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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2500111188 |
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最近更新日期: Date of Last Refreshed on: |
2025-10-27 17:51:31 |
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注册时间: Date of Registration: |
2025-10-27 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
卡度尼利单抗(PD-1/CTLA-4双抗)联合化疗新辅助治疗高级别唾液腺癌的前瞻性探索性研究 |
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Public title: |
A Phase II Trial of Neoadjuvant Cadonilimab Combined with Chemotherapy Followed by Surgery and Radiation Therapy for Resectable High-Grade Salivary Gland Carcinoma |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
卡度尼利单抗(PD-1/CTLA-4双抗)联合化疗新辅助治疗高级别唾液腺癌的前瞻性探索性研究 |
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Scientific title: |
A Phase II Trial of Neoadjuvant Cadonilimab Combined with Chemotherapy Followed by Surgery and Radiation Therapy for Resectable High-Grade Salivary Gland Carcinoma |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
谢舒乐 |
研究负责人: |
林钊宇 |
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Applicant: |
Shule Xie |
Study leader: |
Zhaoyu Lin |
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申请注册联系人电话: Applicant telephone: |
+86 159 8914 6665 |
研究负责人电话:
Study leader's |
+86 159 8635 4617 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
584724537@qq.com |
研究负责人电子邮件: Study leader's E-mail: |
149728957@qq.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
广东省广州市越秀区沿江西路107号 |
研究负责人通讯地址: |
广东省广州市越秀区沿江西路107号 |
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Applicant address: |
No. 107 Yanjiang West Road, Yuexiu District, Guangzhou City, Guangdong Province |
Study leader's address: |
No. 107 Yanjiang West Road, Yuexiu District, Guangzhou City, Guangdong Province |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
中山大学孙逸仙纪念医院 |
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Applicant's institution: |
Sun Yat-sen Memorial Hospital, Sun Yat-sen University? |
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研究负责人所在单位: |
中山大学孙逸仙纪念医院 |
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Affiliation of the Leader: |
Sun Yat-sen Memorial Hospital, Sun Yat-sen University? |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
SYSKY-2025-592 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
中山大学孙逸仙纪念医院医学伦理委员会 |
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Name of the ethic committee: |
??Medical Ethics Committee, Sun Yat-sen Memorial Hospital, Sun Yat-sen University? |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-09-05 00:00:00 | ||
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伦理委员会联系人: |
区柳珊 |
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Contact Name of the ethic committee: |
liushan ou |
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伦理委员会联系地址: |
广东省广州市越秀区沿江西路107号 |
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Contact Address of the ethic committee: |
No. 107 Yanjiang West Road, Yuexiu District, Guangzhou City, Guangdong Province |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 81332471 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
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研究实施负责(组长)单位: |
中山大学孙逸仙纪念医院 |
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Primary sponsor: |
Sun Yat-sen Memorial Hospital, Sun Yat-sen University? |
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研究实施负责(组长)单位地址: |
广东省广州市越秀区沿江西路107号 |
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Primary sponsor's address: |
No. 107 Yanjiang West Road, Yuexiu District, Guangzhou City, Guangdong Province |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
公司资助 |
