Endoscopic Cryoablation Combined With PD-1 in Advanced Gastric Cancer

Phase 2

Not yet recruiting

• Conditions: Gastric Cancer

• Registration Number: NCT06759233
• Lead Sponsor: Zhongguang Luo, MD

Brief Summary

To clarify the efficacy and safety of endoscopic cryoablation combined with PD-1 monoclonal antibody treatment regimen in advanced gastric cancer.

Detailed Description

This study is a single-center, single-arm, self-controlled, experimental, non-randomized exploratory clinical trial, aiming to enroll 15 patients with advanced gastric cancer. Each enrolled patient will be assigned a case number. This case number, along with the patient's name initials, will be recorded on every page of the case report form (CRF). Enrolled patients will receive local gastric ECAT (endoscopic cryoballoon ablation treatment) combined with PD-1 monoclonal antibody therapy for the evaluation of efficacy and safety, as well as immunological assessments of peripheral circulation and local tumor tissue. Patients will be followed during the treatment period and for six months after treatment termination for study observation.

Study Timeline

• Study First Submitted: 2024-09-19
• Study First Submitted QC: 2024-12-28
• Study First Posted: 2025-01-06
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-28
• Last Update Posted: 2025-04-29
• Study Start: 2025-05-15
• Primary Completion: 2025-12-31
• Study Completion: 2026-12-31

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 15

Inclusion Criteria

1. Patients diagnosed with advanced gastric cancer (stage IV in AJCC 8th edition staging, including locally progressive gastric cancer with unresectable factors (IVa) and gastric cancer with distant metastases (IVb); Bowman's staging type I, II, and III), who are unable to be surgically resected or do not tolerate surgical resection, and who have undergone progression after 1-2 lines of conventional chemotherapy;
2. Age greater than 18 years and less than 80 years;
3. WHO pathology type: adenocarcinoma, neuroendocrine tumor;
4. Expected survival greater than 3 months and controllable distant metastases as judged by the physician;
5. Important organ functions must be met: ① Liver function: ALT and AST ≤ 2.5 times the positive range, total bilirubin ≤ 2.0mg/dL; ② Renal function: creatinine clearance ≥ 40mL/min calculated using the EPI formula;
6. Blood routine: Hgb≥70g/L,ANC≥1.5×109/L,PLT≥80×109/L;
7. Coagulation function: PT and APPT <2 times the normal value;
8. Pregnancy test must be negative in women of childbearing age;
9. ECOG score ≤2;
10. Signed informed consent.

Exclusion Criteria

1. Pregnant or breastfeeding women, or women with pregnancy plans within six months;
2. Infectious diseases (e.g. AIDS, syphilis, active tuberculosis);
3. Patients with active hepatitis B or C infection;
4. Combination of other primary malignant tumors;
5. Patients who have participated in a clinical trial within one month;
6. Patients taking antiplatelet or anticoagulant drugs within the last week;
7. Patients with gastric cancer combined with active bleeding;
8. Large amount of ascites (ascites ≥3000ml);
9. Cardia obstruction or pyloric obstruction;
10. patients with combined active infection or autoimmune disease;
11. Those who the doctor thinks there are other reasons not to be included in the treatment.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
Progression-Free Survival (PFS)	From enrollment to study completion, assessed up to 2 years	PFS is measured from the start of treatment until the first documented evidence of disease progression (based on RECIST 1.1) or death from any cause, whichever occurs first.
Overall-Survival (OS)	From enrollment to study completion, assessed up to 5 years	The length of time from the start of treatment until death from any cause.

Secondary Outcome Measures

Name	Time	Method
Percentage of participants achieving complete remission (CR) and partial remission (PR) after treatment	3 to 24 weeks after the end of treatment	Objective remission rate (ORR), the percentage of participants whose tumors shrink by a certain amount and remain there for a certain period of time, including complete remission (CR) and partial remission (PR). CR (Complete remission): Complete disappearance of the target lesion, with no new lesions produced, and lasting for more than 4 weeks. PR (Partial remission): the sum of the largest diameters of the target lesions is reduced by more than 30%, and lasts for more than 4 weeks.
Percentage of participants achieving remission (PR+CR) and lesion stabilization (SD) after treatment	3 to 24 weeks after the end of treatment	Disease control rate (DCR) is the percentage of participants who achieve remission (PR+CR) and stabilization of lesions (SD) after the treatment. Stable disease (SD) means that the sum of the largest diameters of the tumor lesions has not shrunk to PR, or has not enlarged to PD.
Number of participants with treatment-related adverse events	From the start of treatment to 24 weeks after the end of treatment	The number of patients who experience ECAT-related adverse events (such as intraoperative bleeding, intraoperative perforation, postoperative bleeding, etc.)

Trial Locations

Locations (1)

Huashan Hospital, Fudan University; 🇨🇳 Shanghai, China