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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: |
ChiCTR2500112528 |
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最近更新日期: Date of Last Refreshed on: |
2025-11-17 08:23:17 |
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注册时间: Date of Registration: |
2025-11-17 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: |
新辅助维迪西妥单抗联合化疗联合或不联合 PD-1 抑制剂治疗局部进展期 HER2 低表达(HER2 1+或 HER2 2+FISH-)胃或食管胃结合部腺癌患者的 II 期临床研究 |
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Public title: |
Phase II Trial of Neoadjuvant Disitamab Vedotin Combined with Chemotherapy with or without PD-1 Inhibitor in Locally Advanced HER2-Low (IHC 1+ or IHC 2+/FISH-) Gastric/Gastroesophageal Junction Adenocarcinoma |
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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: |
新辅助维迪西妥单抗联合化疗联合或不联合 PD-1 抑制剂治疗局部进展期 HER2 低表达(HER2 1+或 HER2 2+FISH-)胃或食管胃结合部腺癌患者的 II 期临床研究 |
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Scientific title: |
Phase II Trial of Neoadjuvant Disitamab Vedotin Combined with Chemotherapy with or without PD-1 Inhibitor in Locally Advanced HER2-Low (IHC 1+ or IHC 2+/FISH-) Gastric/Gastroesophageal Junction Adenocarcinoma |
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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: |
聂润聪 |
研究负责人: |
李元方 |
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Applicant: |
Runcong Nie |
Study leader: |
Yuanfang Li |
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申请注册联系人电话: Applicant telephone: |
+86 156 2644 7119 |
研究负责人电话:
Study leader's |
+86 135 0306 5940 |
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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: |
nierc@sysucc.org.cn |
研究负责人电子邮件: Study leader's E-mail: |
liyuanf@sysucc.org.cn |
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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东风东路651号 |
研究负责人通讯地址: |
广东省广州市越秀区东风东路651号 |
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Applicant address: |
651 Dongfeng East Road, Yuexiu District, Guangzhou City, Guangdong |
Study leader's address: |
651 Dongfeng East Road, Yuexiu District, Guangzhou City, Guangdong |
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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: |
中山大学肿瘤防治中心 |
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Applicant's institution: |
Sun Yat-Sen University Cancer Center |
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研究负责人所在单位: |
中山大学肿瘤防治中心 |
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Affiliation of the Leader: |
Sun Yat-Sen University Cancer Center |
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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: |
B2025-522-X01 |
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: |
中山大学肿瘤防治中心伦理委员会 |
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Name of the ethic committee: |
Ethics Committee of Sun Yat-sen University Cancer Center |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-11-12 00:00:00 | ||
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伦理委员会联系人: |
袁中玉 |
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Contact Name of the ethic committee: |
Zhongyu Yuan |
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伦理委员会联系地址: |
广东省广州市先烈南路23号翠园楼316室 |
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Contact Address of the ethic committee: |
Room 316, Cuiyuan Building, 23 Xianlie South Road, Guangzhou, Guangdong |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 20 8734 3009 |
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: |
中山大学肿瘤防治中心 |
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Primary sponsor: |
Sun Yat-sen University Cancer Center |
