PROTIEUS

  • Research type

    Research Study

  • Full title

    A Randomised Phase 2 Trial Comparing Proton versus Photon Based Neoadjuvant Chemoradiation, followed by Adjuvant Immunotherapy, in Oesophageal Cancer.

  • IRAS ID

    329646

  • Contact name

    Natasha Hava

  • Contact email

    n.hava@ucl.ac.uk

  • Sponsor organisation

    University College London

  • Duration of Study in the UK

    5 years, 2 months, 1 days

  • Research summary

    Although the optimal treatment strategy in oesophageal (food pipe) cancer has been the subject of research for several decades, overall outcomes are very poor, with a 5-year survival of 15%. In the UK there are 9100 new cases of oesophago-gastric cancer diagnosed and approximately 7925 deaths every year (Cancer Research UK Oct 2019). Oesophageal cancer is a strategic priority for CRUK and a serious health problem world-wide. Pre-surgery treatment consists of chemotherapy or chemoradiation, but the optimal treatment is unknown. Over 60% of patients experience severe side-effects from their treatment and this impacts their outcomes. Proton beam therapy is a new radiotherapy treatment; there are currently only 2 centres in England with Proton beam therapy machines. Proton beam therapy may help to reduce side-effects and is an important avenue of research. This trial has been funded by CRUK.
    This study aims to investigate if Proton beam therapy and chemotherapy given before surgery for oesophageal cancer significantly reduces the risk of severe toxicity and prevents delay of post-operative immunotherapy when compared with standard photon radiotherapy.
    This is a phase II, randomised controlled trial. Patients over 16 years old with resectable oesophageal cancer will be randomised 1:1 into the experimental arm (Proton beam therapy, chemotherapy + surgery) and control arm (photon radiotherapy, chemotherapy + surgery). Patients suitable for immunotherapy will then receive up to 12 months of treatment as per standard of care. This UK trial will recruit patients from 15 NHS sites; all patients randomised to receive Proton beam therapy will be treated at either UCLH/Christie. Patients will receive treatment for 5 weeks before surgery, and for up to 1 year after surgery. Patients will be followed up at NHS sites for up to 1 year, and then survival data will be collected from NHS Digital for a further 2 years.

  • REC name

    London - Camden & Kings Cross Research Ethics Committee

  • REC reference

    23/LO/0964

  • Date of REC Opinion

    23 Jan 2024

  • REC opinion

    Further Information Favourable Opinion