PD-1 Inhibitors (Camrelizumab) Combined With VEGF Inhibitors (Apatinib) for Locally Advanced dMMR/MSI-H Colorectal Cancer: an Open-label, Multi-center, Phase II Clinical Trial
试验速览
- 阶段
- 2 期
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 53
- 试验地点
- 1
- 主要终点
- Clinical complete response or pathological complete response
研究概览
简要总结
In this open-label phase II study, patients will be scheduled for neoadjuvant treatment with PD-1 inhibitors (Camrelizumab) plus VEGF inhibitor (Apatinib) for dMMR/MSI-H colorectal cancer staged as locally advanced (cT3-4N+/-M0 for rectal cancer, cT4 or cT3 with extramural extension ≥5mm for colon cancer). Radiological evaluation will be preformed after 4 cycles of treatment. Patients (either with colon or rectal cancer) who achieve complete clinical response will be offered the choice of Watch & Wait.
详细描述
This is an open-label phase II study, with the aim of determining the efficacy of PD-1 inhibitors (Camrelizumab) plus VEGF inhibitor (Apatinib) as a neoadjuvant therapy for dMMR/MSI-H locally advanced colorectal cancer.
Patients will be evaluated for eligibility within 14 days prior to study initiation with CT (for colon cancer) and/or MRI (for rectal cancer).
Patients will be given four cycles of Camrelizumab (200mg iv every 3 weeks) plus Apatinib (250mg QD day1-14) before being evaluated for response. For patients with colon cancer, if a SD/PD is achieved and the tumor is deemed unresectable, they will be offered chemotherapy±radiotherapy, while if a CR or PR is achieved, they will be offered another four cycles of Camrelizumab + Apatinib. After completing 8 cycles of treatment, if a CR is achieved they will be offered the choice of Watch & Wait. For patients with rectal cancer who have a SD/PD (after 4 cycles), chemoradiotherapy will be offered, while for those with a CR/PR, another four cycles of the treatment will be given. After completing 8 cycles of treatment, if a CR is achieved patients will be offered the choice of Watch & Wait.
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 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Locally confirmed dMMR or MSI-H colorectal carcinoma
- •Tumor staging based on CT/MR or transrectal ultrasound imaging:
- •Colon cancer: radiological high risk (rT4 or rT3 tumour with extramural extension ≥ 5mm with or without lymph node involvement)
- •Rectal cancer: <12 cm from the anal verge and radiological high risk (rT3/4 with or without lymph node involvement)
- •No sign of bowel obstruction, or bowel obstruction has been relieved by ostomy
- •Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 within 10 days prior to study start
- •Aged 18 or over
- •Life expectancy of at least 2 years
- •Measurable disease
- •Female participants of childbearing potential must be willing to use adequate contraception for the course of the study starting with the first dose of study medication through 120 days after the last PD-1 antibody dose
- •Male participants must agree to use adequate contraception for the course of the study starting with the first dose of study medication through 120 days after the last PD-1 antibody dose
- •Adequate organ function
排除标准
- •Active autoimmune disease that has required systemic treatment in past 2 years
- •Diagnosis of immunodeficiency or receiving systemic steroid therapy or any other form of immunosuppressive therapy within 2 weeks prior to this study start
- •Currently participating and receiving treatment in another study within 4 weeks of study start
- •History of severe allergic reaction to monoclonal antibody
- •Strong evidence of distant metastases or peritoneal nodules (M1)
- •Colonic obstruction that has not been defunctioned
- •Has received prior therapy with an immune checkpoint inhibitor (e.g., anti-programmed cell death [PD]-1, anti-PD ligand 1 [L1], anti-PD-L2 agent, or anti-cytotoxic T-lymphocyte-associated protein 4 [CTLA-4] agent, etc.) or anti-VEGF agents (e.g., Bevacizumab, Apatinib)
- •Any other malignant disease within the preceding 5 years with the exception of non-melanomatous skin cancer, carcinoma in situ and early stage disease with a recurrence risk <5%
- •Received a live vaccine within 30 days of planned start of study medication
- •Known history of Human Immunodeficiency Virus (HIV), Hepatitis B or C
- •Known history of, or any evidence of interstitial lung disease or active, non-infectious pneumonitis
- •Known history of active tuberculosis (Bacillus tuberculosis [TB])
- •Active infection requiring systemic therapy
研究组 & 干预措施
PD-1 inhibitors plus VEGF inhibitors
Patients will be given 4 cycles of Camrelizumab (200mg iv every 3 weeks) plus Apatinib (250mg QD day1-14) before being evaluated for response.
干预措施: PD-1 inhibitor plus VEGF inhibitors (Drug)
结局指标
主要结局
Clinical complete response or pathological complete response
时间窗: up to 2 year
Clinical complete response or immunotherapy-related pathological complete response (cCR or immunotherapy-related pCR)
次要结局
- Objective Response Rate (ORR, PR+CR)(up to 2 year)
- Surgical complications(within 1 month after surgery)
- Number of participants with treatment-related adverse events as assessed by CTCAE v4.0(up to 2 year)
- 3-year relapse-free survival(up to 3 years)
- 3-year overall survival(up to 3 years)
研究者
Pei-Rong Ding
Professor
Sun Yat-sen University