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临床试验/NCT06904573
NCT06904573招募中2 期

A Multicenter, Randomized Controlled Phase II Study of Evaluating the Efficacy and Safety of Immunotherapy Combined With Oral Probiotics Compound (Biolosion) in Patients With Advanced Urothelial Carcinoma

Sun Yat-sen University3 个研究点 分布在 1 个国家目标入组 222 人开始时间: 2025年1月1日最近更新:
干预措施
相关药物

试验速览

阶段
2 期
状态
招募中
发起方
入组人数
222
试验地点
3
主要终点
Progression-free Survival (PFS)

研究概览

简要总结

This is a multicenter, randomized, controlled phase II Study of evaluating the efficacy and safety of immunotherapy combined with probiotics compound (Biolosion) in patients with advanced urothelial carcinoma.

详细描述

This multicenter, randomized phase II trial is designed to study the efficacy and safety of probiotics compound (Biolosion) Immunotherapy of the physician's choice (IPC) plus versus IPC in patients with advanced urothelial carcinoma (aUC). Pervious received platinum-based therapies, previous received Immune checkpoint inhibitors, and the treatment lines will stratify randomization.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
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

入选标准

  • Patients included in this study must meet all of the following criteria:
  • Aged 18 or above;
  • Histologically or cytologically confirmed locally advanced inoperable (such as T4b, or N2-3) or metastatic urothelial carcinoma, including bladder, ureter, renal pelvis and urethra;
  • Patients who have received previous treatment with immune checkpoint inhibitors (PD-1/PD-L1 monoclonal antibodies) are allowed;
  • According to RECIST1.1 standard, there is at least one measurable target lesion;
  • ECOG score ≤2;
  • Good bone marrow, kidney (serum creatinine clearance calculated by CG formula> 30 mL/min), liver and coagulation function:
  • Expected survival period ≥ 6 months;
  • The patient understands the research procedures and signs the informed consent form in writing to indicate his/her agreement to participate in the study;
  • Female subjects of childbearing potential should have a negative urine or serum pregnancy test within 7 days before the first dose of study drug (Cycle 1, Day 1). If the urine pregnancy test result cannot be confirmed as negative, a blood pregnancy test is required.
  • If there is a risk of pregnancy, male and female patients should use highly effective contraception (i.e., a method with a failure rate of less than 1% per year) and continue for at least 180 days after stopping the trial treatment.

排除标准

  • Any of the following will be considered as meeting the exclusion criteria of the study:
  • Patients with locally advanced disease may receive local radical treatment;
  • History of clinically symptomatic cardiovascular, liver, respiratory, renal, hematoendocrine, or neuropsychiatric diseases;
  • Clear brain/meningeal metastasis;
  • Peripheral neuropathy >1 degree;
  • Patients who have received anti-tumor monoclonal antibody treatment within 4 weeks before the start of the study, or have received other anti-tumor drug treatment and have not recovered from adverse events/reactions;
  • Participated in any investigational drug treatment within 4 weeks before the start of treatment;
  • Patients who had received axial bone radiotherapy within 4 weeks before the start of the study or had not recovered from adverse reactions caused by previous radiotherapy;
  • Known severe allergic reaction to the study drug, its active ingredients and/or any excipients;
  • Patients diagnosed with immunodeficiency or receiving systemic glucocorticoids or any other form of immunosuppressive therapy within 7 days before the first dose of the study; physiological doses of glucocorticoids (≤10 mg/day of prednisone or equivalent drugs) are allowed;
  • Active autoimmune diseases requiring systemic treatment (such as the use of disease-modifying drugs, corticosteroids, or immunosuppressants) occurred within 2 years before the first dose. Replacement therapies (such as thyroxine, insulin, or physiological corticosteroids for adrenal or pituitary insufficiency) are not considered systemic treatment; a history of non-infectious pneumonia requiring glucocorticoid treatment within 1 year before the first dose or current interstitial lung disease;
  • Received solid organ or blood system transplantation;
  • Known history of human immunodeficiency virus (HIV) infection (i.e. HIV 1/2 antibody positive). Untreated active hepatitis B;
  • Untreated active hepatitis B; Note: Hepatitis B subjects who meet the following criteria are also eligible for inclusion: HBV viral load must be <1000 copies/ml (200 IU/ml) before the first dose, and subjects should receive anti-HBV treatment during the entire study chemotherapy treatment to avoid viral reactivation. For subjects with anti-HBc (+), HBsAg (-), anti-HBs (-), and HBV viral load (-), preventive anti-HBV treatment is not required, but viral reactivation needs to be closely monitored;
  • Subjects with active HCV infection (HCV antibody positive and HCV-RNA level above the detection limit) received live vaccine within 30 days before the first dose (Cycle 1, Day 1);
  • A history of other malignant tumors in the past 5 years, excluding cured non-malignant melanoma of the skin, cervical carcinoma in situ, and incidentally discovered prostate cancer (stage lower than T2N0M0, Gleason score <7, or undetectable PSA);
  • Medical history or disease evidence, abnormal treatment or laboratory test values, or other conditions that the researcher considers unsuitable for enrollment that may interfere with the trial results or prevent the subject from fully participating in the study;
  • Breastfeeding women
  • People with chronic diseases who need to take antibiotics for a long time.

