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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: |
ChiCTR2600122824 |
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最近更新日期: Date of Last Refreshed on: |
2026-04-19 17:53:13 |
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注册时间: Date of Registration: |
2026-04-19 00:00:00 |
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注册号状态: |
补注册 |
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Registration Status: |
Retrospective registration |
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注册题目: |
依沃西单抗(AK112)联合化疗治疗III期不可切除非小细胞肺癌的前瞻性、单臂、探索性临床研究 |
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Public title: |
A prospective, single-arm, exploratory clinical study of ivonescimab injection (AK112) combined with chemotherapy in the treatment of stage III unresectable non-small cell lung cancer |
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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: |
依沃西单抗(AK112)联合化疗治疗III期不可切除非小细胞肺癌的前瞻性、单臂、探索性临床研究 |
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Scientific title: |
A prospective, single-arm, exploratory clinical study of ivonescimab injection (AK112) combined with chemotherapy in the treatment of stage III unresectable non-small cell lung cancer |
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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: |
王奕洋 |
研究负责人: |
姚烽 |
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Applicant: |
Wang Yiyang |
Study leader: |
Yao Feng |
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申请注册联系人电话: Applicant telephone: |
+86 21 2220000 |
研究负责人电话:
Study leader's |
+86 21 22200000 |
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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: |
Wangyiyang_SCH@163.com |
研究负责人电子邮件: Study leader's E-mail: |
yaofeng6796678@126.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: |
中国上海市徐汇区淮海西路241号 |
研究负责人通讯地址: |
中国上海市徐汇区淮海西路241号 |
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Applicant address: |
241 Huai Hai (W.) Road, Xuhui District, Shanghai, China |
Study leader's address: |
241 Huai Hai (W.) Road, Xuhui District, Shanghai, 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: |
上海市胸科医院 |
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Applicant's institution: |
Shanghai Chest Hospital |
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研究负责人所在单位: |
上海市胸科医院 |
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Affiliation of the Leader: |
Shanghai Chest?Hospital |
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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: |
IS25125 |
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: |
上海市胸科医院伦理委员会 |
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Name of the ethic committee: |
Ehtics Committee of Shanghai Chest Hospital |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-06-18 00:00:00 | ||
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伦理委员会联系人: |
陈仲林 |
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Contact Name of the ethic committee: |
Chen Zhonglin |
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伦理委员会联系地址: |
中国上海市徐汇区淮海西路241号 |
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Contact Address of the ethic committee: |
241 Huai Hai (W.) Road, Xuhui District, Shanghai, China |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 21 22200000 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
chestgcp@126.com |
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研究实施负责(组长)单位: |
上海市胸科医院 |
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Primary sponsor: |
Shanghai Chest?Hospital |
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研究实施负责(组长)单位地址: |
中国上海市徐汇区淮海西路241号 |
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Primary sponsor's address: |
241 Huai Hai (W.) Road, Xuhui District, Shanghai, 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: |
自筹 |
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Source(s) of funding: |
Self-funded |
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研究疾病: |
III期不可手术切除(经MDT专家组讨论)且不携带EGFR/ALK/ROS1/RET等基因突变的NSCLC患者 |
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Target disease: |
Patients with stage III non-resectable NSCLC (discussed by the MDT panel) without EGFR/ALK/ROS1/RET mutations |
