Actively Recruiting

Phase Not Applicable
Age: 18Years - 75Years
All Genders
ID06349044

Randomized Phase II Study of Hypofractionated Radiotherapy Followed by Immunotherapy With or Without L. Rhamnosus M9 for Advanced Digestive System Cancers

Led by Zhejiang Cancer Hospital · Updated on 2024-08-27

120

Participants Needed

1

Research Sites

N/A

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating a combined treatment approach for advanced gastrointestinal tumors, focusing on the interaction between radiation therapy and immunotherapy. The study aims to design a first-line treatment protocol using macrofractionated radiotherapy to activate the immune system, along with the potential synergistic effects of the Probio-M9 microbial agent and PD-1 inhibitors. This randomized, multicenter phase II basket study includes patients with various advanced digestive system malignancies such as gastric adenocarcinoma, hepatocellular carcinoma, biliary tract carcinoma, and colorectal adenocarcinoma. Participants are assigned to receive either Probio-M9 with hypofractionated radiotherapy or a placebo with radiotherapy, followed by immunotherapy-based systemic treatments. The radiotherapy involves targeting one primary or metastatic tumor focus with doses of 5-10 Gy per fraction over 3-5 fractions. Immunotherapy includes administration of anti-PD-1 monoclonal antibodies and chemotherapy agents such as oxaliplatin, capecitabine, bevacizumab, gemcitabine, and cisplatin, depending on the cancer type. The study groups correspond to specific tumor types and compare the effects of adding Probio-M9 to standard treatment. During the study, participants will be monitored through assessments of tumor response using the objective response rate (ORR) at two months after radiotherapy. Additional evaluations include adverse effects, quality of life, progression-free survival, and overall survival with follow-ups lasting up to 10 years. Safety and treatment adherence will be closely observed. The total participation timeline includes regular clinical visits and assessments to measure treatment outcomes and patient well-being.

CONDITIONS

Brief Title

A Randomized, Multicenter Phase II Basket Study of Hypofractionated Radiotherapy/Stereotactic Body Radiotherapy Followed by Immunotherapy-Based Systemic Therapy +/- L. Rhamnosus M9 for the First-Line Treatment of Advanced Digestive System Malignancies.

Who Can Participate

Age: 18Years - 75Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Histopathologically confirmed diagnosis of malignant tumors of the gastrointestinal tract, including Her-2 negative adenocarcinoma of the gastroesophageal junction/gastric adenocarcinoma, hepatocellular carcinoma, malignant tumors of the biliary system, or colorectal cancer
  • Advanced patients initially evaluated as non-operable resectable who have not received any antitumor therapy
  • At least one measurable or evaluable lesion per RECIST v1.1 criteria, with non-operable resectable lymph node metastases excluding brain metastases
  • Age between 18 and 75 years
  • ECOG performance status of 0 or 1
  • Able to accept the treatment regimen during the study
  • Signed written informed consent
Not Eligible

You will not qualify if you...

  • History of uncontrolled epilepsy, central nervous system disease, or severe psychiatric disorder interfering with consent or adherence
  • Prior immunotherapy or severe hypersensitivity to monoclonal antibodies
  • Active cardiac disease including symptomatic coronary artery disease, NYHA class II or worse heart failure, severe arrhythmias needing treatment, or myocardial infarction within last 12 months
  • Organ transplantation requiring immunosuppressive therapy
  • History of other malignant disease within last five years
  • Severe uncontrolled infections or other severe concomitant diseases
  • Baseline blood and biochemical values outside specified limits (hemoglobin, neutrophils, platelets, liver enzymes, bilirubin, creatinine)
  • Active gastrointestinal diseases causing bleeding or risk of perforation
  • Active bleeding or bleeding tendencies
  • Pregnant or breastfeeding women
  • Allergy to any study drug ingredients

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)

Hypofractionated Radiotherapy

Duration - 3 to 5 treatment sessions over approximately 1 to 2 weeks

Participants receive hypofractionated radiotherapy targeting one primary or metastatic tumor lesion with 3 to 5 treatment sessions.

3 to 5 visits (in-person)

Immunotherapy-Based Systemic Treatment

Duration - Ongoing treatment cycles every 3 weeks until disease progression or discontinuation

Participants receive immunotherapy with anti-PD-1 monoclonal antibody and chemotherapy regimens as part of systemic treatment following radiotherapy.

Visits every 3 weeks for treatment administration and assessments

Follow-up and Monitoring

Duration - Up to 10 years

Participants are monitored for treatment response, adverse effects, and quality of life for up to several years after treatment.

Periodic visits as scheduled for assessments

Trial Site Locations

Total: 1 location

1

Zhengjiang Cancer Hospital

Hangzhou, Zhejiang, China

Actively Recruiting

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Research Team

Z

zhu ji

How is the study designed?

Study Type

INTERVENTIONAL

Masking

DOUBLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

8

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