研究组 & 干预措施

Experiment group

Experimental

Subjects in this arm will receive an oral probiotics compound (Biolosion) plus the Investigator's choice of immune checkpoint inhibitor-based (ICIs-based) therapies:

Regimens that combine with chemotherapy agents can include but are not limited to Nab-paclitaxel, Cisplatin, Gemcitabine, Disitamab vedotin, Enfortumab Vedotin; Immune checkpoint inhibitors include but are not limited to Pembrolizumab and toripalimab.

干预措施: Probiotics Compound (Biolosion) (Drug)

Experiment group

Experimental

Subjects in this arm will receive an oral probiotics compound (Biolosion) plus the Investigator's choice of immune checkpoint inhibitor-based (ICIs-based) therapies:

Regimens that combine with chemotherapy agents can include but are not limited to Nab-paclitaxel, Cisplatin, Gemcitabine, Disitamab vedotin, Enfortumab Vedotin; Immune checkpoint inhibitors include but are not limited to Pembrolizumab and toripalimab.

干预措施: Nab-paclitaxel (Drug)

Experiment group

Experimental

Subjects in this arm will receive an oral probiotics compound (Biolosion) plus the Investigator's choice of immune checkpoint inhibitor-based (ICIs-based) therapies:

Regimens that combine with chemotherapy agents can include but are not limited to Nab-paclitaxel, Cisplatin, Gemcitabine, Disitamab vedotin, Enfortumab Vedotin; Immune checkpoint inhibitors include but are not limited to Pembrolizumab and toripalimab.

干预措施: Cisplatin (Drug)

Experiment group

Experimental

Subjects in this arm will receive an oral probiotics compound (Biolosion) plus the Investigator's choice of immune checkpoint inhibitor-based (ICIs-based) therapies:

Regimens that combine with chemotherapy agents can include but are not limited to Nab-paclitaxel, Cisplatin, Gemcitabine, Disitamab vedotin, Enfortumab Vedotin; Immune checkpoint inhibitors include but are not limited to Pembrolizumab and toripalimab.

干预措施: Gemcitabine (Drug)

Experiment group

Experimental

Subjects in this arm will receive an oral probiotics compound (Biolosion) plus the Investigator's choice of immune checkpoint inhibitor-based (ICIs-based) therapies:

Regimens that combine with chemotherapy agents can include but are not limited to Nab-paclitaxel, Cisplatin, Gemcitabine, Disitamab vedotin, Enfortumab Vedotin; Immune checkpoint inhibitors include but are not limited to Pembrolizumab and toripalimab.

