Actively Recruiting

Phase 3
Age: 18Years - 70Years
All Genders
ID06017583

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

Led by Yong Zhang,MD · Updated on 2023-10-11

48

Participants Needed

1

Research Sites

104 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating the safety and effectiveness of combining tislelizumab, a PD-1 inhibitor, with simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for treating locally advanced rectal cancer. This randomized controlled trial includes patients with stage T3-4 rectal cancer or positive regional lymph nodes without distant metastases, aiming to explore a new adjuvant chemotherapy model using PD-1 inhibitors alongside radiotherapy. Participants are randomly assigned to two groups. The experimental group receives concurrent SIB-IMRT radiotherapy with capecitabine chemotherapy, completes 2 to 4 cycles of XELOX chemotherapy, and receives intravenous tislelizumab every 21 days for at least 4 cycles. The control group receives standard intensity-modulated radiotherapy (IMRT) without tislelizumab, combined with the same chemotherapy regimens. During the study, tumor size is assessed by MRI or CT imaging, and side effects are carefully recorded. The main outcome measured is the complete response rate between 12 and 18 weeks after treatment. Secondary outcomes include monitoring side effects over 6 months and 3 years, as well as overall survival and disease-free survival over 3 years. Participation includes regular treatment cycles and follow-up evaluations to assess both safety and effectiveness up to three years after treatment begins.

CONDITIONS

Brief Title

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

Who Can Participate

Age: 18Years - 70Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Aged 18 to 70 years.
  • Diagnosed with rectal adenocarcinoma confirmed by histopathology.
  • Stage T3-4 in the eighth AJCC or positive regional lymph nodes without distant metastasis.
  • At least one measurable lesion according to RECIST 1.1.
  • ECOG performance status score of 0 or 1.
  • Expected survival time of at least 6 months.
  • Normal major organ function meeting specified blood and biochemical criteria.
  • Volunteered and signed informed consent with good compliance and willingness to follow up.
Not Eligible

You will not qualify if you...

  • History of other malignant tumors within 5 years.
  • Allergy or sensitivity to any study drugs.
  • Innate or acquired immune deficiency such as HIV infection.
  • Active or suspected autoimmune diseases or certain other conditions like vitiligo or asthma requiring bronchodilators.
  • Active infections requiring systemic treatment.
  • Prior treatment with PD-1, PD-L1, CTLA-4 antibodies, or related immunoregulatory drugs.
  • Unresolved toxic effects above CTCAE grade 1 from previous treatments, excluding alopecia.
  • History of serious heart conditions like myocardial infarction or stroke.
  • Recent major surgery, severe injury, or wounds within 4 weeks.
  • Pregnant or breastfeeding women.
  • Liver or kidney dysfunction.
  • History of psychotropic drug abuse or mental disorders affecting participation.
  • Participation in other drug clinical trials within 4 weeks.
  • Other diseases or conditions judged by investigators to affect safety or study completion.
  • Investigator determination that participation is not in the participant's best interest.

AI-Screening

AI-Powered Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - At least 12 weeks (4 cycles of 21 days each for tislelizumab and chemotherapy)

Participants receive neoadjuvant therapy including concurrent radiotherapy and chemotherapy. The experimental group receives simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) with concurrent capecitabine chemotherapy and at least 4 cycles of tislelizumab. The control group receives intensity-modulated radiotherapy (IMRT) without tislelizumab, along with concurrent capecitabine chemotherapy and 2 to 4 cycles of XELOX chemotherapy after radiotherapy.

Weekly visits during radiotherapy and chemotherapy cycles

Follow-up

Duration - Up to 3 years

Participants are monitored for side effects, overall survival, and disease-free survival after treatment completion.

Periodic visits for up to 3 years

Trial Site Locations

Total: 1 location

1

First Affiliated Hospital of Guangxi Medical University

Nanning, Guangxi, China, 530021

Actively Recruiting

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How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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