The PALEO team, led by Dr Fiona Day, is studying the effects of nivolumab and SBRT added to chemoradiotherapy in metastatic oesophageal cancer. It aims to prolong relief from dysphagia (difficulty swallowing) for patients undergoing palliative treatment for oesophageal or gastro-oesophageal cancer.
Due to an anticipated delay in multisite activation due to COVID-19, PALEO remains a single site study at Calvary Mater Newcastle, with patient recruitment now projected to extend to 2023.
“PALEO offers multimodality treatment to address the complications of oesophageal cancer,” says Dr Day. “Each of the treatment components is typically well tolerated, which fits our aim of optimising patient quality of life by aiding return to a normal diet with minimal side effects. The feasibility of this approach is demonstrated by recruitment of our first patient shortly after trial opening.”
Typically, patients with oesophageal cancer present with dysphagia. Dr Day and Prof Martin found that first line concurrent chemoradiotherapy with low dose weekly carboplatin and paclitaxel resulted in all 18/ patients in a phase I study achieving improvement in their dysphagia. The majority of patients also returned to a normal diet, and at least three achieved complete relief of their dysphagia for over a year.
In the PALEO study, researchers aim to prolong this dysphagia relief and simultaneously provide distant disease control with the use of immunotherapy and SBRT to a metastatic site.
PALEO is open in Calvary Mater Newcastle and recruiting patients with oligometastatic oesophageal or gastro-oesophageal cancer. It was the first trial to be activated under the AGITG Endorsed Study Model.