A Study on the Efficacy and Safety of Multi-mode Ablation Combined With Systemic Therapy in the Treatment of CRCLM
A Study on the Efficacy and Safety of Multi-mode Ablation Combined With Systemic Therapy Including PD-1 Inhibitor in the Treatment of Colorectal Cancer Liver Metastasis(CRCLM)
Shanghai 6th People's Hospital
20 participants
Mar 12, 2024
INTERVENTIONAL
Conditions
Summary
The goal of this study is to evaluate the efficacy and safety of multi-mode ablation combined with systemic therapy including PD-1(programmed death receptor 1) inhibitor for colorectal cancer liver metastasis and furthermore to clarify its application value by comparing preoperative and postoperative immune indicators.
Eligibility
Inclusion Criteria9
- Age 18-75 years, gender not specified;
- Pathologically or clinically confirmed colorectal cancer liver metastases, with liver lesions unsuitable for surgical resection or intolerance or refusal of surgical resection;
- In the case of an unresectable primary tumor or recurrence, the absence of serious complications such as bleeding or obstruction;
- Failure of first-line treatment, with disease progression or new liver metastases;
- No more than 5 liver lesions, with single lesion diameter ≤ 3cm;
- For those who have received previous chemotherapy, radiotherapy or local liver treatment, the interval from the last systemic treatment or local liver treatment should be at least 1 month;
- Child-Pugh A or B; bilirubin ≤ 3.0 mg/dL, creatinine ≤ 2.5 mg/dL, white blood cell count ≥ 2.0 ×10\^9/L, platelets ≥ 100 ×10\^9/L;
- ECOG PS ≤ 2;
- Willing to accept subsequent treatment regimens that include anti-PD-1 monoclonal antibody therapy.
Exclusion Criteria8
- Liver function Child-Pugh class C;
- Expected survival \< 3 months;
- Major organ insufficiency or failure;
- Active infection;
- Irreversible coagulation disorders;
- Refractory massive ascites, pleural effusion or cachexia;
- Unable to cooperate with treatment;
- Any other factors deemed inappropriate for inclusion or that may affect the subject's participation in the study, as determined by the investigator.
Interventions
All subjects are treated using the multi-mode tumor treatment system (Shanghai MAaGI Medical Technology Co., Ltd), with the treatment procedure conducted according to the temperature control mode for tumor ablation. Complete ablation of intrahepatic lesions is achieved to realize an intrahepatic no-evidence-of-disease (NED) state. For lesions that could not be ablated in a single session, two treatments are performed to achieve NED within the liver.
Systemic therapy including PD-1 inhibitor starts on the 7th day after ablation (sintilimab 200 mg IV D1 + mFOLFOX6 or FOLFIRI + bevacizumab or cetuximab (determined according to the subject's first-line chemotherapy regimen), Q3W, chemotherapy for 4-6 cycles. Sintilimab continues until disease progression, not exceeding a maximum of 2 years.）
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06590259