Fruquintinib Combined With PD-1 Antibody in pMMR / MSS Locally Advanced Rectal Cancer (LARC) With High Immune Score: an Open-label, Multi-center, Phase II Clinical Trial
试验速览
- 阶段
- 2 期
- 发起方
- 入组人数
- 48
- 试验地点
- 1
- 主要终点
- ORR
研究概览
简要总结
This is a prospective, one arm phase II study aimed to observe the efficacy and safety of tislelizumab combined with fruquintinib in treatment of patients with pMMR / MSS locally advanced rectal cancer with high immune score.
详细描述
48 patients of pMMR / MSS locally advanced rectal cancer with high immune score will be administered with tislelizumab (200mg IV d1, Q3W ) combined with fruquintinib (5mg QD d1-d14, Q3W) with a total of 2 cycles as neoadjuvant therapy. After TME, tislelizumab and fruquintinib will be given again for up to 6 months as adjuvant therapy. If the patient after neoadjuvant therapy is evaluated as SD/PD, the neoadjuvant therapy will be converted to neoadjuvant chemo-radiotherapy/chemotherapy or palliative therapy, and then the patient will be treated according to the norms of adjuvant therapy for rectal cancer if TME is performed. If the patient choose Watch & Wait when evaluated as CR, tislelizumab plus fruquintinib for at least one year is requested.
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
- •18-75 yrs old;
- •pMMR/MSS rectal adenocarcinoma;
- •Pelvic MRI / endoscopic ultrasonography or transrectal ultrasound were used for reoperative staging: T3-4N+ with resectable tumor;
- •High immune score (Immunoscore®️ ≥3);
- •No sign of bowel obstruction, or bowel obstruction has been relieved by ostomy;
- •Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
- •No previous chemotherapy, radiotherapy or immunotherapy;
- •Distant metastasis was excluded by CT of chest, abdomen and pelvis before operation;
- •Able to swallow tablets;
- •Life expectancy of at least 2 years;
- •Adequate organ function;
- •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.
排除标准
- •Any active autoimmune disease or history of autoimmune disease;
- •Immunosuppressants, systemic or absorbable local hormones are being used to achieve the purpose of immunosuppression (dose > 10mg / day, prednisone or other effective hormones) and continue to be used within 2 weeks before enrollment;
- •History of severe allergic reaction to monoclonal antibody;
- •Subjects with untreated active brain metastasis or meningeal metastasis with clinical symptoms;
- •Suffering from hypertension and can not be well controlled by antihypertensive drugs (systolic blood pressure ≥ 140 mmHg and / or diastolic blood pressure ≥ 90 mmHg);
- •Have previously received other PD-1 antibody therapy or other immunotherapy against PD-1 / PD-L1, or have previously received anti angiogenesis drugs;
- •There are cardiac clinical symptoms or diseases that are not well controlled, such as: (1) heart failure above NYHA grade 2 (2) unstable angina pectoris (3) myocardial infarction within 1 year (4) clinically significant supraventricular or ventricular arrhythmias requiring treatment or intervention;
- •Known hereditary or acquired bleeding and thrombotic tendency (such as hemophilia, coagulation dysfunction, thrombocytopenia, hypersplenism, etc.) or undergoing thrombolytic or anticoagulant therapy;
- •Urine routine examination indicates that urinary protein is ≥ + +, or confirmed 24-hour urinary protein is ≥ 1.0g;
- •Significant clinical bleeding symptoms or definite bleeding tendency occurred within 3 months before enrollment, such as gastrointestinal bleeding, active bleeding, baseline fecal occult blood + + or above, or vasculitis;
- •Arteriovenous thrombosis events occurred within 6 months before enrollment, such as cerebrovascular accidents (including transient ischemic attack, intracerebral hemorrhage and cerebral infarction), deep venous thrombosis and pulmonary embolism;
- •Subjects with active infection;
- •Congenital or acquired immune deficiency (such as HIV infection) or active hepatitis (hepatitis B: HBsAg positive and HBV DNA > 104 copy number /ml; Hepatitis C: HCV antibody positive);
- •Those who participated in clinical trials of other drugs within 3 months before enrollment;
- •There was evidence of distant metastasis before operation;
- •History of pelvic or abdominal radiotherapy;
- •Any other malignant disease within the preceding 5 years with the exception of cured skin basal cell carcinoma, cervical carcinoma in situ and ovarian cancer;
- •Live vaccines were administered less than 4 weeks before the study or possibly during the study period;
- •Known or suspected allergy to the study drug or to any drug given in connection with this test;
- •In the judgment of the researcher, the subject has other circumstances that may affect the results of the study or cause the study to be forced to stop halfway.
研究组 & 干预措施
Fruquintinib plus Tislelizumab
Fruquintinib 5mg QD d1-d14, Q3W; Tislelizumab 200mg IV Q3W d1
干预措施: Fruquintinib plus Tislelizumab (Drug)
结局指标
主要结局
ORR
时间窗: up to 3 years
Objective Response Rate
次要结局
- 3-year RFS(up to 3 years)
- 3-year OS(up to 3 years)
- Safety and Tolerability(up to 3 years)
研究者
Pei-Rong Ding
Professor
Sun Yat-sen University
