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Concurrent Chemoradiotherapy Combined With Immunotherapy in Patients With Potentially Resectable Pancreatic Cancer

Phase 2
Recruiting
Conditions
Pancreatic Carcinoma
Interventions
Radiation: Hypofractionated radiotherapy with simultaneous integrated boost
Registration Number
NCT05634564
Lead Sponsor
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Brief Summary

The objective of this study is to evaluate the efficacy and safety of concurrent chemoradiotherapy combined with immunotherapy in patients with potentially resectable pancreatic cancer.

Detailed Description

Due to the hidden onset and rapid progression of pancreatic cancer, most patients are already locally advanced or have distant metastasis at the time of diagnosis and lose the opportunity for surgery. Even among operable patients, about 50% will have recurrence and metastasis one year after surgery. Therefore, more and more evidence supports neoadjuvant therapy for patients with high risk factors for resectable pancreatic cancer, and conversion therapy followed by surgery for patients with borderline resectable and locally advanced pancreatic cancer. Therefore, the objective of this study is to evaluate the efficacy and safety of concurrent chemoradiotherapy combined with immunotherapy in patients with potentially resectable pancreatic cancer.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
62
Inclusion Criteria
  1. Age >= 18 years; 2. Eastern Cooperative Oncology Group (ECOG) score of 0-1; 2. Pancreatic cancer confirmed by histology or cytology; 3. Potentially resectable pancreatic cancer documented by contrast enhanced CT (or MRI) scan; 4. Hematological indexes: Neutrophil count >= 1.5 x 10^9/L Hemoglobin >= 10g / dl Platelet count >= 100 x 10^9 / L 5. Biochemical indicators: Total bilirubin <= 1.5 x upper limit of normal value (ULN); Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) < 1.5 x ULN; Creatinine clearance rate >= 60ml / min.

  2. Participants of childbearing age need to take appropriate protective measures (contraceptive measures or other methods of birth control) before entering the group and during the test: 7. Signed informed consent; 8. Follow the protocol and follow-up procedures.

Exclusion Criteria
  1. Have received systematic anti-tumor treatment.
  2. Previous history of other tumors, except for cervical cancer in situ, treated squamous cell carcinoma or bladder epithelial tumor (TA and TIS) or other malignant tumors that have received radical treatment (at least 5 years before enrollment).
  3. Active bacterial or fungal infection (> = level 2 of National Cancer Institute Common Toxicity Criteria (NCI-CTC), Version 3.0).
  4. Human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) infection, uncontrollable coronary artery disease or asthma, uncontrollable cerebrovascular disease or other diseases considered by researchers to be out of the group.
  5. Autoimmune diseases or immune defects who are treated with immunosuppressive drugs.
  6. Pregnant and lactating women. Pregnant women of childbearing age must be tested negative within 7 days before entering the group.
  7. Drug abuse, clinical or psychological or social factors make informed consent or research implementation affected.
  8. Allergic to programmed cell death protein-1 (PD-1) monoclonal antibody immunotherapy drugs.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Concurrent radiochemotherapy combined with immunotherapyNab paclitaxelParticipants will receive tislelizumab plus gemcitabine and nab-paclitaxel in cycles of 21 days. Non-progressors will plus concurrent radiotherapy during the 3rd cycle of chemotherapy. After 4-6 cycles treatment, Multiple disciplinary team (MDT) will evaluate whether to undergo radical surgery.
Concurrent radiochemotherapy combined with immunotherapyHypofractionated radiotherapy with simultaneous integrated boostParticipants will receive tislelizumab plus gemcitabine and nab-paclitaxel in cycles of 21 days. Non-progressors will plus concurrent radiotherapy during the 3rd cycle of chemotherapy. After 4-6 cycles treatment, Multiple disciplinary team (MDT) will evaluate whether to undergo radical surgery.
Concurrent radiochemotherapy combined with immunotherapyTislelizumabParticipants will receive tislelizumab plus gemcitabine and nab-paclitaxel in cycles of 21 days. Non-progressors will plus concurrent radiotherapy during the 3rd cycle of chemotherapy. After 4-6 cycles treatment, Multiple disciplinary team (MDT) will evaluate whether to undergo radical surgery.
Concurrent radiochemotherapy combined with immunotherapyGemcitabineParticipants will receive tislelizumab plus gemcitabine and nab-paclitaxel in cycles of 21 days. Non-progressors will plus concurrent radiotherapy during the 3rd cycle of chemotherapy. After 4-6 cycles treatment, Multiple disciplinary team (MDT) will evaluate whether to undergo radical surgery.
Primary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR)Up to 2 years

RECIST Version 1.1

Secondary Outcome Measures
NameTimeMethod
Median Overall survival (mOS)Up to 2 years

RECIST Version 1.1

Median Progression Free Survival (mPFS)Up to 2 years

RECIST Version 1.1

Disease control rate (DCR)Up to 2 years

RECIST Version 1.1

Pathological grade of tumor tissue after neoadjuvant therapyUp to 1 years

Pathological grade of tumor tissue after neoadjuvant therapy

Adverse EventsUp to 2 years

Adverse event (AE)、Serious adverse event (SAE)

R0 resection rateUp to 1 years

R0 resection rate

Trial Locations

Locations (1)

The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

🇨🇳

Nanjing, Jiangsu, China

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