NCT06464601尚未招募不适用
A Real-World Study of Neoadjuvant/Conversion Therapy for Locally Advanced or Metastatic Gastric Cancer With Chemotherapy Combined With Immune Checkpoint Inhibitors and Anti-Angiogenic Targeted Agents
Wuhan University1 个研究点 分布在 1 个国家目标入组 70 人开始时间: 2025年4月1日最近更新:
适应症
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Corhot2: R0 surgical conversion rate
研究概览
简要总结
Chemotherapy, immune checkpoint inhibitors, and anti-angiogenic targeted therapies have been explored in combination for neoadjuvant and conversion therapies. However, the efficacy of the novel anti-angiogenic agent fruquintinib in combination with immune checkpoint inhibitors and chemotherapy in the neoadjuvant and conversion treatment of locally advanced or metastatic gastric cancer has not been reported. This study aims to observe the efficacy and safety of fruquintinib combined with immune checkpoint inhibitors and chemotherapy in real-world settings.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients must meet all of the following criteria to be enrolled in this study:
- •Age ≥18 years and ≤75 years;
- •Either gender;
- •Histologically confirmed gastric or gastroesophageal junction adenocarcinoma. For neoadjuvant therapy cohort: candidates for Initial potentially curative surgery with cII, cIII, or cIVA stage disease (>cT2N0-3M0 or cT0-4N+M0); no distant metastasis. For conversion therapy cohort: patients with locally advanced unresectable or stage IV metastatic disease (per AJCC 8th edition). Pre-treatment imaging (CT or MRI, PET-CT, etc.) must indicate only one of the following unresectable factors:
- •(1) Lymph node metastasis around the abdominal aorta (2) Virchow lymph node metastasis (left supraclavicular lymph node metastasis) (3) Resectable liver metastases: 2 to 5 metastatic lesions, total diameter >5 cm and ≤8 cm, tumor invades the vena cava or portal vein (4) Lung metastases (5) Isolated peritoneal implantation
- •Have received chemotherapy, immune checkpoint inhibitors, and fruquintinib for at least 2 cycles. For the neoadjuvant therapy cohort, patients who have not previously received anticancer treatment (radiotherapy, chemotherapy, targeted therapy, or immunotherapy, etc.). The patients are eligible for inclusion in the analysis set if they have received fruquintinib treatment for at least 2 cycles and have undergone at least one baseline tumor assessment. All patients included in the efficacy analysis are included in the safety analysis set.
- •Eastern Cooperative Oncology Group (ECOG) performance status of 0-1 before treatment.
- •Expected survival time of >6 months before neoadjuvant therapy and >3 months before conversion therapy.
- •No significant organ dysfunction or drug contraindications before receiving neoadjuvant or conversion therapy.
- •There is no mandatory requirement for target lesions. Objective response rate (ORR) assessment is based on all evaluable patients, regardless of the presence of target lesions. For patients without target lesions, those assessed as non PR/non PD will be analyzed as stable disease (SD).
排除标准
- •Patients meeting any of the following criteria are not eligible to enter the study:
- •History of other primary malignant tumors, except: (1) complete remission of malignant tumors at least 2 years before enrollment and no need for other treatment during the study period; (2) adequately treated non-melanoma skin cancer or malignant melanoma without evidence of disease recurrence; (3) adequately treated in situ carcinoma.
- •Conversion therapy cohort: Diagnosis of HER2-positive gastric or gastroesophageal junction adenocarcinoma.
- •Conversion therapy cohort: Evidence of distant metastases beyond oligometastases as defined in the inclusion criteria before the first dose of study treatment (such as brain, bone, etc.).
- •Female patients who are pregnant or lactating.
- •Known allergy (Grade 3 or higher allergic reaction) or contraindication to anti-angiogenic drugs, any monoclonal antibody, or chemotherapy drug components.
- •Use of non-study drug treatments during the study period that may interfere with the analysis.
- •Patients who did not undergo any tumor efficacy assessment after receiving neoadjuvant or conversion therapy.
- •Less than 2 cycles of fruquintinib neoadjuvant or conversion therapy.
- •Patients with insufficient follow-up information as judged by the investigator (such as not returning to the hospital for treatment or efficacy assessment after initial treatment).
结局指标
主要结局
Corhot2: R0 surgical conversion rate
时间窗: Time from the first treatment up to 24 weeks
R0 surgical conversion rate：The proportion of subjects who achieve complete R0 resection of both the primary gastric lesion and any metastases among all subjects receiving the conversion therapy regimen.
Corhot1: Pathological Complete Response Rate (pCR)
时间窗: Time from the first treatment up to 12 weeks
Pathological Complete Response Rate (pCR), defined as no residual tumor cells in the surgical specimen of the primary tumor and lymph nodes (ypT0N0); corresponds to TRG grade 0.
次要结局
- Corhot1: Event-Free Survival (EFS)(Time from the first treatment up to 2 years.)
- Corhot1: 1-year Event-Free Survival (EFS) rate(Time from the first treatment up to 12 months.)
- Corhot1 and Corhot2: Disease Control Rate (DCR)(corhot1 ：Time from the first treatment up to 12 weeks. Corhot2：Time from the first treatment up to 2 years.)
- Corhot1 and Corhot2: Overall Survival (OS)(Time from the first treatment up to 2 years.)
- Corhot1: R0 resection rate(Time from the first treatment up to 12 weeks)
- Corhot1 and Corhot2: Objective Response Rate (ORR)(corhot1 ：Time from the first treatment up to 12 weeks. Corhot2：Time from the first treatment up to 2 years.)
- Corhot1 and Corhot2: 1-year Overall Survival (OS) rate(Time from the first treatment up to 12 months.)
- Corhot2: Curative Surgery Conversion Rate(Time from the first treatment up to 24 weeks)
- Corhot2: Progression-Free Survival (PFS)(Time from the first treatment up to 2 years.)
- Corhot1and Corhot2: Adverse events(through study completion, an average of 1 year.)
研究者
Bin Xiong, MD
Chief Physician
Wuhan University
研究点 (1)
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