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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: |
ChiCTR2600121582 |
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最近更新日期: Date of Last Refreshed on: |
2026-04-01 10:17:07 |
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注册时间: Date of Registration: |
2026-04-01 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: |
一项评估不同给药时段输注培鲁利单抗联合化疗新辅助治疗局部晚期胸段食管癌疗效与安全性的随机、三队列研究(TD-NICE-Timing) |
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Public title: |
A Randomized, Three-Cohort Study to Evaluate the Efficacy and Safety of Different Time-of-Day Administration of Serplulimab Combined with Chemotherapy as Neoadjuvant Therapy for Locally Advanced Thoracic Esophageal Squamous Cell Carcinoma (TD-NICE-Timing) |
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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: |
一项评估不同给药时段输注培鲁利单抗联合化疗新辅助治疗局部晚期胸段食管癌疗效与安全性的随机、三队列研究(TD-NICE-Timing) |
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Scientific title: |
A Randomized, Three-Cohort Study to Evaluate the Efficacy and Safety of Different Time-of-Day Administration of Serplulimab Combined with Chemotherapy as Neoadjuvant Therapy for Locally Advanced Thoracic Esophageal Squamous Cell Carcinoma (TD-NICE-Timing) |
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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: |
杨阳 |
研究负责人: |
闫小龙 |
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Applicant: |
Yang Yang |
Study leader: |
Yan Xiaolong |
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申请注册联系人电话: Applicant telephone: |
+86 176 9110 3508 |
研究负责人电话:
Study leader's |
+86 159 9126 9383 |
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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: |
yangyang20180809@163.com |
研究负责人电子邮件: Study leader's E-mail: |
yanxiaolong@fmmu.edu.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: |
中国陕西省西安市灞桥区新寺路569号 |
研究负责人通讯地址: |
中国陕西省西安市灞桥区新寺路569号 |
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Applicant address: |
569 Xinsi Road, Baqiao District, Xi'an, Shaanxi, China |
Study leader's address: |
569 Xinsi Road, Baqiao District, Xi'an, Shaanxi, China |
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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: |
空军军医大学唐都医院 |
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Applicant's institution: |
Tangdu Hospital,Air Force Medical University |
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研究负责人所在单位: |
空军军医大学唐都医院 |
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Affiliation of the Leader: |
Tangdu Hospital,Air Force Medical 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: |
第K202602-40号 |
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: |
第四军医大学唐都医院医学伦理委员会 |
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Name of the ethic committee: |
IEC of Institution for National Drug Clinical nials, Tangdu Hospital, Fourth Mlitary Medical University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2026-02-27 00:00:00 | ||
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伦理委员会联系人: |
李诗草 |
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Contact Name of the ethic committee: |
Li Shicao |
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伦理委员会联系地址: |
中国陕西省西安市灞桥区新寺路569号 |
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Contact Address of the ethic committee: |
569 Xinsi Road, Baqiao District, Xi'an, Shaanxi, China |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 29 8471 7761 |
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: |
空军军医大学唐都医院 |
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Primary sponsor: |
Tangdu Hospital, Air Force Medical University |
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研究实施负责(组长)单位地址: |
中国陕西省西安市灞桥区新寺路569号 |
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Primary sponsor's address: |
569 Xinsi Road, Baqiao District, Xi'an, Shaanxi, 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: |
上海复宏汉霖生物技术股份有限公司 |
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Source(s) of funding: |
Shanghai Henlius Biotech, Inc |
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研究疾病: |
