Preoperative Short-course Radiation Followed by Envafolimab Plus CAPEOX for MSS Locally Advanced Rectal Adenocarcinoma: a Prospective, Multicenter, Randomized Controlled Study (PRECAM-R)
Overview
- Phase
- Phase 3
- Intervention
- Not specified
- Conditions
- Rectal Cancer
- Sponsor
- Sir Run Run Shaw Hospital
- Enrollment
- 108
- Locations
- 1
- Primary Endpoint
- pCR rate
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
Short-course radiotherapy combined with immunotherapy may bring revolutionary changes to the preoperative neoadjuvant treatment mode for locally advanced rectal cancer.In view of the shortcomings of the current preoperative neoadjuvant treatment model for locally advanced rectal cancer, we will explore the feasibility of a new model of short-course radiotherapy combined with immunotherapy, and develop a possible optimal plan based on the existing theoretical basis, namely "short-course radiotherapy + PD-L1 monoclonal antibody combined with CAPEOX chemotherapy for 2 cycles", and explore the efficacy and adverse effects of this model. The study will also attempt to explore the characteristics of the treatment beneficiary population, explore the characteristics of the treatment beneficiary population by multi-dimensional tumor and microenvironmental information through multi-omics sequencing analysis, attempt to build an efficacy prediction model, early screening of the treatment beneficiary population for precise treatment, and thus explore a new model of radiotherapy combined with immunotherapy.
Investigators
Sheng Dai
Principal Investigator, head of medical affairs
Sir Run Run Shaw Hospital
Eligibility Criteria
Inclusion Criteria
- •Patients who are willing to receive neoadjuvant therapy.
- •≧18 years old.
- •Diagnosed by digital rectal examination, colonoscopy, and high-resolution MRI of the pelvis, the tumor is less than or equal to 12 cm from the anus.
- •Histologically diagnosed as rectal adenocarcinoma.
- •The clinical staging by pelvic contrast-enhanced CT and pelvic high-resolution MRI were cT2-4a N+, cT3/T4a N
- •MMR protein detection or MSI gene detection of rectal cancer specimens confirmed pMMR or MSS before treatment .
- •The patient has good compliance and can come to the hospital for re-examination as required.
- •ECOG Scale of Performance Status score 0-1 point.
- •Have not received anti-tumor and immunotherapy before enrollment.
- •Laboratory inspections must meet the following standards:
Exclusion Criteria
- •History of other malignant diseases in the past 5 years.
- •Patients with metastases from other sites (stage IV patients).
- •Patients with clinical staging of T1-2N0 or T4b, or positive lateral lymph nodes by pelvic contrast-enhanced CT and pelvic high-resolution MRI.
- •Patients with intestinal obstruction, intestinal perforation, intestinal bleeding, etc. requiring emergency surgery.
- •Known allergic to oxaliplatin, capecitabine, PD-L1 monoclonal antibody and other drugs.
- •Pathologically suggested signet ring cell carcinoma and mucinous adenocarcinoma.
- •dMMR or MSI-H patients.
- •The patient is accompanied by any unstable systemic disease, including but not limited to: severe infection, uncontrolled diabetes, hypertension uncontrolled by medication, unstable angina, cerebrovascular accident or transient cerebral ischemia, myocardial Infarction, congestive heart failure, severe cardiac arrhythmia requiring medication, hepatic, renal or metabolic disease; disease affecting the patient's life.
- •The disease (such as mental illness, etc.) or condition (such as alcoholism or drug abuse, etc.) associated with the patient will increase the risk of the patient receiving the trial drug treatment or affect the patient's compliance with the trial requirements, or may confuse the research results.
- •Active autoimmune disease that may worsen while receiving immunostimulants.
Outcomes
Primary Outcomes
pCR rate
Time Frame: Up to 10 weeks (once surgery is done) ]
The primary objective of the study is to evaluate the pathologic complete response (pCR) rate following short-course radiation then Envafolimab Plus CAPEOX
Secondary Outcomes
- Tumor regression grade(Up to 10 weeks (once surgery is done))
- PFS(Up to 3 years)
- OS(Up to 3 years)
- TRAEs(Up to 3 years)
- Surgical Complications(Up to 24 weeks)
- QoL(Up to 3 years)