RecruitingPhase 2NCT06353061

Chemoradiotherapy With or Without Metformin in Locally Advanced Cervical Cancer

Phase II Randomized Window of Opportunity Trial of Chemoradiotherapy Alone Versus Combination With Metformin in Locally Advanced Cervical Cancer

Sponsor

Peking Union Medical College Hospital

Enrollment

51 participants

Start Date

Apr 15, 2024

Study Type

INTERVENTIONAL

Conditions

Cervical Cancer PET/CT Radiotherapy Hypoxia Metformin

Summary

This is a prospective, single-center, phase II, randomized, window-of-opportunity trial initiated by researchers. The research hypothesis is that metformin can improve the level of hypoxia in locally advanced cervical cancer and further improve progression-free survival. The study aims to compare the improvement of tumor hypoxia with synchronous chemoradiotherapy with or without metformin, using CA-IX PET/CT and radiation positioning spectral CT to evaluate tumor hypoxia, screening hypoxic patients for inclusion in the study, and comparing the effects of synchronous chemoradiotherapy with or without metformin on the degree of hypoxia and progression-free survival in the two groups of patients.

Eligibility

Sex: FEMALEMin Age: 18 YearsMax Age: 70 Years

Plain Language Summary

Simplified for easier understanding

This study tests whether adding metformin — a common diabetes medication that may also fight cancer by targeting low-oxygen tumor areas — to standard chemotherapy plus radiation improves outcomes for women with locally advanced cervical cancer. **You may be eligible if...** - You are between 18 and 70 years old - You have cervical cancer confirmed by biopsy (squamous cell, adenocarcinoma, or adenosquamous type) - Your cancer is stage IB2 through IVA (locally advanced) - Imaging shows areas of tumor that may have low oxygen (necrosis) - You have not yet received any chemotherapy - You are in good enough health (ECOG 0-2) and have adequate blood counts - You are not pregnant or breastfeeding **You may NOT be eligible if...** - Your kidneys are not functioning well (low eGFR) - You are dehydrated, in shock, or have a serious active infection - You have diabetes being managed with insulin or certain other medications - You have serious liver or heart problems - You have already received cervical cancer treatment Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGMetformin

Patients randomized to the metformin group will start taking metformin within 1 day after group allocation. They will take one tablet of metformin (850 mg) once daily for three consecutive days. Subsequently, they will take metformin orally twice daily throughout the entire external and internal irradiation period, with each administration consisting of one tablet.

RADIATIONRadiotherapy

The study requires all subjects to sequentially undergo external beam radiotherapy (EBRT) and intracavitary brachytherapy (BT). All radiotherapy must be completed within 7-8 weeks after treatment initiation. The total prescribed dose EQD2 for EBRT combined with BT should be ≥80 Gy; for subjects with squamous carcinoma with lesions ≤4 cm, the HR-CTV D90 should be ≥80 Gy; for subjects with adenocarcinoma or lesions \>4 cm, it is recommended that HR-CTV D90 should be ≥85 Gy. When the prescribed dose is limited by organs at risk (OAR), priority should be given to covering HR-CTV. The radiotherapy plan in this study is based on image guidance. Imaging scans can use MRI or CT, and the scanning area should extend at least 5 cm above and below the PTV.

DRUGChemotherapy

The dosage of cisplatin is 40 mg/m2, administered once weekly during radiotherapy for a duration of 5 weeks. Prior to and following cisplatin administration, 1-2 liters of fluid should be given for adequate hydration. Treatment should continue until disease progression or intolerable toxicity occurs.

DIAGNOSTIC_TESTPET/CT

Using 68Ga-NY104 as a small molecule targeted imaging agent for CA-IX, two CA-IX PET/CT scans will be conducted in patients: one upon enrollment and another one week after randomization.