食管鳞状细胞癌 |
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Target disease: |
Esophageal squamous cell 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: |
其它 | ||||||||||||||||||||||
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Study phase: |
N/A |
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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: |
1. 比较早间组,中间组,晚间组的病理完全缓解(pCR)率。 2. 评估主要病理缓解率(MPR)、无事件生存期(EFS)、3 年 EFS 率、总生存期(OS)、R0切除率;评估治疗的安全性和耐受性; 评估客观缓解率(ORR)、缓解持续时间(DOR)。 3. 探索昼夜节律类型、免疫细胞动态、细胞因子谱、皮质醇节律、PD-L1表达等生物标志物与疗效和安全性的关系。 |
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Objectives of Study: |
1. To compare the pathological complete response (pCR) rates among the morning cohort, midday cohort and evening cohort. 2. To evaluate major pathological response (MPR), event-free survival (EFS), 3-year EFS rate, overall survival (OS), and R0 resection rate; To evaluate the safety and tolerability of the treatment; To evaluate objective response rate (ORR) and duration of response (DOR). 3. To explore the association between biomarkers (including circadian rhythm type, dynamics of immune cells, cytokine profile, cortisol rhythm, PD-L1 expression, etc.) and treatment efficacy and safety. |
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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. 签署书面知情同意书,自愿加入本研究; 2. 病理组织学或细胞学确诊的食管鳞癌; 3. 经CT/MRI/EUS等评估为胸段食管癌且临床分期临床分期T1b-4aN+M0或T2-4N0M0(T2N0患者需具有高危因素:淋巴血管侵犯[LVI]或肿瘤>=3cm或分化差)(根据AJCC第8版); 4. 预计可达到R0切除者; 5. 年龄18-75周岁,男女不限; 6. ECOG PS 0-1(见附件1); 7. 既往未接受过任何针对食管癌抗肿瘤治疗,包括放疗、化疗、手术等; 8. 计划在新辅助治疗完成后接受手术治疗; 9. 无手术禁忌症; 10. 主要器官功能正常,包括: (1) 血常规检查(首次使用研究药物前14天内不允许使用任何血液成分、细胞生长因子、升白药、升血小板药、纠正贫血药): 中性粒细胞计数>=1.5×10^9/L;血小板计数>=100×10^9/L;血红蛋白>=90g/L; (2) 血生化检查:总胆红素<=1.5×ULN;ALT<=2.5×ULN,AST<=2.5×ULN;血清肌酐<=1.5×ULN,或肌酐清除率>=50mL/min; (3) 凝血功能:国际标准化比值(INR)<=1.5×ULN;活化部分凝血活酶时间(APTT)<=1.5×ULN 11. 具有生育能力的女性受试者需在开始研究药物给药前72小时内进行血清妊娠检测,且结果为阴性,并在试验期间、以及末次给药后至少3个月内采取有效的避孕措施(如宫内节育器、避孕药或避孕套);对于伴侣为有生育能力的女性的男性受试者,应为手术绝育或同意在试验期间及末次给药后3个月内采取有效的避孕措施; 12. 组前需完成《清晨型-夜晚型问卷》评估。 13. 同意在基线期接受活检取样,在手术时提供肿瘤组织样本,并配合完成全研究周期内的5次纵向血样采集(基线、治疗期、术前及术后随访)用于生物标志物分析。 14. 依从性良好,能够配合随访计划、定期复查,并严格遵守随机分配的治疗时间窗口(如早间、中间或晚间时段)进行给药。 |
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Inclusion criteria |
1. Voluntarily provide written informed consent and agree to participate in this study. 2. Histologically or cytologically confirmed esophageal squamous cell carcinoma. 3. Thoracic esophageal cancer evaluated by CT/MRI/EUS with clinical stage T1b?4aN+M0 or T2?4N0M0 (T2N0 patients must have high?risk factors: lymphovascular invasion [LVI], tumor size >=3 cm, or poor differentiation), according to the 8th edition of AJCC staging system. 4. Expected to be eligible for R0 resection. 5. Age 18–75 years, male or female. 6. ECOG performance status 0–1 (see Appendix 1). 7. No prior anti?tumor therapy for esophageal cancer, including radiotherapy, chemotherapy, surgery, etc. 8. Planned to undergo surgical resection after completion of neoadjuvant therapy. 9. No contraindications to surgery. 10. Adequate organ function, defined as: (1) Hematology (no blood products, colony?stimulating factors, leukocyte?elevating agents, platelet?elevating agents or anti?anemia agents within 14 days before first study drug administration): Absolute neutrophil count >=1.5×10^9/L; platelet count >=100×10^9/L; hemoglobin >=90 g/L. (2) Blood biochemistry: Total bilirubin <=1.5×ULN; ALT <=2.5×ULN; AST <=2.5×ULN; 2) Serum creatinine <=1.5×ULN, or creatinine clearance >=50 mL/min. (3) Coagulation: International normalized ratio (INR) <=1.5×ULN; activated partial thromboplastin time (APTT) <=1.5×ULN. 11. Female subjects of childbearing potential must have a negative serum pregnancy test within 72 hours before first study drug administration, and use effective contraception during the study and for at least 3 months after last administration (e.g., intrauterine device, contraceptive pills, condoms). Male subjects with female partners of childbearing potential must be surgically sterile or agree to use effective contraception during the study and for 3 months after last administration. 12. Completion of the Morningness?Eveningness Questionnaire (MEQ) before enrollment. 13. Agree to undergo biopsy at baseline, provide tumor tissue samples at surgery, and cooperate with 5 longitudinal blood collections throughout the study (baseline, on?treatment, pre?surgery, post?surgery follow?up) for biomarker analysis. 14. Good compliance, able to adhere to the follow?up schedule and regular assessments, and strictly comply with the randomly assigned treatment time windows (morning, midday, or evening). |
