Trial Title:
Cadonilimab With Chemotherapy in Treating Advanced Biliary Cancer
NCT ID:
NCT05978609
Condition:
Cholangiocarcinoma Non-resectable
Conditions: Official terms:
Cholangiocarcinoma
Gemcitabine
Study type:
Interventional
Study phase:
Phase 2
Overall status:
Recruiting
Study design:
Allocation:
N/A
Intervention model:
Single Group Assignment
Primary purpose:
Treatment
Masking:
None (Open Label)
Intervention:
Intervention type:
Drug
Intervention name:
Candonilimab
Description:
Candonilimab 10mg/kg, Ivgtt，Q3W，Every 21 days is a cycle, administered on the first day
of each cycle, and used continuously；
Arm group label:
Candonilimab in combination with cisplatin and gemcitabine
Intervention type:
Drug
Intervention name:
Cisplatin
Description:
Cisplatin，25mg/m2，Ivgtt，Dosing on days 1 and 8，Every 21 days is a cycle, administered on
the first day of each cycle, and used continuously；
Arm group label:
Candonilimab in combination with cisplatin and gemcitabine
Intervention type:
Drug
Intervention name:
Gemcitabine
Description:
gemcitabine 1000mg/m2，Ivgtt，Dosing on days 1 and 8，Every 21 days is a cycle, administered
on the first day of each cycle, and used continuously；
Arm group label:
Candonilimab in combination with cisplatin and gemcitabine
Summary:
The goal of this single-arm, Phase II interventional clinical trial is to test the safety
and effectiveness of a combination treatment using the Cadonilimab with Gemcitabine and
Cisplatin in patients with unresectable, locally advanced or metastatic biliary tract
malignancies. The main questions it aims to answer are:
- Is this combined treatment protocol safe for these patients?
- Is this combined treatment protocol effective in treating these patients?
Participants will be given a combination treatment of Cadonilimab, Gemcitabine, and
Cisplatin. Researchers will monitor their health conditions to assess the safety and
effectiveness of this treatment protocol.
Criteria for eligibility:
Criteria:
Inclusion Criteria:
1. Obtain written informed consent before implementing any experimental procedures.
2. Age between 18 and 75 years (any gender).
3. Histologically or cytologically confirmed unresectable locally advanced or
metastatic biliary tumors (intrahepatic cholangiocarcinoma, extrahepatic
cholangiocarcinoma, and gallbladder carcinoma).
4. No prior systemic treatment, curative surgery, or adjuvant therapy allowed within
the past 6 months.
5. Expected survival time > 3 months.
6. Presence of at least one measurable lesion according to RECIST 1.1 criteria.
7. Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0-1.
8. Adequate organ function, with the following laboratory criteria:
1. Absolute neutrophil count (ANC) ≥ 1.5x10^9/L, without the use of
granulocyte-colony stimulating factor in the past 14 days.
2. Platelet count ≥ 90x10^9/L, without transfusion in the past 14 days.
3. Hemoglobin > 9 g/dL, without transfusion or use of erythropoietin-stimulating
agents in the past 14 days.
4. Total bilirubin ≤ 1.5 times the upper limit of normal (ULN).
5. Aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 times ULN
(ALT or AST ≤ 5 times ULN for patients with liver metastases).
6. Serum creatinine ≤ 1.5 times ULN and creatinine clearance (calculated using the
Cockcroft-Gault formula) ≥ 60 ml/min.
7. Coagulation function within normal limits, defined as international normalized
ratio (INR) or prothrombin time (PT) ≤ 1.5 times ULN.
8. Normal thyroid function, defined as thyroid-stimulating hormone (TSH) within
the normal range. If baseline TSH is outside the normal range, subjects with
total triiodothyronine (T3) (or free T3) and free thyroxine (FT4) within the
normal range can still be included.
9. Normal cardiac enzymes (clinically insignificant isolated laboratory
abnormalities are allowed, as determined by the investigator).
9. For premenopausal female subjects, a negative pregnancy test result (urine or serum)
should be obtained within 3 days before the first dose of study drug (Day 1 of Cycle
1). If urine pregnancy test results cannot be confirmed as negative, a blood
pregnancy test is required. Postmenopausal female is defined as at least 1 year
after menopause or having undergone surgical sterilization or hysterectomy.
10. If there is a risk of pregnancy, all subjects (both male and female) must use
contraception with a failure rate of less than 1% per year throughout the entire
treatment period and for 120 days after the last dose of study drug.
Exclusion Criteria:
1. Diagnosis of malignant diseases other than extrahepatic bile duct cancer, excluding
completely resected basal cell carcinoma, squamous cell carcinoma of the skin,
and/or in situ carcinoma within the past 5 years.
2. Tumors located in the ampulla of Vater.
3. Currently participating in an interventional clinical study or received other
investigational drugs or investigational device treatment within 4 weeks prior to
the first dose of study drug.
