Actively Recruiting

Phase 2
Age: 18Years +
All Genders
ID06050707

MR-Adaptive Radiation Therapy for Anal Cancer With Escalated Treatment in a Risk-Optimized Approach

Led by University Health Network, Toronto · Updated on 2026-03-06

80

Participants Needed

4

Research Sites

N/A

Total Duration

On this page

Sponsors

U

University Health Network, Toronto

Lead Sponsor

M

Medical College of Wisconsin

Collaborating Sponsor

AI-Summary

What this Trial Is About

This research evaluates MR-guided radiation therapy (RT) with risk-adapted dose selection for patients diagnosed with anal squamous cell carcinoma (SCC). The study aims to tailor treatment intensity based on clinical and biological markers, including human papillomavirus (HPV) DNA analysis to identify new indicators predicting response and side effects to chemoradiotherapy (CRT). It is a phase II, open-label trial exploring four risk groups: low, standard, intermediate, and high risk. Participants will receive radiation therapy delivered using an MR-Linac for precise image-guided RT. Treatment doses vary by risk group, ranging from 20 fractions over 4 weeks for low risk to 35 fractions over 7 weeks for high risk. Chemotherapy cycles are also adjusted according to risk. After treatment, patients have the option to provide blood and tissue samples to support biomarker research. During the study, patients will be monitored through regular clinic visits and questionnaires for up to five years post-radiotherapy. Researchers will assess outcomes including locoregional failure at 2 years, distant metastasis, colostomy rates, disease-free and overall survival, physician-reported toxicities, patient-reported outcomes, and quality of life over 5 years. This comprehensive follow-up aims to evaluate treatment impact and long-term safety.

CONDITIONS

Brief Title

MR-Adaptive Radiation Therapy for Anal Cancer With EScalated-Treatment in a Risk-Optimized Approach

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Patients with a confirmed diagnosis of anal squamous cell carcinoma, including non-keratinizing types
  • Clinical stage T1-4 N0-1 M0 according to UICC/AJCC 8th edition
  • Eligible for definitive radiation therapy or chemoradiotherapy
  • Age 18 years or older
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
Not Eligible

You will not qualify if you...

  • Previous chemotherapy, radiation therapy, or curative surgery for anal cancer
  • Prior radiation to the abdomino-pelvic area overlapping with planned treatment
  • History of other malignancies unless disease-free for at least 2 years and low risk of recurrence
  • Recent diagnosis (within 5 years) of cervical cancer in situ or skin basal/squamous cell carcinoma

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - 4 to 7 weeks depending on risk group

Participants receive a risk-stratified dose of radiotherapy based on clinical and biological biomarkers. Treatment duration varies by risk group.

Daily visits for radiotherapy sessions during treatment weeks

Follow-up

Duration - Up to 5 years

Participants are followed for up to 5 years after radiotherapy with clinic visits and questionnaires to monitor outcomes and quality of life. Optional blood and tissue samples may be collected.

Periodic clinic visits and questionnaires over 5 years

Trial Site Locations

Total: 4 locations

1

Allegheny Health Network

Pittsburgh, Pennsylvania, United States, 15212

Not Yet Recruiting

2

Medical College of Wisconsin Cancer Center

Milwaukee, Wisconsin, United States, 53226

Not Yet Recruiting

3

Austin Health

Heidelberg, Victoria, Australia, 3084

Not Yet Recruiting

4

Princess Margaret Cancer Centre

Toronto, Ontario, Canada, M5G 2C1

Actively Recruiting

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Research Team

A

Ali Hosni

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NA

Model

SINGLE_GROUP

Primary Purpose

TREATMENT

Number of Arms

0

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