Optimizing Lymph Node Staging in Esophageal Cancer with USPIO-enhanced MRI

2023-506952-26-01 Therapeutic exploratory (Phase II) Authorised, recruitment pending

Status Authorised, recruitment pending · 1 EU/EEA countries · 1 sites

Overview

Sponsor-declared trial summary

Phase Therapeutic exploratory (Phase II)
Status Authorised, recruitment pending
Participants planned 1
Countries 1
Sites 1

Esophageal cancer

The primary objectives of this study are: • To determine the feasibility of using USPIO-enhanced MR imaging for initial staging, prior to neoadjuvant chemoradiotherapy. • To determine the diagnostic performance of USPIO-enhanced MR imaging for detecting lymph node metastases at initial staging, compared to (standard) …

Key facts

Sponsor
Amsterdam UMC
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04], Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Investigative Techniques [E05], Diseases [C] - Digestive System Diseases [C06], Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Diagnosis [E01]
Decision date (initial)
2025-07-31
Transition trial
No
Low-intervention
No
Rare-disease indication
No
Vulnerable population
No

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Diagnosis, Safety, Efficacy

The primary objectives of this study are:
• To determine the feasibility of using USPIO-enhanced MR imaging for initial staging, prior to neoadjuvant chemoradiotherapy.
• To determine the diagnostic performance of USPIO-enhanced MR imaging for detecting lymph node metastases at initial staging, compared to (standard) PET-CT.
• To determine the feasibility of using USPIO-enhanced MR imaging for restaging, after completion of neoadjuvant therapy.
• To determine the diagnostic performance of USPIO-enhanced MR imaging for detecting lymph node metastases at restaging, compared to (standard) PET-CT.

Secondary objectives 3

  1. Complication/(S)AE rate of USPIO infusion
  2. Efficiency of study logistics
  3. Diagnostic performance of the proposed lymph node scoring system for metastatic suspicion on USPIO-enhanced MRI

Conditions and MedDRA coding

Esophageal cancer

VersionLevelCodeTermSystem organ class
21.0 LLT 10015362 Esophageal cancer 10029104

Regulatory references

Plan to share IPD
No
EU CT numberTitleSponsor
2023-506952-26-00 Optimizing Lymph Node Staging in Esophageal Cancer with USPIO-enhanced MRI Amsterdam UMC

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 5

  1. Histopathological proven cT1-4aN+M0 esophageal adenocarcinoma
  2. WHO-performance score between 0-2
  3. Scheduled for neoadjuvant chemoradiotherapy and esophagectomy at baseline
  4. Aged ≥18 years
  5. Written informed consent

Exclusion criteria 12

  1. English and Dutch language difficulty, dementia or altered mental status prohibiting the understanding and giving of informed consent
  2. Contra-indications for MR scanning, including patients with a pacemaker, cochlear implant, neurostimulator, non-MR compatible implants, patients with severe claustrophobia or otherwise contra indicated
  3. Known hypersensitivity to Ferrotran® (or other USPIO holding agents) or its components dextran or Sodium Citrate
  4. History of anaphylaxis or hypersensitivity reactions after intravenous administration
  5. History of iron overload or disturbances in the utilization of iron (e.g., haemochromatosis, hemosiderosis, chronic hemolytic anemia with frequent blood transfusions)
  6. Active inflammatory diseases
  7. History of abnormal liver function, or elevated liver enzymes (ALAT or ASAT > 3 times upper limit of normal)
  8. History of elevated Serum Transferrin Saturation (TSAT) (>50%) or hemoglobin (>10.5mmol/L)
  9. Previous treatment for esophageal cancer
  10. Use of any other investigational medicinal product within 30 days prior to receiving study medication until last follow-up visit
  11. Pregnancy
  12. Non-FDG avid tumor at baseline PET-CT

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 5

  1. Observer’s qualitative assessment of image quality for evaluation of lymph node metastases on USPIO-enhanced MR, compared to PET-CT images
  2. Time required for observers to assess USPIO-enhanced MRI, compared to standard PET-CT, in minutes
  3. Patient questionnaire for perceived burden of undergoing USPIO-enhanced MRI, compared to PET-CT
  4. Accuracy (sensitivity, specificity, positive /negative predictive value, and likelihood ratio) of detecting lymph node metastases on USPIO-enhanced MRI, compared to PET-CT, with pathological assessment as reference standard
  5. Lymph node size, shape, number, intensity, location, and fibrotic characteristics

Secondary endpoints 3

  1. Complications, (S)AEs, SUSARs, and toxicity from USPIO-infusion
  2. Time intervals between all study and standard of care procedures in days
  3. Accuracy (sensitivity, specificity, positive /negative predictive value, and likelihood ratio) of the proposed lymph node scoring system for metastatic suspicion on USPIO-enhanced MRI

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Ferrotran Lyophilisate

PRD7839115 · Product

Active substance
FERUMOXTRAN-10
Other product name
Ferumoxtran Lyophilisate
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS INFUSION
Max daily dose
0.18 millilitre(s)/kilogram
Max total dose
0.18 millilitre(s)/kilogram
Max treatment duration
2 Day(s)
Authorisation status
Not Authorised
ATC code
V08CB03 — IRON OXIDE, NANOPARTICLES
MA holder
SAVING PATIENTS LIVES MEDICAL B.V.
Paediatric formulation
No
Orphan designation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Amsterdam UMC

Sponsor organisation
Amsterdam UMC
Address
De Boelelaan 1117
City
Amsterdam
Postcode
1081 HV
Country
Netherlands

Scientific contact point

Organisation
Amsterdam UMC
Contact name
Dr. S.S. Gisbertz

Public contact point

Organisation
Amsterdam UMC
Contact name
Dr. S.S. Gisbertz

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Netherlands Authorised, recruitment pending 1 1
Rest of world 0

Investigational sites

Netherlands

1 site · Authorised, recruitment pending
Amsterdam UMC
Surgery, De Boelelaan 1117, 1081 HV, Amsterdam

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 5 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_ Protocol 2023-506952-26-01 1.1
Protocol (for publication) D4_ Patient Questionnaire 1.1
Recruitment arrangements (for publication) K1_Recruitment arrangements 1.1
Subject information and informed consent form (for publication) L1_SIS and ICF adult Dutch 1.3
Synopsis of the protocol (for publication) D1_ Protocol synopsis MS 2023-506952-26-01 1

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2025-04-22 Netherlands Acceptable
2025-07-25
2025-07-31