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排除标准: |
1. 肿瘤明显入侵食管病灶相邻器官(大动脉或气管); 2. 存在锁骨上淋巴结转移者; 3. 存在不可控的、需要反复引流的胸腔积液、心包积液或腹水; 4. 营养状况不佳,BMI<18.5 kg/m^2;若经过对症营养支持在随机入组前纠正后,经主要研究者评估后可继续考虑入组; 5. 既往对单克隆抗体、斯鲁利单抗任何成分、紫杉醇、顺铂或其他铂类药物有过敏史; 6. 既往已经接受或正在接受以下任何一种治疗: (1) 任何针对肿瘤的放疗、化疗或其他抗肿瘤药物; (2) 首次使用研究药物前2周内正在使用免疫抑制类药物、或全身激素类药物治疗以达到免疫抑制目的(剂量>10mg/天泼尼松或等效剂量);在没有活动性自身免疫疾病的情况下,允许吸入或局部使用类固醇和剂量>10mg/天泼尼松或等效剂量的肾上腺皮质激素替代; (3) 首次使用研究药物前4周内接受过减毒活疫苗; (4) 首次使用研究药物前4周内接受过大手术或有严重外伤; 7. 患有任何活动性的自身免疫性疾病或自身免疫性疾病病史,包括但不限于:间质性肺炎、肠炎、肝炎、垂体炎、血管炎、肾炎、甲状腺功能亢进、甲状腺功能减退(激素替代治疗后可考虑纳入);患有银屑病或童年期哮喘/过敏已完全缓解且成人后无需任何干预者可考虑纳入,但需支气管扩张剂进行医学干预的患者不可纳入; 8. 有免疫缺陷病史,包括HIV检测阳性,或患有其他获得性或先天性免疫缺陷疾病,或有器官移植史或异基因骨髓移植史; 9. 存在未能良好控制的心脏临床症状或疾病,包括但不限于: (1) NYHA II级以上心力衰竭, (2) 不稳定型心绞痛, (3) 1年内发生过心肌梗死, (4) 有临床意义的室上性或室性心律失常未经临床干预或临床干预后仍控制不佳; 10. 首次使用研究药物前4周内发生过严重感染(CTCAE>2级),如需要住院治疗的严重肺炎、菌血症、感染合并症等;基线胸部影像学检查提示存在活动性肺部炎症、首次使用研究药物前14天内存在感染的症状和体征或需要口服或静脉使用抗生素治疗者,除外预防性使用抗生素的情况; 11. 通过病史或CT检查发现有活动性肺结核感染,或入组前1年内有活动性肺结核感染病史者,或超过1年以前有活动性肺结核感染病史但未经正规治疗者; 12. 存在活动性乙肝(HBV DNA>=2000 IU/mL或10^4 copies/mL),丙型肝炎(丙肝抗体阳性,且HCV RNA高于分析方法检测下限); 13. 首次使用研究药物前5年内曾诊断为其他恶性肿瘤,除非具有低风险转移或死亡风险的恶性肿瘤(5年生存率>90%),如经充分治疗的皮肤基底细胞癌或鳞状细胞皮肤癌或宫颈原位癌等,可考虑入组; 14. 妊娠期或哺乳期女性; 15. 经研究者判断,存在其他可能导致被迫中途终止研究的因素,如患有其他严重疾病(含精神疾病)需要合并治疗,酗酒,药物滥用,家庭或社会因素,可能影响到受试者安全性或依从性的因素。 |
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Exclusion criteria: |
1. Obvious invasion of adjacent organs (aorta or trachea) by the tumor. 2. Presence of supraclavicular lymph node metastasis. 3. Uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage. 4. Poor nutritional status with BMI <18.5 kg/m^2. Subjects may be considered after correction with nutritional support before randomization, at the discretion of the principal investigator. 5. Known hypersensitivity to monoclonal antibodies, any component of serplulimab, paclitaxel, cisplatin, or other platinum-based agents. 6. Previous or ongoing use of any of the following therapies: (1) Any radiotherapy, chemotherapy, or other anti-tumor agents for malignancy. (2) Immunosuppressive drugs or systemic corticosteroids for immunosuppressive purposes (>10 mg/day prednisone or equivalent) within 2 weeks before first study drug administration. Inhaled or topical steroids and physiological replacement doses of corticosteroids are permitted in the absence of active autoimmune disease. (3) Live attenuated vaccines within 4 weeks before first study drug administration. (4) Major surgery or severe trauma within 4 weeks before first study drug administration. 7. Any active or history of autoimmune disease, including but not limited to interstitial pneumonia, enteritis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism. Patients with controlled hypothyroidism on hormone replacement may be considered. Patients with fully resolved psoriasis or childhood asthma/allergies requiring no adult intervention may be included; those requiring medical intervention with bronchodilators are excluded. 8. History of immunodeficiency, including positive HIV test, other acquired or congenital immunodeficiency disorders, organ transplantation, or allogeneic bone marrow transplantation. 9. Uncontrolled cardiac conditions, including but not limited to: (1) Heart failure >= NYHA class II; (2) Unstable angina; (3) Myocardial infarction within 1 year; (4) Clinically significant supraventricular or ventricular arrhythmias that are untreated or poorly controlled. 10. Severe infection (CTCAE grade >2) within 4 weeks before first study drug administration, such as severe pneumonia, bacteremia, infectious complications requiring hospitalization. Active pulmonary inflammation on baseline chest imaging, or signs/symptoms of infection requiring oral or intravenous antibiotics within 14 days before first study drug administration (prophylactic antibiotics excluded). 