Colon Carcinoma Clinical Trial
— NICHEOfficial title:
Neoadjuvant Immune Checkpoint Inhibition and Novel IO Combinations in Early-stage Colon Cancer (Amended Protocol of: Nivolumab, Ipilimumab and COX2-inhibition in Early Stage Colon Cancer: an Unbiased Approach for Signals of Sensitivity: The NICHE TRIAL)
In this exploratory study, patients with stage 1-3 adenocarcinoma of the colon with no signs of distant metastases will be treated with short-term immunotherapy + novel IO combinations (i.e. anti-IL 8, COX2-inhibitors). This treatment will be given during the window period until surgical resection of the tumor. The duration of treatment will be approximately 6 weeks.
Status | Recruiting |
Enrollment | 268 |
Est. completion date | December 2024 |
Est. primary completion date | December 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion criteria: - Signed written informed consent - Patients at least 18 years of age - Non-metastatic adenocarcinoma of the colon (and rectosigmoid considered as nonrectal and not undergoing neoadjuvant treatment) - No signs of distant metastases on CT-scan and physical examination; - dMMR cohorts 3+6: >cT3 and/or N+ Exclusion criteria: - No signs of distant metastases - No signs of obstruction or macroscopic bleeding or suspicion of perforation - Colonoscopy must be performed after registration to obtain study-specific biopsies. If biopsies are not possible, patients cannot be included in the study - WHO performance status of 0 or 1 - No previous treatment with immune checkpoint inhibitors targeting CTLA-4, PD-1 or PD-L1 - For patients with MSS tumors: no current use of NSAIDs or COX2-inhibitors at registration and no active peptic ulcer, gastrointestinal bleeding, unstable ischemic heart disease of thrombus etiology or significant established ischemic heart disease, peripheral arterial disease and/or cerebrovascular disease - No radiotherapy prior to or planned post-surgery radiotherapy - No history of allergy to study drug components, severe hypersensitivity reaction to any monoclonal antibody, allergy or severe hypersensitivity to NSAIDs or COX2-I (MSS tumors) - No intercurrent illnesses, including but not limited to infections, unstable angina pectoris - No positive test for hepatitis B virus surface antigen (HBsAg) or hepatitis C virus ribonucleic acid (HCV antibody) indicating acute or chronic infection - No autoimmune disease - No conditions requiring systemic treatment with either corticosteroids (10 mg daily prednisone or more and equivalents) or other immunosuppressive medications within 14 days of study drug administration - No live vaccines in the 4 weeks prior to inclusion |
Country | Name | City | State |
---|---|---|---|
Netherlands | Marieke van de Belt | Amsterdam | |
Netherlands | OLVG | Amsterdam | |
Netherlands | Haga ziekenhuis | Den Haag | |
Netherlands | Catharina Ziekenhuis | Eindhoven | |
Netherlands | Spaarne Ziekenhuis | Haarlem | |
Netherlands | Tergooi | Hilversum |
Lead Sponsor | Collaborator |
---|---|
The Netherlands Cancer Institute | Bristol-Myers Squibb |
Netherlands,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Incidence of adverse events during the treatment and follow-up (safety) | Adverse events will be assessed (according to CTCAE v4.0) during treatment and follow-up. | until 100 days after last patient last study drug treatment | |
Primary | Disease free survival | To assess efficacy of neoadjuvant ipilimumab plus nivolumab in terms of disease-free survival | until 5 years after diagnosis | |
Secondary | Immune activating capacity of short-term pre-operative immunotherapy | identify underlying potential escape mechanisms by comparing pre-treatment and post-treatment biopsies | within 2 years after study completion | |
Secondary | Relapse free survival | 3-5 years after last patient inclusion. |
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