP regimen chemotherapy, 200 mg Tislelizumab each, on D1, D22 and D43 by intravenous infusion. In patients with successful conversion, one dose of 200 mg was administered 21 days after surgery in concurrent with the 4th to 6th cycles of 5-Fu, then 6 cycles of 200 mg Tislelizumab as adjuvant therapy; in patients with failed conversion, chemotherapy combined with tislelizumab were administered, with or without radiation therapy.<br>Drug: 5-FU<br>* A FP regimen with 5-Fu 850mg/m^2 d1-4 + cis-platinum 850mg/m^2 d1-4 was used, on D1, D22 and D43 infused intravenously. 3 cycles of 5-Fu 850mg/m^2 d1-4 adjuvant chemotherapy were started at 21 days after surgery in patients with a successful conversion. In patients with failed conversion, chemotherapy combined with tislelizumab were administered, with or without radiation therapy.<br>Drug: cis Platinum<br>* A FP regimen with 5-Fu 850mg/m^2 d1-4 + cis-platinum 850mg/m^2 d1-4 was used, on D1, D22 and D43 infused intravenously. In patients with failed conversion, chemotherapy combined with tislelizumab were administered, with or without radiation therapy.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of translational treatment AE | Translational treatment-related AEs resulted in rates of surgery that were more than 30 days late or inoperable than originally planned | up to 2 years | 
| MPR | The proportion of patients whose primary tumor cell residual was less than 10% in the total number of patients enrolled after transformation therapy | up to 2 years | 
| pCR | Pathological complete response refers to that no tumor component or a small amount of carcinoma in situ component can be found on the horizontal line of pathological section after systemic treatment and surgical resection of the lesion. | up to 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| R0 resection rate | The proportion of patients who completed R0 resection through 3 cycles of immunotherapy combined with chemotherapy in the total enrolled population.R0 finger resection margin under microscope was negative. | up to 2 years | 
| Disease-free Survival，DFS | The time from randomization to disease recurrence or death due to disease progression | up to 2 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Drug: Tislelizumab, Chemotherapy