Status:

RECRUITING

Node-sparing Radiotherapy Combined with Total Neoadjuvant CAPOX and Sintilimab for MSS Middle and Low Rectal Cancer

Lead Sponsor:

Jinhua Central Hospital

Conditions:

Locally Advanced Rectal Cancer

Eligibility:

All Genders

18-75 years

Phase:

PHASE2

Brief Summary

phase II clinical trial to evaluate node-sparing short-course radiation combined with total neoadjuvant CAPOX and Sintilimab for MSS locally advanced rectal cancers.

Detailed Description

This is an open-label, prospective, single-center phase II clinical trial to evaluate node-sparing short-course radiation (Radiation targeting the tumor bed without irradiating surrounding tumor-drain...

Eligibility Criteria

Inclusion

  • Patients who have a strong willingness to preserve the anus and are willing to receive neoadjuvant therapy.
  • Male or Female aged 18-75.
  • Patients diagnosed with low rectal cancer within 10 cm from the lower edge of the tumor to the anal verge by pelvic MRI and anorectoscopy, the clinical stage is cT2N+M0/cT3-4aN0/+M0, the lymph nodes are limited to the mesorectum, the circumferential resection margin is negative.
  • Histologically confirmed rectal adenocarcinoma; Genetic testing suggests MSI-L or MSS, or tumor biopsy immunohistochemistry reveals pMMR, that is, MSH1, MSH2, MSH6, and PMS2 are all positive.
  • Eastern Cooperative Oncology Group (ECOG) 0-1.
  • No previous treatment(including anti-tumor therapy、immunotherapy or pelvic radiation).
  • Adequate hematologic, hepatic, renal, thyroid and cardiac function: white blood cells ≥3500/mm3, neutrophils ≥1800/mm3, platelets ≥100,000/mm3, hemoglobin ≥100 g/L; activated partial thromboplastin time, prothrombin time and international normalized ratio ≤1.5 × ULN; aspartate aminotransferase and alanine aminotransferase ≤3.0 × upper limit of normal (ULN), bilirubin ≤1.25 × ULN, serum albumin ≥28 g/L. creatinine clearance ≥50 mL/mi, creatinine ≤1.5 × ULN;
  • Informed consent form signed.

Exclusion

  • Patients with a previous history of malignant tumors besides rectal cancer.
  • Patients with distant metastases before enrollment.
  • Patients with positive internal or external iliac lymph nodes are assessed by MRI or CT.
  • Patients with obstruction, perforation, or bleeding that require emergency surgery.
  • Patients with severe concomitant diseases and estimated survival time ≤ 5 years.
  • Allergic to any component of the therapy.
  • Patients with poorly differentiated adenocarcinoma, signet ring cell carcinoma, or mucinous adenocarcinoma.
  • Patients who received immunosuppressive or systemic hormone therapy for immunosuppressive purposes within 1 month prior to the initiation of therapy.
  • Patients who have received any other experimental drug (including immunotherapy) or participated in another interventional clinical trial within 30 days before screening.
  • Factors leading to study termination, such as alcoholism, drug abuse, other serious illnesses (including psychiatric disorders) requiring combination therapy, and patients with severe laboratory abnormalities.
  • Patients with congenital or acquired immune deficiency (such as HIV infection).
  • Vulnerable groups, including mentally ill, cognitively impaired, critically ill patients, minors, pregnant or lactating women, illiterate, etc.
  • Other conditions that investigators consider not suitable for this study.

Key Trial Info

Start Date :

February 5 2024

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

September 1 2028

Estimated Enrollment :

37 Patients enrolled

Trial Details

Trial ID

NCT06204094

Start Date

February 5 2024

End Date

September 1 2028

Last Update

January 7 2025

Active Locations (1)

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1

Zhejiang University Affiliated Jinhua Hospital

Jinhua, Zhejiang, China, 0579