RecruitingNot ApplicableNCT05655078

Hemithoracic Irradiation With Proton Therapy in Malignant Pleural Mesothelioma


Sponsor

University College, London

Enrollment

148 participants

Start Date

Mar 28, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

Phase III randomised-controlled trial for patients with unilateral malignant pleural mesothelioma (MPM).


Eligibility

Min Age: 18 Years

Inclusion Criteria12

  • Patients ≥18 years of age, with biopsy confirmed MPM and histological subtyping (epithelioid or non-epithelioid)
  • N0 or N1 and M0 disease
  • Written informed consent
  • Patient and local/regional MDT opt for active surveillance and deferral of SACT until clinical or radiological progression
  • WHO Performance Status 0-1
  • Disease confined to one hemithorax based on CT assessment
  • Adequate pulmonary function
  • ≥ 40% predicted post-FEV1;
  • ≥ 40% predicted DLCO/TLCO
  • Agreement to travel to either proton beam therapy centres (i.e. UCLH or The Christie) if randomised to arm 2
  • Agreement to be followed up at a local HIT-Meso trial site
  • Patient likely able to complete PBT planning based on local assessment

Exclusion Criteria16

  • Presence of metastatic or contralateral disease
  • Cytological diagnosis and/or undetermined histological subtype
  • Prior thoracic radiotherapy, chemotherapy, immunotherapy for MPM
  • Prior radical surgery for MPM (extrapleural pneumonectomy or extended pleurectomy decortication or pleurectomy decortication)
  • Initial systemic therapy or surgery is required and the patient and local/regional MDT do not opt for active surveillance
  • Involvement of contralateral or supraclavicular lymph nodes
  • T4 disease with invasion of the myocardium
  • N2 and/or M1 disease
  • Presence of new effusion that is not amenable to drainage
  • WHO Performance Status ≥ 2
  • Women who are pregnant or breast feeding
  • Current or previous malignant disease which may impact on the patient's life expectancy
  • Patient fitted with a pacemaker or implantable cardioverter-defibrillator (ICD)\\
  • Diagnosis of clinically significant interstitial lung disease (ILD), excluding mild fibrosis or incidental findings
  • Chronic non-malignant disease with an estimated three-year survival rate of less than 20%
  • Patient with prior thoracic / abdominal radiotherapy for malignancy who was not discussed with sponsor before recruitment

Interventions

RADIATIONProton beam therapy

5 weeks (Mon-Fri) of proton beam treatment to the hemithorax to a dose of 50Gy in 25 fractions with a boost to 60Gy for the visible tumour (gross tumour volume-GTV).


Locations(21)

East Sussex Healthcare NHS Trust - Eastbourne Hospital

Eastbourne, East Sussex, United Kingdom

East Sussex Healthcare NHS Trust - Conquest Hospital

Saint Leonards-on-Sea, East Sussex, United Kingdom

Royal Berkshire Hospital

Reading, England, United Kingdom

Southend University Hospital

Southend, Essex, United Kingdom

Queen Alexandra Hospital

Portsmouth, Hampshire, United Kingdom

Queen Elizabeth Hospital, King's Lynn

Kings Lynn, Norfolk, United Kingdom

Betsi Cadwaladr University Health Board -Glan Clwyd Hospital

Bodelwyddan, United Kingdom

Southmead Hospital

Bristol, United Kingdom

Addenbrooke's Hospital

Cambridge, United Kingdom

Velindre Cancer Centre

Cardiff, United Kingdom

Broomfield Hospital

Chelmsford, United Kingdom

St James University Hospital

Leeds, United Kingdom

Leicester Royal Infirmary

Leicester, United Kingdom

Clatterbridge Cancer Centre

Liverpool, United Kingdom

St Bartholomew's Hospital

London, United Kingdom

University College London Hospital

London, United Kingdom

Maidstone Hospital

Maidstone, United Kingdom

Christie Hospital

Manchester, United Kingdom

Wythenshawe Hospital

Manchester, United Kingdom

Weston Park Cancer Centre

Sheffield, United Kingdom

Torbay Hospital

Torquay, United Kingdom

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