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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东风东路651号 |
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Primary sponsor's address: |
651 Dongfeng East Road, Yuexiu District, Guangzhou, Guangdong, China |
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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: |
荣昌生物制药(烟台)股份有限公司 |
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Source(s) of funding: |
RemeGen (Yantai) Co., Ltd. |
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研究疾病: |
胃/食管胃结合部腺癌 |
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Target disease: |
Gastric or gastro-esophageal junction adenocarcinoma |
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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: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
主要目的: 评估新辅助维迪西妥单抗联合化疗联合或不联合PD-1抑制剂治疗局部进展期HER2低表达(HER2 1+或 HER2 2+FISH-)胃/食管胃结合部腺癌的有效性。 次要目的: 评估新辅助维迪西妥单抗联合化疗联合或不联合PD-1抑制剂治疗局部进展期HER2低表达(HER2 1+或 HER2 2+FISH-)胃/食管胃结合部腺癌的安全性。 探索性目的: 1. 评估肿瘤组织 HER2 表达的不同状态(HER2 1+ VS. HER2 2+)与抗肿瘤应答的相关性。 2. 评估肿瘤组织程序性死亡受体-配体 1(PD-L1)表达情况、肿瘤组织 EB 病毒(EBV)表达、微卫星不稳定性(MSI)状态与抗肿瘤应答情况的相关性 3. 探索免疫相关的其它潜在预测抗肿瘤应答的指标 |
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Objectives of Study: |
Primary Objective: To evaluate the effectiveness of neoadjuvant Disitamab Vedotin in combination with chemotherapy with or without PD-1 inhibitors in the treatment of locally advanced stage HER2-low expression (HER2 1+ or HER2 2+FISH-) gastric/esophagogastric junction adenocarcinoma. Secondary objective: To evaluate the safety of neoadjuvant Disitamab Vedotin in combination with chemotherapy with or without PD-1 inhibitors in the treatment of locally advanced stage HER2-low expression (HER2 1+ or HER2 2+FISH-) gastric/esophagogastric junction adenocarcinoma. Exploratory Objectives: 1. To evaluate the correlation between different status of HER2 expression in tumor tissues (HER2 1+ VS. HER2 2+) and anti-tumor responses. 2. To evaluate the correlation between programmed death receptor-ligand 1 (PD-L1) expression, Epstein-Barr virus (EBV) expression in tumor tissue, and microsatellite instability (MSI) status and anti-tumor response in tumor tissue. 3. Explore other potential indicators of immune-related predictors of anti-tumor response. |
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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: |
入选研究的患者必须满足以下所有条件: 1)对本研究已充分了解并自愿签署知情同意书(ICF); 2)组织学确诊的胃/食管胃结合部腺癌,根据增强 CT/MRI 检查进行临床分期 II/III 期,也即分期为 cT1-2N+M0 或 cT3-4aNanyM0; 3)免疫组化 HER2 1+或 HER2 2+且 FISH 检测阴性; 4)同意提供既往储存的肿瘤组织标本或者进行活检以采集肿瘤病灶组织送往中心实验室进行 HER2、PD-L1、EBV、MSI IHC 检测; 5)性别不限,年龄 18-75 周岁; 6)一般状况好,ECOG 评分在 0-1 分,无手术禁忌症; 7)体力状况及脏器功能允许接受较大的腹部手术; 8)预期生存期 ≥ 3 月; 9)入组前 7 天内实验室检查值必须符合以下标准: a. WBC > 4.0×109/L 和 < 15×109/L,ANC > 1.5×109/L,Hb ≥80g/L,PLT ≥ 100×109/L; b. 血清胆红素 ≤ 1.5×ULN(正常值高限),AST、ALT ≤ 2.5×ULN; c. 肌 酐 ≤ 1.5 × ULN 且 血 清 清 除 率 > 60ml/min , 根 据Cockcroft-Gault 肾小球滤过率预估值: (140 ? 年龄)×(体重, kg)×(0.85,如果是女性)/72 ×(血清肌酐, mg/dL) 或: (140 ? 年龄)×(体重, kg)×(0.85,如果是女性)/0.818 ×(血清肌酐, umol/L) d. INR 和 aPTT ≤ 1.5 × ULN,仅适用于未接受抗凝治疗的受试者;接受抗凝治疗受试者应采用稳定剂量 10)依从性好,可配合本方案的实验室、辅助检查以及相应的标本收集; 11)具有生育能力的女性(包括因化学绝经或其他医学原因导致绝经的女性)必须同意在从签署知情同意书到研究治疗或伴随化疗末次给药后至少 5 个月(以较晚者为准)期间采取避孕措施。女性也必须同意在从签署知情同意书到研究药物或伴随化疗末次给药后至少 5 个月(以较晚者为主)期间不进行哺乳;男性必须同意在从试验药品给药到试验药品或伴随化疗给药后至少 7 个月(以较晚者为主)期间采取避孕措施。 |
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Inclusion criteria |
Patients eligible for the study must meet all of the following criteria: 1. Have a full understanding of the study and voluntarily sign the informed consent form (ICF). 2. Histologically confirmed gastric or esophagogastric junction adenocarcinoma, clinically staged as II/III based on enhanced CT/MRI scans, i.e., staged as cT1-2N+M0 or cT3-4aNanyM0. 3. Immunohistochemistry HER2 1+ or HER2 2+ with negative FISH test. 4. Agree to provide either archived tumor tissue specimens or undergo biopsy to collect tumor tissue for HER2, PD-L1, EBV, and MSI immunohistochemistry (IHC) testing at the central laboratory. 5. Age between 18 and 75 years, regardless of gender. 6. Good general condition, with an ECOG score of 0-1 and no surgical contraindications. 7. Physical condition and organ function allow for acceptance of major abdominal surgery. 8. Expected survival period >= 3 months. 9. Laboratory values within the following criteria within 7 days before enrollment: a. WBC > 4.0×10^9/L and < 15×10^9/L, ANC > 1.5×10^9/L, Hb >= 90g/L, PLT >= 100×10^9/L. b. Serum bilirubin <= 1.5× upper limit of normal (ULN), AST, ALT <= 2.5× ULN. c. Creatinine <= 1.5× ULN or serum clearance rate > 60ml/min, estimated glomerular filtration rate according to Cockcroft-Gault formula: (140 - age) × (weight, kg) × (0.85 for females)/72 × (serum creatinine, mg/dL) or: (140 - age) × (weight, kg) × (0.85 for females)/0.818 × (serum creatinine, μmol/L). d. INR and aPTT <= 1.5 × ULN, applicable only for subjects not receiving anticoagulant therapy; subjects receiving anticoagulant therapy should be on stable doses. 10. Good compliance and willingness to cooperate with laboratory tests, auxiliary examinations, and corresponding specimen collection according to the protocol. 11. Women of childbearing potential (including those who are postmenopausal due to chemical menopause or other medical reasons) must agree to use contraception from the signing of the informed consent form until at least 5 months after the last dose of study treatment or adjuvant chemotherapy (whichever is later). Women must also agree not to breastfeed during this period. Men must agree to use contraception from the administration of the investigational drug until at least 7 months after the last dose of investigational drug or adjuvant chemotherapy (whichever is later). |
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排除标准: |
1.已知对一水枸橼酸、二水枸橼酸钠、甘露醇、聚山梨酯过敏者(试验药物的组分); 2.既往或现在同时患有其它恶性肿瘤(完全切除的基底细胞癌、I期鳞状细胞癌、原位癌、粘膜内癌、浅表膀胱癌或任何其他已至少5年未复发的癌症除外); 3.入组2周内有无法控制的心包积液、胸腔积液或腹水、消化道出血或有出血高风险; 4.入组2周内体重下降超过20%; 5.无法口服药物; 6.既往有化疗、放疗、免疫治疗或胃癌手术治疗等病史; 7.既往使用过抗HER2、抗PD-1抗体、抗PD-L1抗体、抗PD-L2抗体或抗CTLA-4抗体(或作用于T细胞协同刺激或检查点通路的任何其它抗体); 8.入组前2 周内接受过酪氨酸激酶抑制剂治疗; 9.患有需要长期使用免疫抑制药物治疗、或需要全身或局部使用具有免疫抑制作用剂量(剂量 > 10mg/天的泼尼松或其它等疗效激素)的皮质类固醇的合并症; 10.入组前4周内接种过任何抗感染疫苗(如流感疫苗、水痘疫苗等); 11.非得到控制的糖尿病、高血压等全身性疾病; 12.正在接受或需要抗凝血剂治疗(包括低剂量阿司匹林的抗血小板治疗除外); 13.受试者存在任何活动性自身免疫性疾病或有自身免疫性疾病病史(包括但不限于:间质性肺炎、葡萄膜炎、肠炎、肝炎、垂体炎、肾炎、甲状腺功能亢进、甲状腺功能降低;患有白癜风或在童年期哮喘已完全缓解,成人后无需任何干预的受试者可纳入;患有需要支气管扩张剂进行医学干预的哮喘则不能纳入); 14.患有活动性肺结核(TB)的受试者,正在接受抗结核治疗或者筛选前1年内接受过抗结核治疗; 15.根据影像学(最好是CT)或临床结果确诊有以下肺部疾病史:间质性肺炎、非感染性肺炎、肺纤维化、急性肺疾病; 16.存在奥沙利铂或卡培他滨使用禁忌; 17.妊娠或哺乳期妇女或可能妊娠者; 18.无活动性肝炎; 19.以下任何检查的结果阳性:人类免疫缺陷病毒-1(HIV-1)抗体、人类免疫缺陷病毒-2(HIV-2)抗体、人嗜T淋巴细胞病毒-1(HTLV-1)抗体、丙型肝炎病毒(HCV)抗体; 20.研究者认为可影响方案依从性,或影响受试者签署知情同意书(ICF),或不适宜参加本临床试验的具有临床意义的任何其它疾病或状况。 |
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Exclusion criteria: |
Patients meeting any of the following criteria must not be enrolled: 1. Known allergy to any component of the investigational drugs, including monohydrate citric acid, sodium dihydrate citrate, mannitol, and polysorbate. 2. Previous or concurrent malignancies, except for completely excised basal cell carcinoma, stage I squamous cell carcinoma, carcinoma in situ, mucosal carcinoma, superficial bladder carcinoma, or any other cancer without recurrence for at least 5 years. 3. Uncontrollable pericardial effusion, pleural effusion, ascites, gastrointestinal bleeding, or high-risk bleeding within 2 weeks before enrollment. 