RecruitingPhase 2NCT06547203

Cetuximab, Irinotecan, Toripalimab in RAS/BRAF Wild-type Ultraselected Right-sided Colorectal Cancer Study

Negative Ultraselection of Patients With RAS/BRAF Wild-type Refractory Right-Sided Metastatic Colorectal Cancer Receiving Cetuximab in Combination With Toripalimab and Irinotecan: A Phase II, Single-arm Study

Sponsor

Sun Yat-sen University

Enrollment

34 participants

Start Date

Jul 18, 2024

Study Type

INTERVENTIONAL

Conditions

Colorectal Cancer Metastatic

Summary

The objective of this clinical trial is to evaluate the efficacy and safety of cetuximab combined with PD-1 inhibitor and irinotecan in negative ultraselection RAS/BRAF wild-type refractory right-sided metastatic colorectal cancer.

Eligibility

Min Age: 18 YearsMax Age: 80 Years

Inclusion Criteria16

Histologically confirmed colorectal adenocarcinoma.
Primary tumor located in the right colon.
Metastatic disease with at least one measurable lesion according to RECIST v1.1 criteria.
Histologically tested as RAS/BRAF V600E wild-type and negative ultraselected for mutations including: RAS/BRAF V600E/PIK3CA/PTEN/EGFR (ECD), HER2 and MET amplification, and ALK/RET/NTRK1 gene fusions.
Patients who have progressed after previous treatments including bevacizumab, irinotecan, oxaliplatin, and 5-fluorouracil, with tumor progression occurring during or within 3 months after irinotecan treatment.
No prior treatment with anti-EGFR or PD-1 antibodies.
Normal hematological function (platelets \>90×10\^9/L; white blood cells \>3×10\^9/L; neutrophils \>1.5×10\^9/L).
Serum bilirubin ≤1.5 times the upper limit of normal (ULN), transaminases ≤5 times ULN.
No ascites, normal coagulation function, albumin ≥35 g/L.
Liver function classified as Child-Pugh grade A.
Serum creatinine less than ULN, or calculated creatinine clearance \>50 ml/min (using the Cockcroft-Gault formula).
At least one measurable lesion according to RECIST v1.1 criteria.
ECOG performance status of 0-2.
Expected survival \>3 months.
Signed written informed consent.
Willing and able to undergo follow-up until death or study completion or termination.

Exclusion Criteria19

Severe arterial thrombosis or ascites.
Bleeding tendencies or coagulation disorders.
Hypertensive crisis or hypertensive encephalopathy.
Severe uncontrolled systemic complications such as infections or diabetes.
Clinically significant cardiovascular diseases such as cerebrovascular accident (within 6 months prior to enrollment), myocardial infarction (within 6 months prior to enrollment), uncontrolled hypertension despite appropriate medication, unstable angina, congestive heart failure (NYHA grade 2-4), or arrhythmias requiring medication.
History of or physical examination showing central nervous system diseases (e.g., primary brain tumor, uncontrolled epilepsy, any history of brain metastasis or stroke).
Other malignancies within the past 5 years (except for basal cell carcinoma of the skin after curative surgery and/or carcinoma in situ of the cervix).
Use of immunosuppressive drugs within 1 week before treatment, excluding nasal, inhaled, or other topical steroids or physiological doses of systemic steroids (i.e., not exceeding 10 mg/day of prednisone or an equivalent dose of other steroids) or steroids used to prevent contrast agent allergies.
Steroid-dependent interstitial lung disease.
Known active autoimmune disease requiring symptomatic treatment or history of such disease within the past 2 years. Patients with vitiligo, psoriasis, alopecia, or -Graves' disease not requiring systemic treatment within the past 2 years, hypothyroidism requiring only thyroid hormone replacement, and type I diabetes requiring only insulin replacement can be enrolled.
Known history of primary immunodeficiency.
Known active tuberculosis.
Known history of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation.
Receipt of any investigational drug treatment within the last 28 days before the study.
Allergy to any drugs in the study.
Pregnant or breastfeeding women.
Women of childbearing potential (within 2 years of last menstruation) or men capable of fathering a child who are not using or refuse to use effective non-hormonal contraceptive methods (e.g., intrauterine device, barrier method combined with spermicide, or sterilization).
Inability or unwillingness to comply with the study protocol.
Presence of any other disease, functional impairment caused by metastatic lesions, or suspicious conditions found during a physical examination indicating a contraindication to the study drugs or high risk for treatment-related complications.