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Source(s) of funding: |
The project received ??financial support from a biotech company?? |
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研究疾病: |
唾液腺癌 |
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Target disease: |
Salivary gland carcinoma? |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
II期临床试验 | ||||||||||||||||||||||
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Study phase: |
2 |
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研究设计: |
单臂 |
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Study design: |
Single arm |
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研究目的: |
1.1 主要目的 评估卡度尼利单抗联合化疗新辅助治疗高级别唾液腺癌患者的MPR率(Major Pathological Response, MPR)。 1.2 次要目的 1)评估新辅助治疗后的手术完整切除率(Complete Resection Rate) 2)评估完全病理缓解率(Pathological Complete Response, PCR) 3)评估新辅助治疗后的客观缓解率(Objective Response Rate, ORR) 4)评估 2 年的无事件存率(Event Free Survival,EFS) 和总生存率(Overall Survival,OS) 5)评估卡度尼利单抗联合化疗作为新辅助治疗方案的安全性和对根治性切除术 的影像(根据 NCI-CTCAE v5 版评估,手术并发症根据 Clavien-Dindo 评分标准 评估) 6)评估患者治疗后的生活质量 1.3 探索性目的 存档和/或新鲜采集的肿瘤组织和采集的血液(或血液衍生物)中(联合治 疗之前或疾病进展时)的探索性生物标记物的状态,包括但不限于 ? 免疫组化(HER2、AR 等) ? 程序性细胞死亡蛋白配体-1(Programmed cell death 1 ligand 1,PD-L1)表 达 ? 外周血生物标志物(CD4+ T 细胞、CD8+ T 细胞、髓源性抑制细胞 (MDSC)、Treg 等) ? 肿瘤细胞和肿瘤微环境细胞的多重荧光测量 安全性分析集:包括至少接受 1 剂任何研究药物治疗(新辅助联合治疗的 任何组分)的所有患者。 有效性分析集:包括至少接受 1 剂任何研究药物治疗(新辅助联合治疗的 任何组分)且在该治疗后接受了根治性唾液腺癌切除术的所有患者。 |
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Objectives of Study: |
1.1 Primary Objective?? To evaluate the ??Major Pathological Response (MPR) rate?? in patients with high-grade salivary gland carcinoma treated with ??neoadjuvant cadonilimab combined with chemotherapy??. ??1.2 Secondary Objectives?? To evaluate the ??complete resection rate (CRR)?? after neoadjuvant therapy. To evaluate the ??pathological complete response (PCR) rate??. To evaluate the ??objective response rate (ORR)?? after neoadjuvant therapy. To evaluate the ??2-year event-free survival (EFS)?? and ??overall survival (OS)??. To evaluate the ??safety?? of cadonilimab combined with chemotherapy as a neoadjuvant treatment regimen, and its ??impact on definitive surgical resection?? (adverse events will be assessed according to the ??NCI-CTCAE v5.0??, and surgical complications will be graded using the ??Clavien-Dindo classification??). To evaluate ??patient-reported quality of life (QoL)?? after treatment. ??1.3 Exploratory Objectives?? To explore the status of ??exploratory biomarkers?? in ??archived and/or freshly collected tumor tissue and blood (or blood-derived samples)?? (either ??before combination treatment?? or ??at the time of disease progression??), including but not limited to: ??Immunohistochemistry (IHC)?? markers (e.g., HER2, AR, etc.) ??Programmed cell death 1 ligand 1 (PD-L1)?? expression ??Peripheral blood biomarkers?? (e.g., CD4? T cells, CD8? T cells, myeloid-derived suppressor cells [MDSCs], regulatory T cells [Tregs], etc.) ??Multiplex fluorescence assays?? for tumor cells and tumor microenvironment (TME) components ??Analysis Sets?? ??Safety Analysis Set??: Includes all patients who receive ??at least one dose of any study drug (any component of the neoadjuvant combination therapy)??. ??Efficacy Analysis Set??: Includes all patients who receive ??at least one dose of any study drug (any component of the neoadjuvant combination therapy)?? and subsequently undergo ??definitive surgical resection of salivary gland carcinoma??. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1.自愿参加本试验,能够提供书面版知情同意书,并且能理解并同意依从本项研究的要求以及评估时间表。 2.签署知情同意书之日年龄为 18 岁以上。 3.组织病理学或细胞组织学证实的高级别唾液腺癌患者,包括实性> 30%的低分化癌,高级别黏液表皮样癌,高级别多形性腺癌,淋巴上皮癌,唾液腺导管癌,高级别肌上皮癌,癌肉瘤,高级别腺癌。 4.用药前 21 天基于 CT,MRI 或 PET-CT 检查确认至少有 1 处可测量的病灶。 