11. Active pulmonary tuberculosis confirmed by medical history or CT scan, history of active tuberculosis within 1 year before enrollment, or history of active tuberculosis more than 1 year previously without standard treatment. 12. Active hepatitis B (HBV DNA >=2000 IU/mL or 10^4 copies/mL) or hepatitis C (positive anti-HCV antibody with detectable HCV RNA above the lower limit of quantification). 13. Diagnosis of another malignancy within 5 years before first study drug administration, except for adequately treated malignancies with very low metastatic or mortality risk (5-year survival >90%), such as basal cell carcinoma, squamous cell carcinoma of the skin, or carcinoma in situ of the cervix. 14. Pregnant or lactating female subjects. 15. Any other conditions judged by the investigator that may lead to premature study discontinuation, including other severe diseases (including psychiatric disorders), alcoholism, drug abuse, social or family factors that may compromise subject safety or compliance. |
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研究实施时间: Study execute time: |
从 From 2025-12-31 00:00:00至 To 2027-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2026-04-01 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): |
通过交互式网络应答系统(IWRS)进行随机化。所有受试者均接受共 3 个周期(每周期 21 天)的新辅助免疫联合化疗,随后进行术前评估及根治性食管癌切除术。符合入排标准的受试者将在签署知情同意书后进入筛选期。合格的受试者将按 1:1:1 的比例通过中央随机系统(IWRS)随机分配至以下三个队列之一:队列 1(早间组)、队列 2(中间组)或队列 3(晚间组) |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Randomization was conducted through the Interactive Network Response System (IWRS). All subjects received a total of 3 cycles (each cycle lasting 21 days) of neoadjuvant immunotherapy combined with chemotherapy, followed by preoperative assessment and radical esophageal cancer resection. Subjects who meet the inclusion and exclusion criteria will enter the screening period after signing the informed consent form. Qualified subjects will be randomly assigned in a 1:1:1 ratio through the Central Randomization System (IWRS) to one of the following three cohorts: Cohort 1 (morning group), Cohort 2 (intermediate group), or Cohort 3 (evening group). |
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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: |
公开/Public |
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盲法: |
盲态评估(针对主要终点 pCR)。独立病理审查委员会(IPRC)盲态:在评估前,由独立于研究团队的数据管理人员对标本进行去标识化编码。IPRC 专家在阅片过程中,对受试者的个人信息、所属研究中心以及其被随机分配的治疗组别(早间、中间或晚间组)处于盲态。采用独立双阅制度。 统计分析盲态:主要分析采用全分析集(FAS)和符合方案集(PPS)。PPS 集将用于主要疗效终点的敏感性分析,以评估方案违背对结果的影响 |
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Blinding: |
Blind assessment (for the primary endpoint pCR). Independent Pathological Review Committee (IPRC) blinding: Before assessment, specimens are de-identified and encoded by data managers independent of the research team. During the film review process, IPRC experts were blind to the personal information of the subjects, the research centers they belonged to, and the treatment groups they were randomly assigned to (morning, intermediate or evening groups). Adopt an independent double-reading system. Blind statistical analysis: The main analyses were conducted using the full analysis set (FAS) and the protocol set (PPS). The PPS set will be used for sensitivity analysis of the primary efficacy endpoints to assess the impact of protocol violations on the outcomes |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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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: |
本研究采用CRF记录受试者数据,通过ResMan等基于互联网的EDC系统进行电子采集与管理。数据由经GCP培训的人员录入,系统内置逻辑核查;独立数据管理团队开展源数据核查,确保数据可溯源;数据库锁定后用于统计分析,全程符合 GCP 数据管理要求。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
This study uses CRFs for data documentation and a web-based EDC system (e.g., ResMan) for electronic data capture and management. Data are entered by GCP-trained personnel with built-in edit checks; an independent DM team conducts SDV to ensure traceability; the database is locked for statistical analysis, complying with GCP data management requirements. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |