Neoadjuvant Tisleizumab(BGB-A317) for dMMR/MSI-H Non-late Stage Colorectal Cancer Patients
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 发起方
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- pathological complete regression rate
研究概览
简要总结
According to the cancer statistics in 2020, colorectal cancer (CRC) remains a major public health issue worldwide, representing the third common cancer (10%) and second leading cause of death (9.4%) with 5-year survival rate approaching 65%. Meanwhile, 28.8% of the newly diagnosed cases and 30.3% of the CRC-related death occurs in China. Among all the CRC, stage I-III account for 75%. For the standard management for non-late stage(stage I-III) CRC patients, surgery including the primary site and local lymph nodes dissection has been the most important one. But for the high-risk stage II and locally-advanced stage III CRC, neoadjuvant or adjuvant therapy such as chemotherapy and radiotherapy plays a vital role in preventing the residual cancer cells to relapse and spread to distant sites after surgery. For the past decades, immunotherapy like anti-PD-1 and anti-CTLA4 checkpoint inhibitor achieves great process in solid tumor treatment especially for late-stage CRC. And Pembrolizumab and Nivolumab has been proved for dMMR/MSI-H late-stage-CRC by FDA. Combination of Ipilimumab and Nivolumab has achieved great success among the early-stage-CRC in NICHE study. The investigators here to carry out a phase II clinical trial to explore the safety and effect of single anti-PD-1 (Tisleizumab-BGB-A317 ) neoadjuvant treatment for non-late stage CRC patients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Able to provide consents and agree to follow the trial requirement and assessment;
- •Age >=18
- •ECOG score: 0 or1
- •Biopsy pathological diagnosis as MSI-H/dMMR( both IHC and PCR method required)
- •Measurable and assessible primary tumor sites according to RECIST 1.1
- •Able to provide 22ml peripheral blood for assessment for ctDNA
- •With all organ function sufficient
- •No bowel obstruction or fistula
- •No previous chemotherapy, radiotherapy and immunotherapy accepted history
- •Distant metastasis excluded before surgery by CT scan
- •Contraception required for women for the whole enrollment time until 3 months after last dose of immunotherapy
排除标准
- •self-autoimmune diseases history such as SLE
- •People who using the immune suppressor
- •Severe allergy to other mono-clone antibody
- •Cerebral metastasis which hasn't be managed yet
- •Hypertension(SBP>140mmHg,DBP>90mmHg)
- •Uncontrolled diabetes(FBG>10mmol/L)
- •Accepted anti-PD-1 or anti-PD-L1 immunotherapy in the past
- •Uncontrolled heart diseases such as NYHA II heart failure, unstable angina , cardiac infarction in 1 year and arrhythmia
- •Systemic inflammation which needs whole body treatment
- •Urine routine: protein >=++ or 24hr urine protein>=1g
- •Innate or acquired immune deficiency like HIV and HBV
- •Enrolled in other clinical trial already
- •Confirmed as metastasis before the surgery
- •Other malignancies has been diagnosed before
- •Tuberculosis
- •Pregnancy
研究组 & 干预措施
dMMR/MSI-H stage I-III CRC patients
Patients will accept 4 dose of Tisleizumab(BGB-A317) treatment after enrollment and the assessment of the therapeutic effect by clinicians would be finished after that. Once the patients has been qualified as cCR , they could be exempted for surgery and continued the watch and wait management. If the patient has been assessed as able to R0 surgery , then they would received surgery. Otherwise ,they would be excluded from the trial.
干预措施: Tisleizumab(BGB-A317) (Drug)
结局指标
主要结局
pathological complete regression rate
时间窗: From enrollment to 1 year after surgery
Patients without noninvasive or focal-invasive residues or involved lymph nodes should be considered as having achieved pCR. The rate is these patients over the whole group.
次要结局
- CR rate(From enrollment to 1 year after surgery)
- Major Pathological Response rate(From enrollment to 1 year after surgery)
- Disease free survival(From enrollment to 1 year after surgery)
研究者
Gong Chen
Professor
Sun Yat-sen University
