Neoadjuvant Long-course Chemoradiotherapy Followed by Immunotherapy for Locally Advanced Mid-low Rectal Cancer

Trial Title: Neoadjuvant Long-course Chemoradiotherapy Followed by Immunotherapy for Locally Advanced Mid-low Rectal Cancer

NCT ID: NCT06493240

Condition: Locally Advanced Rectal Cancer

Conditions: Official terms:
Rectal Neoplasms
Antibodies
Antibodies, Monoclonal

Conditions: Keywords:
Locally Advanced Rectal Cancer
PD-1 inhibition
neoadjuvant therapy

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)

Masking description: Masking is not practically possible

Intervention:

Intervention type: Radiation
Intervention name: radiation
Description: 45 Gy radiation dose in 25 fractions to the pelvis
Arm group label: nCRT+PD-1

Intervention type: Drug
Intervention name: PD-1 Monoclonal Antibody
Description: 200mg Sintilimab after radiation (3 times, 2-week interval)
Arm group label: nCRT+PD-1

Other name: Sintilimab

Intervention type: Procedure
Intervention name: TME surgery
Description: TME surgery for 6~8 weeks after radiation
Arm group label: nCRT+PD-1

Other name: radical proctectomy

Summary: The purpose of this study was to evaluate the effect of capecitabine-based long-term radiotherapy followed by 3 cycles Sintilimab (PD-1 inhibitor) in patients with locally advanced rectal cancer.

Detailed description: Investigator designed a single-arm, open-label, phase II trial and the purpose of this study is to observe and evaluate the efficacy and safety of capecitabine-based long-term radiotherapy followed by 3 cycles Sintilimab (PD-1 inhibitor) for locally advanced rectal cancer.Participants will accept capecitabine-based long-term radiotherapy(50.4Gy radiation) followed by 200mg Sintilimab each time for 3 times, with 2-week intervals. The primary endpoint is pCR rate, and secondary endpoints include sphincter-preserving rate, adverse event rates.

Criteria for eligibility:
Criteria:
Inclusion Criteria: - aged 18~75 - ECOG score 0~2 - biopsy diagnosed rectal adenocarcinoma, distal margin within 10cm to anal verge - no distant metastasis, staged II/III (T4b excluded) by MRI - maximum diameter of rectal cancer lesion≥10mm according to baseline CT or MR - willing and able to comply with study protocol - consent to the use of blood and tissue specimens for study - no history of previous anti-tumor treatment (e.g. radiation, chemo, immuno, bio, herbal, etc.) - no disorders/diseases of immune system (e.g. systemic lupus erythematosus, rheumatoid arthritis, systemic vasculitis, scleroderma, pemphigus, dermatomyositis, mixed connective tissue disease, autoimmune hemolytic anemia, hyperthyroidism/hypothyroidism, ulcerative colitis, autoimmune hemolytic anemia, HIV infection, etc.) - no significant dysfunction of major viscera (e.g. heart, lung, liver, kidney, etc.) - no jaundice or gastrointestinal obstruction - no acute/ongoing infection - no significant irregularities in blood routine test and biochemical test results, particular requirements include: neutrophils≥1.5×109/L, HGB≥80g/L, platelet≥100×109/L, serum creatinine≤1.5×ULN, total bilirubin≤1.5×ULN, ALT、AST≤2.5×ULN - no social or mental disorder - for women of child-bearing age, a negative result of serological pregnancy test is required, and effective contraception measures from inclusion till 60 days after the last dose of study drug is required Exclusion Criteria: - multiple cancers, or with concomitant malignant tumors besides rectal cancer - having received any anti-cancer treatment (surgery, drugs, etc.) in the past 5 years - history of recent major surgery - with condition that affects the absorption of capecitabine via gastrointestinal tract (e.g. inability to swallow, nausea, vomiting, chronic diarrhea, etc.) - with uncontrolled, severe, concomitant diseases of any sort - allergic to any of the ingredients under study - estimated survival ≤ 5 years due to any reason - preparing for or having previously received organ or bone marrow transplant - having received immunosuppressive or systemic hormone therapy for immunosuppressive purposes within 1 month prior to inclusion - for patients with history of disorder of central nervous system, investigator discretion is required as to whether the clinical severity prevents the signing of informed consent or affects the patient or oral medication compliance - with other conditions/issues that may affect the study results or cause the study treatment to be terminated halfway (e.g. alcoholism, drug abuse, etc.) - pregnant or lactating women, or women intending on conception during treatment period

Gender: All

Minimum age: 18 Years

Maximum age: 75 Years

Healthy volunteers: No

Locations:

Facility:
Name: Peking University People's Hospital

Address:
City: Beijing
Zip: 100044
Country: China

Status: Recruiting

Contact:
Last name: Shen Zhanlong, M.D.

Phone: +86 13810230190
Email: shenzhanlong@pkuph.edu.cn

Start date: January 1, 2023

Completion date: April 1, 2025

Lead sponsor:
Agency: Peking University People's Hospital
Agency class: Other

Source: Peking University People's Hospital

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT06493240