Actively Recruiting
Tuvonralimab and Iparomlimab Based Regimens for the Neoadjuvant Treatment of Biliary Tract Cancer
Led by Peking Union Medical College Hospital · Updated on 2025-12-05
45
Participants Needed
1
Research Sites
156 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
The goal of this clinical trial is to learn if Tuvonralimab/Iparomlimab-based neoadjuvant regimens can improve surgical and pathological outcomes in adults (≥18 years) with resectable or borderline-resectable biliary tract cancer (intrahepatic/extrahepatic cholangiocarcinoma or gallbladder cancer), ECOG 0-1, and no prior neoadjuvant therapy. The main questions it aims to answer are: 1. Does the regimen increase the R0 resection rate (negative margins)? 2. Does it raise major or pathologic complete response rates (MPR/pCR) and improve event-free survival (EFS) without increasing perioperative complications? Researchers will compare Tuvonralimab/Iparomlimab-based therapy + GEMOX chemotherapy to surgery to see if immunotherapy leads to higher R0 resection, deeper pathologic response, and better EFS/PFS/OS with acceptable safety. Participants will: Undergo baseline assessments: imaging (contrast-enhanced CT/MRI ± PET), labs, histology, and optional biomarker sampling. Receive neoadjuvant therapy: 2-4 cycles (\\\~6-12 weeks) of a Tuvonralimab/Iparomlimab-based regimen per protocol. Have restaging by RECIST 1.1; eligible participants proceed to curative-intent surgery with central review of margins and tumor regression grading (TRG/MPR/pCR). Receive protocol-directed postoperative management and safety monitoring (CTCAE v5.0) and be followed every 8-12 weeks for EFS, PFS, OS, conversion-to-resection rate, nodal down-staging, perioperative complications, length of stay, and any surgery delays.
CONDITIONS
Official Title
Tuvonralimab and Iparomlimab Based Regimens for the Neoadjuvant Treatment of Biliary Tract Cancer
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Subjects voluntarily consented and can comply with follow-up
- Age 18 to 75 years, any gender
- Diagnosed with bile duct cancer by histology or imaging with borderline resectability
- At least one measurable lesion per RECIST 1.1 criteria (≥10mm CT diameter or ≥15mm lymph node short diameter)
- No prior systemic treatment
- Locally advanced disease without distant metastasis, with potential for R0 resection
- One of these vascular or bile duct involvement situations: affected main portal vein or hepatic artery segment with possible reconstruction; tumor involving bile duct beyond one secondary branch but sparing primary opposite branch; suspected regional lymph node metastasis without distant nodes or peritoneal implants
- ECOG score 0-1 within one week before enrollment
- Adequate hematology and organ function per lab tests within 14 days prior to treatment
- Fertile women agree to abstain or use effective contraception during and 6 months after treatment
- Men agree to abstain or use contraception and not donate sperm
You will not qualify if you...
- Prior systemic treatment
- ECOG score greater than 1
- Confirmed distant liver metastasis
- Pregnant or breastfeeding women
- Allergy to PD-1 or CTLA-4 monoclonal antibodies or their components
- Major surgery within 4 weeks before first drug dose or unhealed surgical wounds
- Significant cardiovascular or cerebrovascular disease within 6 months
- Impaired liver or kidney function beyond specified thresholds
- Persistent infection grade 2 or higher
- History of thromboembolic events within 6 months
- Uncontrolled hypertension
- Active or recent autoimmune diseases requiring immunosuppression
- Known active CNS metastasis or cancerous meningitis
- Prior organ or bone marrow transplant
- Active tuberculosis
- Recent gastrointestinal bleeding or fistula
- HIV infection
- Active hepatitis B or C without adequate treatment
- Severe non-healing wounds, ulcers, or fractures
- Drug abuse or medical/social conditions affecting safety or compliance
- Unresolved toxicities above grade 1 from prior treatments
- Severe lung function impairment or related lung diseases
- Recent use of potent CYP3A4 inhibitors or inducers
- Other untreated malignant tumors within past 5 years except certain treated cancers
- Investigator determination of unsuitability
- Concurrent participation in another clinical trial
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Trial Site Locations
Total: 1 location
1
Peking Union Medical College Hospital
Beijing, Beijing Municipality, China, 100730
Actively Recruiting
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
1
Not the Right Trial for You?
Explore thousands of other clinical trials that might be a better match.
Sign up to get personalized trial recommendations delivered to your inbox.
Already have an account? Log in here