RecruitingPhase 3NCT06017583

Neoadjuvant Chemotherapy With PD-1 Inhibitors Combined With SIB-IMRT in the Treatment of Locally Advanced Rectal Cancer

Neoadjuvant Chemotherapy With PD-1 Inhibitors Combined With Simultaneous Integrated Boost Intensity-modulated Radiotherapy in the Treatment of Locally Advanced Rectal Cancer


Sponsor

Yong Zhang,MD

Enrollment

48 participants

Start Date

Sep 1, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

This study aims to evaluate the efficacy and safety of tislelizumab combined with simultaneous integrated boost intensity-modulated radiotherapy in treating locally advanced rectal cancer. To explore a new PD-1 inhibitor adjuvant chemotherapy model combined with radiotherapy to treat locally advanced rectal cancer.


Eligibility

Min Age: 18 YearsMax Age: 70 Years

Inclusion Criteria8

  • Aged 18 to 70 years.
  • The pathological type of rectal cancer diagnosed by histopathology is adenocarcinoma.
  • Patients with T3-4 in the eighth AJCC stage or positive regional lymph node and no distant metastasis.
  • Having at least one measurable lesion according to RECIST 1.1.
  • ECOG score 0-1.
  • Expected survival time ≥6 months.
  • Major organ function is normal, that is, meeting the following criteria: blood routine: HB≥90g/L, ANC≥1.5×109/L, PLT≥80×109/L; Biochemical examination of ALB≥30g/L, TBIL≤1.5 ULN, ALT and AST≤2.5 ULN, plasma Cr≤1.5 ULN or creatinine clearance ≥60 ml/min.
  • Subjects volunteered to join the study, signed the informed consent, had good compliance, and cooperated with follow-up.

Exclusion Criteria15

  • Patients have had or currently have other malignant tumors within 5 years.
  • Patients allergic or sensitive to any drug in the study protocol.
  • Patients innate or acquired immune deficiency (e.g. HIV infection).
  • The presence of any active, known or suspected autoimmune disease (such as, but not limited to, interstitial pneumonia, uveitis, enteritis, hepatitis, arthritis, nephritis, hypophysitis, hyperthyroidism, hypothyroidism, etc.); The subject had vitiligo. Subjects with asthma require bronchodilators for medical intervention.
  • The presence of active infections requiring systemic treatment.
  • The subject has previously received other PD-1 or PD-L1, or CTLA-4 antibody therapy, or other drug therapy targeting immunoregulatory receptor preparations.
  • Unrelieved toxic effects above CTCAE grade 1 due to any previous treatment, excluding alopecia.
  • Patients with a history of myocardial infarction or stroke, unstable angina pectoris, decompensated heart failure or deep vein thrombosis.
  • Patients with long-term untreated wounds or fractures, major surgical operations or severe traumatic injuries, fractures or ulcers within 4 weeks.
  • Pregnant or lactating women.
  • Patients with liver and kidney dysfunction.
  • Patients with a history of abuse of psychotropic drugs and unable to abstain or patients with mental disorders.
  • Patients who have participated in clinical trials of other drugs within 4 weeks.
  • Patients with concomitant diseases that, in the judgment of the investigator, seriously endanger the patient's safety or affect the patient's completion of the study.
  • The investigator judged that participation in this study was not conducive to the maximum benefit of the subjects.

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Interventions

DRUGTislelizumab

Tirellizumab was administered intravenously at 200mg/d1, 21 days per cycle, with at least 4 cycles completed.

DRUGCapecitabine

Oral capecitabine 825mg/m2 bid, radiotherapy day concurrent chemotherapy. Chemotherapy regimen after radiotherapy: XELOX regimen: oxaliplatin intravenous infusion of 130mg/m2/d1+ oral capecitabine 1000mg/m2 bid/ d1-14, 21 days per cycle, at least 2 cycles completed.

DRUGOxaliplatin

Chemotherapy regimen after radiotherapy: XELOX regimen: oxaliplatin intravenous infusion of 130mg/m2/d1+ oral capecitabine 1000mg/m2 bid/ d1-14, 21 days per cycle, at least 2 cycles completed.

RADIATIONSIB-IMRT

The tumor and the related mesenteric region 1cm above and below were simultaneously integrated boost to 5600cGy with the intensity-modulated radiotherapy. The other dose for clinical target volume is 5000 cGy.

RADIATIONIMRT

The whole dose of the clinical target volume is 5000 cGy with intensity-modulated radiotherapy.


Locations(1)

First Affiliated Hospital of Guangxi Medical University

Nanning, Guangxi, China

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