干预措施: Disitamab vedotin (Drug)

Experiment group

Experimental

Subjects in this arm will receive an oral probiotics compound (Biolosion) plus the Investigator's choice of immune checkpoint inhibitor-based (ICIs-based) therapies:

Regimens that combine with chemotherapy agents can include but are not limited to Nab-paclitaxel, Cisplatin, Gemcitabine, Disitamab vedotin, Enfortumab Vedotin; Immune checkpoint inhibitors include but are not limited to Pembrolizumab and toripalimab.

干预措施: Enfortumab Vedotin (Drug)

Experiment group

Experimental

Subjects in this arm will receive an oral probiotics compound (Biolosion) plus the Investigator's choice of immune checkpoint inhibitor-based (ICIs-based) therapies:

Regimens that combine with chemotherapy agents can include but are not limited to Nab-paclitaxel, Cisplatin, Gemcitabine, Disitamab vedotin, Enfortumab Vedotin; Immune checkpoint inhibitors include but are not limited to Pembrolizumab and toripalimab.

干预措施: Pembrolizumab (Drug)

Experiment group

Experimental

Subjects in this arm will receive an oral probiotics compound (Biolosion) plus the Investigator's choice of immune checkpoint inhibitor-based (ICIs-based) therapies:

Regimens that combine with chemotherapy agents can include but are not limited to Nab-paclitaxel, Cisplatin, Gemcitabine, Disitamab vedotin, Enfortumab Vedotin; Immune checkpoint inhibitors include but are not limited to Pembrolizumab and toripalimab.

干预措施: Toripalimab (Drug)

Control group

Active Comparator

Subjects in this arm will receive Investigator's choice of immune checkpoint inhibitors-based (ICIs-based) therapies

干预措施: Nab-paclitaxel (Drug)

Control group

Active Comparator

Subjects in this arm will receive Investigator's choice of immune checkpoint inhibitors-based (ICIs-based) therapies

干预措施: Cisplatin (Drug)

Control group

Active Comparator

Subjects in this arm will receive Investigator's choice of immune checkpoint inhibitors-based (ICIs-based) therapies

干预措施: Gemcitabine (Drug)

Control group

Active Comparator

Subjects in this arm will receive Investigator's choice of immune checkpoint inhibitors-based (ICIs-based) therapies

干预措施: Disitamab vedotin (Drug)

Control group

Active Comparator

Subjects in this arm will receive Investigator's choice of immune checkpoint inhibitors-based (ICIs-based) therapies

干预措施: Enfortumab Vedotin (Drug)

Control group

Active Comparator

Subjects in this arm will receive Investigator's choice of immune checkpoint inhibitors-based (ICIs-based) therapies

干预措施: Pembrolizumab (Drug)

Control group

Active Comparator

Subjects in this arm will receive Investigator's choice of immune checkpoint inhibitors-based (ICIs-based) therapies

干预措施: Toripalimab (Drug)

结局指标

主要结局

Progression-free Survival (PFS)

时间窗: Within approximately 48 months

Progression-Free Survival (PFS) is defined as the time from randomization to the first documented disease progression, as determined by RECIST v1.1, or death from any cause, whichever occurs first. Disease progression will be assessed by independent radiologic review. Patients without documented progression or death at the time of analysis will be censored at their last tumor assessment date.

次要结局

  • Duration of Response (DOR)(Within approximately 48 months)
  • Overall Survival (OS)(Within approximately 48 months)
  • Objective Response Rate (ORR)(Within approximately 48 months)
  • Disease Control Rate (DCR)(Within approximately 48 months)
  • Time to Response (TTR)(Within approximately 48 months)
  • Number of participants with treatment-related adverse events as assessed by CTCAE v5.0(Within approximately 48 months)

研究者

发起方
Sun Yat-sen University
申办方类型
Other
责任方
Principal Investigator
主要研究者

Shi Yanxia

Professor

Sun Yat-sen University

研究点 (3)

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