5.ECOG 的体能状态为>1 或 Karnofsky 体能状态为 80%。 6.可切除的唾液腺肿瘤(T3-4a,N0-2,AJCC 8th.。 7.必须提供根治术的肿瘤组织样本,同时要求能提供相关病理报告,可选择送检新鲜手术组织(>=50mg,肿瘤细胞含量>=20%.或送检病理白片(FFPE的组织块或 20 张新切的未染色 FFPE 组织切片,肿瘤细胞含量>=20%.。 8.患者的器官功能良好,由以下筛选期实验室检查值(入组前<=21 天获得.衡量: (1) 在筛选以下项目时,患者不得在采集样本前<=14 天使用生长因子支持 : 中性粒细胞绝对计数>=1.5x10^9/L 血小板>=100*10^9/L 血红蛋白>=90g/L (2)国际标准化比值或活化部分凝血活酶时间<=1.5 正常值上限(ULN. (3)血清总胆红素<=1.5*ULN(如果是 Gilbert 综合征或间接胆红素浓度显示为肝外源性升高,则应<=3*ULN. (4)AST、ALT 和碱性磷酸酶<=1.5*ULN.肺功能:FEV1>=50%预计值,DLCO>=40%。 9.男性或女性受试者应同意使用适当的避孕方法,从研究治疗的第一剂开始到研究的最后一剂后 6 个月(如宫内节育器、避孕药或避孕套);没有孕妇或哺乳期妇女,并且在随机分组前 7 天内收到阴性妊娠试验。 |
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Inclusion criteria |
1. Volunteer to participate in this trial, be able to provide written informed consent, and understand and agree to comply with the requirements of the study and the evaluation schedule. 2. Be at least 18 years of age on the date of signing the informed consent form. 3. Patients with histopathologically or cytohistologically confirmed high-grade salivary gland carcinoma, including solid > 30% poorly differentiated carcinoma, high-grade mucoepidermoid carcinoma, high-grade pleomorphic adenocarcinoma, lymphoepithelial carcinoma, ductal carcinoma of the salivary gland, high-grade myoepithelial carcinoma, carcinosarcoma, and high-grade adenocarcinoma. 4. Confirmation of at least 1 measurable lesion based on CT, MRI or PET-CT 21 days prior to dosing. 5. ECOG fitness status of >1 or Karnofsky fitness status of 80%. 6. Resectable salivary gland tumour (T3-4a, N0-2, AJCC 8th.). 7. Tumour tissue samples from radical surgery must be provided, along with a pathology report, either fresh surgical tissue (>=50mg, tumour cell content >=20%.) or white slices (>=20%.). Or send a pathology white slice (FFPE tissue block or 20 freshly cut unstained FFPE tissue sections with tumour cell content >=20%). 8. Patients with good organ function as measured by the following screening laboratory values (obtained <= 21 days prior to enrolment.). Measurements: (1) At screening for the following items, the patient must not be on growth factor support <=14 days prior to sample collection : Absolute neutrophil count >= 1.5x10^9/L Platelets >=100*10^9/L Haemoglobin >=90g/L (2) International normalised ratio or activated partial thromboplastin time <=1.5 upper limit of normal (ULN.). (3) Serum total bilirubin <=1.5*ULN (or <=3*ULN in the case of Gilbert's syndrome or if indirect bilirubin concentration is shown to be extrahepatic. (4) AST, ALT, and alkaline phosphatase <=1.5*ULN. Pulmonary function: FEV1 >= 50% of predicted value, DLCO >= 40%. 9.Male or female subjects should agree to use an appropriate method of contraception from the first dose of study treatment until 6 months after the last dose of the study (e.g., IUD, birth control pills, or condoms); be free of pregnant or lactating women and have received a negative pregnancy test within 7 days prior to randomisation to group. |
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排除标准: |
1.既往接受过免疫检查点抑制剂(抗 PD-1/L1、CTLA-4 或双抗); 2.影像学检查(CT 或 MRI)显示肿瘤包绕颈内动脉>180%或侵犯颅底; 3.初次给药前 2 个月内,有出血倾向证据或病史的受试者,无论严重程度如何; 初次给药前 2 周内有咯血史或未愈合的伤口、溃疡或骨折; 4.存在严重活动性自身免疫病。允许入选处于稳定状态,不需要系统性免疫抑制治疗的受试者,如:I 型糖尿病、只需要接受激素替代治疗的甲状腺功能减退症和无需行全身治疗的皮肤疾病(例如,白癜风、银屑病和脱发); 5.患有先天或后天免疫功能缺陷(如 HIV 感染者)、活动性乙肝(HBV- DNA>=104拷贝/ml)或丙肝(丙肝抗体阳性,且 HCR-RNA 高于分析方法的检测下限); 6.已知对研究药物或其任何辅料过敏;或者对其他单克隆抗体发生过严重过敏反应; 7.随机前 6 个月内,出现以下情况:心肌梗死、严重/不稳定型心绞痛、NYHA2 级以上心功能不全及症状性充血性心力衰竭; 8.首次使用研究药物前 4 周内接种过活疫苗,允许接受针对季节性流感,注射用药的灭活病毒疫苗,但是不允许接受经鼻使用药的减毒活流感疫苗; 9.已知异体器官移植史或异体造血干细胞移植史; 10.已知有精神类药物滥用或吸毒史。 11.妊娠期或哺乳期妇女; 12.进入研究前 5 年内曾诊断为任何其他恶性肿瘤,可进行局部治疗且已治愈的皮肤基底细胞癌或鳞状细胞癌、浅表性膀胱癌、宫颈原位癌、乳腺导管内原位癌和甲状腺乳头状癌除外; 13.存在其他严重身体或精神疾病或实验室检查异常,可能增加参与研究的风险,或干扰研究结果,以及研究者认为不适合参与本研究的患者。 |