4. Weight loss exceeding 20% within 2 weeks before enrollment. 5. Inability to take oral medications. 6. History of chemotherapy, radiotherapy, immunotherapy, or gastric cancer surgery. 7. Previous use of anti-HER2, anti-PD-1 antibody, anti-PD-L1 antibody, anti-PD-L2 antibody, or anti-CTLA-4 antibody (or any other antibody acting on T cell co-stimulation or checkpoint pathways). 8. Receipt of tyrosine kinase inhibitor therapy within 2 weeks before enrollment. 9. Complications requiring long-term use of immunosuppressive drugs or requiring systemic or local administration of corticosteroids with immunosuppressive doses (> 10mg/day of prednisone or equivalent) before enrollment. 10. Vaccination with any anti-infective vaccines (such as influenza vaccine, varicella vaccine, etc.) within 4 weeks before enrollment. 11. Uncontrolled diabetes, hypertension, or other systemic diseases. 12. Receiving or requiring anticoagulant therapy (excluding low-dose aspirin antiplatelet therapy). 13. Active autoimmune diseases or history of autoimmune diseases (including but not limited to: interstitial pneumonia, uveitis, enteritis, hepatitis, pituitary inflammation, nephritis, hyperthyroidism, hypothyroidism; subjects with vitiligo or childhood asthma completely relieved, and no intervention required in adulthood may be included; subjects with asthma requiring bronchodilators for medical intervention in adulthood cannot be included). 14. Active pulmonary tuberculosis (TB), undergoing anti-tuberculosis treatment, or having received anti-tuberculosis treatment within 1 year before screening. 15. History of the following pulmonary diseases confirmed by imaging (preferably CT) or clinical results: interstitial pneumonia, non-infectious pneumonia, pulmonary fibrosis, acute pulmonary diseases. 16. Contraindications to oxaliplatin or capecitabine. 17. Pregnant or lactating women or women of childbearing potential. 18. No active hepatitis. 19. Positive results for any of the following tests: human immunodeficiency virus-1 (HIV-1) antibody, human immunodeficiency virus-2 (HIV-2) antibody, human T-lymphotropic virus-1 (HTLV-1) antibody, hepatitis C virus (HCV) antibody. 20. Any other clinically significant diseases or conditions that investigators believe may affect protocol compliance, affect subjects' signing of informed consent forms (ICFs), or are not suitable for participation in this clinical trial. |
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研究实施时间: Study execute time: |
从 From 2025-11-17 00:00:00至 To 2027-11-17 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2025-11-17 00:00:00 至 To 2027-11-17 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): |
研究人员使用临床试验随机化系统(IWRS)将合适的受试者随机分配至新辅助维迪西妥单抗+XELOX 治疗(A 组)及新辅助维迪西妥单抗+XELOX+PD1 抑制剂治疗(B 组)。 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Researchers used the clinical trial interactive web response system (IWRS) to randomly assign eligible subjects to either neoadjuvant disitamab vedotin plus XELOX (Group A) or neoadjuvant disitamab vedotin plus XELOX plus a PD-1 inhibitor (Group B). |
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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: |
无 |
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Blinding: |
None |
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是否共享原始数据: IPD sharing |
否No |
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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): |
无 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
None |
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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: |
病历记录表 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
CRF |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
暂未确定/Not yet |