4. Previously received therapy with anti-PD-1, anti-PD-L1, or anti-PD-L2 agents, or
drugs targeting another T-cell receptor with inhibitory or co-stimulatory function
(e.g., CTLA-4, OX-40, CD137).
5. Previously received palliative radiotherapy for biliary tumors, excluding
postoperative adjuvant radiotherapy.
6. Received traditional Chinese medicine or immune modulatory drugs with anti-tumor
indications within 2 weeks prior to the first dose of study drug (including
thymosin, interferon, interleukins), except for local use to control pleural
effusion.
7. Active autoimmune diseases requiring systemic treatment within 2 years prior to the
first dose of study drug, or known history of primary immunodeficiency diseases.
Patients with positive autoimmune antibodies alone will be evaluated by the
investigator to determine if they have autoimmune diseases.
8. Currently receiving systemic corticosteroid therapy (excluding intranasal, inhaled,
or topical corticosteroids) or any other form of immunosuppressive therapy within 4
weeks prior to the first dose of study drug. Physiological doses of corticosteroids
(≤10 mg/day prednisone or equivalent) are permitted.
9. Uncontrolled pleural effusion or ascites that requires drainage or has not shown a
significant increase in the past 3 days in patients who do not require drainage or
whose drainage has been stopped.
10. Prior solid organ transplantation (excluding corneal transplantation) or allogeneic
hematopoietic stem cell transplantation.
11. Known hypersensitivity to the study drug, Candonilimab active substance, or
excipients.
12. Insufficient recovery from any toxicities and/or complications related to previous
interventions before starting treatment (i.e., ≤ Grade 1 or returning to baseline,
excluding fatigue or alopecia).
13. Known history of human immunodeficiency virus (HIV) infection (i.e., positive for
HIV 1/2 antibodies).
14. Untreated active hepatitis B defined as positive HBsAg and detectable HBV-DNA levels
above the upper limit of normal at the study center. Note: The following
HBV-infected patients may be included:
HBV viral load <2.5 × 10^3 copies/mL (500 IU/mL) prior to the first dose of study
drug, and patients should receive anti-HBV therapy throughout the study treatment.
For patients who are anti-HBc positive, HBsAg negative, anti-HBs negative, and HBV
DNA negative, no prophylactic anti-HBV therapy is required, but viral reactivation
needs to be closely monitored.
15. Active hepatitis C infection (positive for hepatitis C virus (HCV) antibodies and
HCV-RNA levels above the lower limit of detection).
16. Vaccination with live attenuated vaccines within 4 weeks prior to the first dose of
study drug.
17. Pregnant or lactating women.
18. Presence of any severe or uncontrolled systemic diseases, including:
Resting electrocardiogram with significant and symptomatic abnormalities in rhythm,
conduction, or morphology, such as complete left bundle branch block, grade II or
higher cardiac conduction block, ventricular arrhythmia, or atrial fibrillation.
Unstable angina, congestive heart failure, chronic heart failure with New York Heart
Association (NYHA) classification ≥ Grade 2.
Any arterial thrombosis, embolism, or ischemia event within the past 6 months prior
to enrollment, such as myocardial infarction, unstable angina, cerebrovascular
accident, or transient ischemic attack.
Major surgery (e.g., craniotomy, thoracotomy, or laparotomy) within 4 weeks prior to
the first dose of study drug or unhealed wounds, ulcers, or fractures. Minor
surgical procedures, including venous puncture for intravenous infusion, within 7
days prior to the first dose of study drug are excluded.
Poor blood pressure control (systolic blood pressure >140 mmHg, diastolic blood
pressure >90 mmHg).
Active pulmonary tuberculosis. Active or uncontrolled infections requiring systemic
treatment. Clinical active diverticulitis, intra-abdominal abscess, or
gastrointestinal obstruction.
Liver diseases such as cirrhosis, decompensated liver disease, acute or chronic
active hepatitis.
Poorly controlled diabetes (fasting blood glucose >10 mmol/L). Urine analysis
showing urinary protein ≥++ and confirmed 24-hour urinary protein >1.0 g.
Presence of psychiatric disorders that would hinder compliance with treatment.
19. Any medical history, evidence of disease, or abnormal laboratory values that could
interfere with the study results, hinder the subject's full participation in the
study, or pose other potential risks as determined by the investigator.
Gender:
All
Minimum age:
18 Years
Maximum age:
75 Years
Healthy volunteers:
No
Locations:
Facility:
Name:
West China Hospital, Sichuan University
Address:
City:
Chengdu
Zip:
610041
Country:
China
Status:
Recruiting
Contact:
Last name:
Tao Wang, Dr.
Start date:
July 1, 2023
Completion date:
July 1, 2026
Lead sponsor:
Agency:
West China Hospital
Agency class:
Other
Source:
West China Hospital
Record processing date:
ClinicalTrials.gov processed this data on November 12, 2024
Source: ClinicalTrials.gov page:
https://clinicaltrials.gov/ct2/show/NCT05978609
