Rectal Cancer Clinical Trial
Official title:
The Safety and Efficacy of Sintilimab Combined With Hypofractionated Radiotherapy in MSI-H/dMMR Rectal Cancer: a Prospective, Single-arm, Multicenter, Phase Ib Study
This prospective, single-arm study is conducted to investigate the safety and efficacy of Sintilimab combined with hypofractionated radiotherapy in patients with microsatellite instability-high (MSI-H)/ DNA mismatch repair-deficient (dMMR) non-metastatic rectal cancer.
Status | Recruiting |
Enrollment | 20 |
Est. completion date | November 2022 |
Est. primary completion date | November 2022 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: 1. Histologically confirmed rectal adenocarcinoma; 2. With DNA mismatch repair-deficient (dMMR) or microsatellite instability-high (MSI-H) status, whether or not being Lynch syndrome; 3. Not received any anti-rectal cancer treatment previously; for patients with Lynch syndrome, not received any anti-tumor therapy about rectal cancer diagnosed this time; 4. No distant metastasis except for lateral lymph nodes on thoracic and abdominal enhanced computed tomography (CT) scans; the distance between tumor's lower edge and anus within 15cm; clinical T stage =T2 on high-resolution pelvic magnetic resonance imaging (MRI); 5. Men and women =18 years of age; 6. Eastern Cooperative Oncology Group performance status score 0 or 1; 7. Adequate hematologic, hepatic, renal, thyroid and cardiac function: hemoglobin =90 g/L, neutrophils =1500/mm3, platelets =75,000/mm3; aspartate aminotransferase and alanine aminotransferase =3.0 × upper limit of normal (ULN), bilirubin =1.5 × ULN; creatinine =1.5 × ULN, creatinine clearance =50 mL/min; activated partial thromboplastin time, prothrombin time and international normalized ratio =1.5 × ULN; serum albumin =28 g/L;thyroid stimulating hormone and free thyroxine within ±10% of normal levels; no obvious abnormality in electrocardiogram; 8. Not received blood, blood products and hematopoietic growth factor (e.g. granulocyte colony-stimulating factor) within 2 weeks before inclusion; 9. Informed consent form signed; 10. Life expectancy of =3 months. Exclusion Criteria: 1. Allergic disease history, severe hypersensitivity to drugs, antibody products or Sintilimab; 2. Other malignancy history with disease free survival <5 years, except for curative in situ cervical cancer, curative skin basal cell carcinoma and curative gastrointestinal cancer by endoscopic mucoresection; 3. Current or past history of autoimmune diseases, including but not limited to: interstitial lung disease, uveitis, enteritis,active hepatitis (HBV DNA=103 copies/mL after regular antiviral therapy),nephritis, hyperthyroidism and hypothyroidism; 4. Immunosuppressant or corticosteroid (systemic or local) use to suppress immune function within 2 weeks before inclusion; 5. Severe infection needing intravenous antibiotics, antifungal agents or antiviral drugs, et al; 6. Congenital or acquired immunodeficiency such as HIV infection; active Hepatitis B (HBV DNA=103 copies/mL after regular antiviral therapy); 7. Having one of the following complications: massive gastrointestinal hemorrhage, gastrointestinal perforation or obstruction; symptomatic heart diseases including unstable angina, myocardial infarction and heart failure; uncontrollable diabetes mellitus or hypertension; uncontrollable diarrhea (interfering with daily activities although receiving adequate treatment); 8. Bleeding tendency or receiving thrombolytic or anticoagulant therapy; 9. Pregnant or breastfeeding female; male and female unwilling to take any contraceptive measures; 10. Psychiatric disorders that would interfere with cooperation with the requirements of the study; 11. Other conditions that investigators consider not suitable for this study. |
Country | Name | City | State |
---|---|---|---|
China | West China Hospital of Sichuan University | Chengdu | Sichuan |
Lead Sponsor | Collaborator |
---|---|
West China Hospital | Chengdu Third People's Hospital, First Affiliated Hospital of Chongqing Medical University, Sichuan Cancer Hospital and Research Institute, The Affiliated Hospital Of Southwest Medical University, Yunnan Cancer Hospital |
China,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Adverse reaction | Adverse reaction after receiving treatment of Sintilimab combined with hypofractionated radiotherapy and perioperative complications | up to 10 weeks | |
Secondary | Pathological response rate | Pathological response rate after treatment | 6-8 weeks after radiotherapy | |
Secondary | Complete resection rate | Complete resection rate after treatment | 6-8 weeks after radiotherapy | |
Secondary | Quality of life questionnaire | Quality of life during treatment | up to 10 weeks |
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