Actively Recruiting

Phase 2
Age: 18Years - 70Years
All Genders
ID06831175

Phase II Study of PD-1 Inhibitor Camrelizumab Combined With Apatinib and Mitotane in the Treatment of Advanced Adrenal Cortical Carcinoma

Led by West China Hospital · Updated on 2025-06-03

28

Participants Needed

1

Research Sites

260 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Adrenal cortical carcinoma (ACC) is a rare and aggressive cancer with a low 5-year survival rate ranging from 12% to 47%. For advanced ACC, first-line treatment typically involves mitotane alone or combined with chemotherapy, but its effectiveness is limited with progression-free survival around one year and response rates between 10% and 30%. This study aims to evaluate the safety and effectiveness of combining the PD-1 inhibitor camrelizumab with apatinib and mitotane to explore a new treatment option for advanced ACC patients. In this phase II trial, participants will receive camrelizumab at 200 mg intravenously every three weeks, apatinib at 250 mg taken orally once daily, and oral mitotane with plasma levels monitored to maintain a target concentration between 14 and 20 mg/L. The study treatment is designed to assess the combined impact of these three drugs on advanced ACC, without comparison to placebo or other groups. Participants will be monitored for up to 24 months to measure the objective response rate, while secondary outcomes include disease-free survival, progression-free survival, and the incidence of adverse events over 60 months. The study involves regular visits for treatment delivery, laboratory tests, and assessments of tumor response. Safety and treatment effects will be closely tracked throughout the study period, with total participation lasting several years depending on individual outcomes.

CONDITIONS

Brief Title

Phase II Study of PD-1 Inhibitor Combined With Apatinib and Mitotane in the Treatment of Advanced Adrenal Cortical Carcinoma

Who Can Participate

Age: 18Years - 70Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Histopathological diagnosis of adrenocortical carcinoma
  • Unresectable advanced adrenocortical carcinoma without prior first-line standard treatment
  • Age 18 to 70 years
  • No gender restriction
  • Eastern Cooperative Oncology Group (ECOG) score of 0-1
  • At least one measurable lesion by RECIST v1.1
  • Adequate major organ function within 28 days before treatment meeting specific blood, biochemical, coagulation, and cardiac marker criteria
  • Women of childbearing potential must agree to use contraception during and for 120 days after the study, with a negative pregnancy test before entry
  • Men must agree to use contraception during and for 6 months after the study
  • Willingness and ability to provide informed consent and comply with study procedures
Not Eligible

You will not qualify if you...

  • History of other malignant tumors within 5 years except certain cured cancers
  • Allergic reactions to monoclonal antibodies, mitotane, apatinib, or excipients
  • Symptomatic CNS metastases or progressive brain metastases requiring intervention
  • Recent use of potent CYP3A4 inhibitors or inducers
  • Uncontrolled hypertension
  • NYHA class III-IV heart failure
  • Arterial/venous thrombosis events within 1 year
  • QT interval greater than 500 ms
  • Prior systemic immunosuppressive therapy or prior anti-PD-1/PD-L1/CTLA-4 treatment
  • Tyrosine kinase inhibitor treatment within 2 weeks before study
  • Participation in other interventional drug trials within 4 weeks
  • Recent antineoplastic or live vaccine administration
  • Major surgery or trauma within 4 weeks
  • Serious infections or active pulmonary inflammation within 4 weeks
  • Active autoimmune diseases or history except stable thyroid or diabetes conditions
  • History of immunodeficiency or organ/bone marrow transplantation
  • History of non-infectious pneumonia
  • Active or recent pulmonary tuberculosis
  • Active hepatitis B or C infection
  • History of substance abuse
  • Gastrointestinal bleeding or bleeding risk
  • Pregnancy or lactation
  • Any condition or abnormality interfering with study participation or results according to investigator judgment

AI-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 - Up to 24 months

Participants receive Camrelizumab intravenously every 3 weeks, take Apatinib orally once daily, and take Mitotane orally with plasma concentration monitoring to achieve a target steady-state level.

Visits every 3 weeks for Camrelizumab infusion and regular monitoring visits for oral medications and plasma concentration

Trial Site Locations

Total: 1 location

1

West China Hospital

Chengdu, Sichuan, China, 610041

Actively Recruiting

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Research Team

X

Xingchen Peng, PhD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NA

Model

SINGLE_GROUP

Primary Purpose

TREATMENT

Number of Arms

1

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Published Research Related To This Trial

Etoposide, doxorubicin and cisplatin plus mitotane in the treatment of advanced adrenocortical carcinoma: a large prospective phase II trial.

Alfredo Berruti, Massimo Terzolo, Paola Sperone...

https://pubmed.ncbi.nlm.nih.gov/16172198

Clinical and biological features in the prognosis of adrenocortical cancer: poor outcome of cortisol-secreting tumors in a series of 202 consecutive patients.

Gwenaelle Abiven, Joel Coste, Lionel Groussin...

https://pubmed.ncbi.nlm.nih.gov/16670169

Adrenocortical carcinomas: surgical trends and results of a 253-patient series from the French Association of Endocrine Surgeons study group.

P Icard, P Goudet, C Charpenay...

https://pubmed.ncbi.nlm.nih.gov/11572030