A Prospective Phase II Trial of Immunotherapy Combined With Short-course Radiotherapy in Early Low Rectal Cancer
Overview
- Phase
- Phase 2
- Intervention
- PD-1 antibody
- Conditions
- Early Low Rectal Cancer
- Sponsor
- Fudan University
- Enrollment
- 34
- Locations
- 1
- Primary Endpoint
- complete response (CR) rate
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
The study evaluates the combination of immunotherapy of PD-1 antibody and neoadjuvant short-course radiotherapy in early low rectal cancer. A total of 34 patients will receive 5*5Gy short-course radiotherapy, followed by 4 cycles of capecitabine plus oxaliplatin (CAPOX) chemotherapy and PD-1 antibody, finally receive the local excision(TEM) or total mesorectal excision (TME). The rate of complete response (cCR+pCR), Organ retention rate, long-term prognosis, and adverse effects will be analyzed.
Investigators
Zhen Zhang
Professor
Fudan University
Eligibility Criteria
Inclusion Criteria
- •age 18-70 years old, female and male
- •pathological confirmed adenocarcinoma
- •clinical stage T1-3bN0, tumor maximum diameter less than 4cm
- •the distance from anal verge less than 5 cm
- •without distance metastases
- •with good compliance
- •microsatellite repair status is MSS/pMMR
- •without previous anti-cancer therapy or immunotherapy
- •signed the inform consent
Exclusion Criteria
- •pregnancy or breast-feeding women
- •pathological confirmed signet ring cell carcinoma
- •clinical stage T1N0 and can be resected locally
- •history of other malignancies within 5 years
- •serious medical illness, such as severe mental disorders, cardiac disease, uncontrolled infection, etc.
- •immunodeficiency disease or long-term using of immunosuppressive agents
- •baseline blood and biochemical indicators do not meet the following criteria: neutrophils≥1.5×10\^9/L, Hb≥90g/L, PLT≥100×10\^9/L, ALT/AST ≤2.5 ULN, Cr≤ 1 ULN
- •DPD deficiency
- •allergic to any component of the therapy
Arms & Interventions
Treatment Arm
A total of 34 patients will receive 5\*5Gy short-course radiotherapy, followed by 4 cycles of CAPOX chemotherapy and PD-1 antibody, finally receive the TEM or TME surgery.
Intervention: PD-1 antibody
Treatment Arm
A total of 34 patients will receive 5\*5Gy short-course radiotherapy, followed by 4 cycles of CAPOX chemotherapy and PD-1 antibody, finally receive the TEM or TME surgery.
Intervention: Capecitabine
Treatment Arm
A total of 34 patients will receive 5\*5Gy short-course radiotherapy, followed by 4 cycles of CAPOX chemotherapy and PD-1 antibody, finally receive the TEM or TME surgery.
Intervention: Oxaliplatin
Treatment Arm
A total of 34 patients will receive 5\*5Gy short-course radiotherapy, followed by 4 cycles of CAPOX chemotherapy and PD-1 antibody, finally receive the TEM or TME surgery.
Intervention: Short-course radiotherapy
Outcomes
Primary Outcomes
complete response (CR) rate
Time Frame: The status of cCR will be evaluated after the completion of neoadjuvant therapy. The pCR rate will be evaluated after surgery. The cCR patients who adopted W&W strategy will be included into the CR rate caluculation.
Rate of complete response (CR), including the rate of pathologic complete response (pCR) after surgery and the rate of cCR with W\&W strategy.
Secondary Outcomes
- Organ preservation rate(from date of receiving neoadjuvant therapy, assessed up to 2 years)
- Grade 3-4 adverse effects rate(From date of initiation of treatment until the date of death from any cause, assessed up to 5 years)
- 3 year disease free survival rate(From date of initiation of treatment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 36 months.)
- 3 year local recurrence free survival rate(From date of initiation of treatment until the date of first documented pelvic failure, assessed up to 36 months.)
- 3 year overall survival rate(From date of initiation of treatment until the date of death from any cause, assessed up to 36 months.)
- 10 year Quality of Life(From date of initiation of treatment until the date of death from any cause, assessed up to 10 years)