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Exclusion criteria: |
1. Prior treatment with any immune-checkpoint inhibitor (anti-PD-1/PD-L1, anti-CTLA-4, or bispecific antibodies). 2. Imaging (CT or MRI) showing tumor encasing the internal carotid artery for > 180°or invading the skull base. 3. Evidence or history of bleeding diathesis within 2 months before first dose, or hemoptysis within 2 weeks, or unhealed wound, ulcer, or fracture. 4.Active severe autoimmune disease. Stable conditions not requiring systemic immunosuppression are permitted (e.g., type I diabetes, hypothyroidism on replacement therapy, vitiligo, psoriasis, or alopecia not requiring systemic therapy). 5. Congenital or acquired immunodeficiency (e.g., HIV infection), active hepatitis B (HBV DNA >= 10^4 copies/mL), or active hepatitis C (anti-HCV positive and HCV RNA detectable). 6. Known hypersensitivity to any study drug component or previous severe allergic reaction to another monoclonal antibody. 7. Within 6 months before randomization: myocardial infarction, severe/unstable angina, NYHA class >= 2 heart failure, or symptomatic congestive heart failure. 8. Live-virus vaccination within 4 weeks before first dose (inactivated influenza vaccine by injection is allowed; intranasal live attenuated influenza vaccine is not). 9. Prior allogeneic organ or hematopoietic stem-cell transplantation. 10. History of substance abuse (drugs or alcohol) or psychiatric disorder that may interfere with study compliance. 11. Pregnant or lactating women. 12. Any other malignancy within 5 years except adequately treated basal- or squamous-cell skin cancer, superficial bladder cancer, cervical carcinoma in situ, breast ductal carcinoma in situ, or papillary thyroid carcinoma. 13. Any concurrent severe medical or laboratory abnormality that, in the investigator’s opinion, could increase study-related risk, interfere with data interpretation, or render the patient unsuitable for the trial. |
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研究实施时间: Study execute time: |
从 From 2025-11-24 00:00:00至 To 2029-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2025-12-08 00:00:00 至 To 2027-12-31 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
无 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
none |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
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Blinding: |
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是否共享原始数据: IPD sharing |
是Yes |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
国家生物信息中心 China National center for Bioinformation (htp://ngdc.cncb.ac.cn/gsub/) 共享原始数据日期:2029-12-14 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
National biological information center, China National center for Bioinformation (HTP://NGDC. CNCB. Ac. Cn/gsub /) |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
临床试验中的文件(方案和方案修订,完成的 CRF,签署的 ICF 等)需按照GCP 的要求进行保存和管理。研究中心应将这些文件保存到研究结束后 5 年。 研究文件应合理保存,以便日后访问或数据溯源。保存文件时应考虑安全及环境风险问题。 研究者同意相关监管部门直接访问所有研究相关文件,包括受试者病历。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Documents in clinical trials (protocols and protocol revisions, completed CRFS, signed ICFs, etc.) need to be preserved and managed in accordance with the requirements of GCP. The research center should keep these documents for five years after the end of the research. Research documents should be properly preserved for future access or data traceability. When saving files, security and environmental risks should be taken into consideration. The researchers agreed that the relevant regulatory authorities could have direct access to all research-related documents, including the medical records of the subjects. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |