Recruiting
Phase 1

Radiotherapy & Radiopharmaceutical Therapy

Sponsor:

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Code:

NCT04892303

Conditions

Recurrent Thyroid Cancer

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

Interventions

Combination treatment (CXRPT) of external beam radiation (XRT) plus radioactive iodine (RAI)

Study Details

Brief summary:

The goal of this study is to evaluate combined radioactive iodine (RAI, 131-I) and external beam radiotherapy (XRT) to optimize the radiation dose delivered to treat well differentiated thyroid cancers (DTC) with iodine-avid metastases. The investigators hypothesize that precise dosimetric planning will permit this combined RAI-XRT radiotherapeutic approach to be safe and permit higher tumor radiation doses than could otherwise be delivered. Patients with metastatic well-differentiated DTC) that is not completely resectable with macroscopic invasion of tumor into cervical soft tissues and/or non-resectable distant metastases, are the target study population. The primary objective is to evaluate safety as defined by the incidence of maximum grade 3 or greater NCI CTCAE toxicity observed during the treatment period and for the first 30 days following completion of radiotherapy. Secondary endpoints will evaluate efficacy at 6 months and feasibility of this combination to deliver a minimum cumulative dose of 80 Gy to the index tumors selected prior to treatment initiation. The investigators plan to enroll 48 subjects at an accrual rate of 1 subject per month over a study duration of 4 years.

Conditions

Recurrent Thyroid Cancer

Study ID

NCT04892303

Start date

Mar 17, 2021

Status verified date

Jun, 2026

Completion date

Dec, 2030

Anticipated

Primary completion date

Dec, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

Inclusion:

  • 18 and 85 years, inclusive.
  • Histologically confirmed papillary or follicular thyroid carcinoma, collectively referred to as differentiated thyroid carcinoma (DTC), that is incompletely responsive to initial surgery +/- 131-Iodine as established by anatomic imaging (CT, MRI, and Ultrasound).
  • DTC that is not completely resectable with macroscopic invasion of tumor into cervical soft tissues and/or non-resectable distant metastases.
  • Iodine avid residual disease, but with a sub-therapeutic level of lesional radioiodine uptake demonstrated in either a pre-treatment diagnostic scan or a previous post-treatment radioiodine scan, making it unlikely that the patient would benefit from radioiodine therapy alone.
  • Adequate organ function, including: a) adequate renal function, defined as a measured creatinine clearance >70 ml/min/1.73 m2 or normal radioisotope glomerular filtration rate (GFR); and b) adequate hematologic function, defined as a platelet count > 50,000 cells/mm3 and an absolute neutrophil count (ANC) > 500 cells/mm3
  • Life expectancy of at least 8 weeks.
  • Karnofsky performance status (KPS) > 50%
  • Patients must have adequately recovered from the effects of any prior chemotherapy, as determined by the treating physician and study team, based in part on organ function defined above. Toxicities from previous therapies must have recovered to CTCAE v5.0 grade 2 or better.
  • Patients with previously identified cardiac disease will be eligible, as Sodium Iodide I-131 (131I NaI) is not expected to cause cardiac dysfunction

Exclusion:

  • Patient is pregnant or breastfeeding.
  • Patient is sexually active, premenopausal, and does not agree to use accepted, effective forms of contraception.
  • Any criteria that would contraindicate radioiodine therapy or external beam radiotherapy.
  • Patient having alimentary toxic aleukia (ATA) low and intermediate risk tumors, not meeting the guidelines for either radioactive iodine (RAI) treatment or External beam radiotherapy (EBRT).
  • Patient with advanced central nervous system (CNS) metastatic disease, critical lesions in the hip and spine, etc. that would make RAI treatment prior to EBRT potentially harmful, with respect to worsening of disease as a result of the recombinant thyroid-stimulating hormone (TSH) stimulation.
  • Patients having recent exposure to iodinated contrast (within 6 weeks, that could render RAI treatment ineffective).

Study Design

Enrollment

48 participants

Anticipated

Intervention Model

Single group

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

other: High-risk thyroid cancer patients

All study patients will have histologically confirmed recurrence of thyroid cancer that is incompletely responsive to initial surgery.

Interventions

Combination treatment (CXRPT) of external beam radiation (XRT) plus radioactive iodine (RAI)

To safely administer a minimum cumulative dose of external beam radiation to up 3 index tumors per patient, supplemented radiation dose delivered by radioactive iodine (RAI)

Primary outcome measure

  • Safety of combined therapy of XRT plus RAI measured by NCI-CTCAE toxicity [ Time Frame: During external beam radiation therapy (over a 2 week period) ]
  • Safety of combined therapy of XRT plus RAI measured by NCI-CTCAE toxicity [ Time Frame: Within 30 days of completing external beam radiation therapy ]

Central Contacts and Locations

Central contacts

Dana B. Kaplin, MPH

410-614-3950dkaplin1@jhmi.edu

Harry Quon, MD

410-502-3877hquon2@jhmi.edu

Locations

The Johns Hopkins SKCCC

Recruiting

Baltimore, Maryland, United States, 21287

Contacts

Harry Quon, M.D.

410-502-3877hquon2@jhmi.edu

More Information

Sponsor

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Last update posted

Jun 30, 2026

Last verified

Jun, 2026

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins on 2026-06-30.