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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: |
主要目的:评估依沃西单抗(AK112)联合化疗用于III期不可手术切除非小细胞肺癌诱导治疗的疗效 次要目的:评估依沃西单抗(AK112)联合化疗用于III期不可手术切除非小细胞肺癌诱导治疗的安全性 探索性研究目的:配对治疗前后外周血/组织多组学检测与疗效的相关性 |
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Objectives of Study: |
Main objection: to evaluate the efficacy of (AK112) in combination with chemotherapy for the induction of stage III non-surgically resectable non-small cell lung cancer. Secondary objective: to evaluate the safety of (AK112) in combination with chemotherapy for the induction of stage III non-surgically resectable non-small cell lung cancer. Objective of the exploratory study: association of peripheral blood/tissue multiomics testing with efficacy before and after paired therapy. |
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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. 年龄18~75岁,性别不限; 2. 病理组织学或细胞学证实的、经MDT评估后为III期不可切除的 NSCLC(按照 AJCC 第九版肺癌分期,为T1-4N2-3M0的患者,胸部增强 CT 和/或 PET/CT 检查考虑单站N2短径大于3cm、或多站N2短径大于2cm、或N3转移); 3. 既往未接受过针对 NSCLC 的局部治疗(手术或放疗)及任何既往系统抗肿瘤治疗,包括细胞毒性治疗、靶向治疗(包括酪氨酸激酶抑制剂或单克隆抗体)、细胞治疗、免疫治疗、系统中药治疗及任何其他研究药物治疗; 4. 有足够的肿瘤组织(非细胞学标本)可用于分子标志物分析(NGS及IHC); 5. 根据实体瘤疗效评价标准第1.1版 (RECIST v1.1),至少有一个可测量病灶; 6. 东部肿瘤协作组(ECOG)体能状态评分为0-1; 7. 3个月内肺功能至少达到 FEV1>1.2 L,FEV1%>40%;在保证手术切缘及综合考虑患者一般情况的条件下,有行根治性手术切除及系统性淋巴结清扫的可能; 8. 主要脏器功能充足:(1) 造血功能,其定义为中性粒细胞绝对计数>=1.5 × 10^9/L,血小板计数>=100 × 10^9/L,血红蛋白>=9.0 g/dL; (2) 肝功能,定义为总胆红素<=1.5倍正常值上限(ULN),谷草转氨酶(AST)和谷丙转氨酶(ALT)<=2.5倍ULN;血清白蛋白(ALB)>=28 g/L; (3) 肾功能:1) 血清肌酐<=1.5倍ULN或肌酐清除率* (CrCl) 计算值 >=45 mL/min - 计划接受顺铂的患者:CrCl>=60 mL/min - 计划接受卡铂的患者:CrCl >=45 mL/min * CrCl (mL/min) = {(140 -年龄) ×体重 (kg)×F}/ (SCr (mg/dL)×72),其中男性的 F = 1, 女性的 F = 0.85; SCr = 血清肌酐; 2) 尿蛋白 < 2+ 或 24 小时(h) 尿蛋白定量 < 1.0 g; (4) 凝血功能,定义为未接受抗凝治疗的受试者凝血酶原时间(PT)或国际标准化比值(INR)<=1.5倍ULN,活化部分凝血活酶时间(APTT)<=1.5倍ULN。接受全剂量或肠外抗凝治疗的受试者,如果在入组临床试验前抗凝药物剂量稳定至少2周,且凝血试验结果在当地实验室定义的范围内; 9. 预期寿命> 6个月; 10. 对于拟接受顺铂治疗的患者:无听力损伤; 11. 育龄妇女必须在首次用药前3天内进行血清妊娠试验,且结果为阴性。育龄妇女受试者和伴侣为育龄妇女的男性受试者必须同意在研究期间和末次给予研究药物后180天内采用高效方法避孕; 12. 对本研究已充分了解并自愿签署知情同意书(ICF); |
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Inclusion criteria |
1. Age 18 to 75 years, no gender restriction; 2. Pathologically or cytologically confirmed, unresectable stage III NSCLC after MDT assessment (according to AJCC 9th edition staging, for patients with T1-4N2-3M0, chest enhanced CT and/or PET/CT examination suggests single-station N2 short axis > 3 cm, multi-station N2 short axis > 2 cm, or N3 metastasis); 3. No prior local treatment (surgery or radiotherapy) for NSCLC, nor any prior systemic anti-tumor therapy, including cytotoxic therapy, targeted therapy (including tyrosine kinase inhibitors or monoclonal antibodies), cellular therapy, immunotherapy, traditional Chinese medicine, or any other research drug therapy; 4. Sufficient tumor tissue (non-cytological specimens) available for molecular marker analysis (NGS and IHC); 5. At least one measurable lesion according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1); 6. Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1; 7. Pulmonary function at least FEV1 > 1.2 L and FEV1% > 40% within 3 months; possibility of radical surgical resection and systematic lymph node dissection, under the condition of ensuring surgical margins and comprehensively considering the patient's general condition; 8. Adequate major organ function: (1) Hematopoietic function, defined as absolute neutrophil count >= 1.5 × 10^9/L, platelet count >= 100 × 10^9/L, hemoglobin >= 9.0 g/dL; (2) Liver function, defined as total bilirubin <= 1.5 × upper limit of normal (ULN), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) <= 2.5 × ULN; serum albumin (ALB) >= 28 g/L; (3) Renal function: 1) Serum creatinine <= 1.5 × ULN or calculated creatinine clearance* (CrCl) >= 45 mL/min - For patients planned to receive cisplatin: CrCl >= 60 mL/min - For patients planned to receive carboplatin: CrCl >= 45 mL/min * CrCl (mL/min) = {(140 - age) × body weight (kg) × F} / (SCr (mg/dL) × 72), where F = 1 for males and F = 0.85 for females; SCr = serum creatinine; 2) Urine protein < 2+ or 24-hour urine protein quantification < 1.0 g; (4) Coagulation function, defined as prothrombin time (PT) or international normalized ratio (INR) <= 1.5 × ULN, activated partial thromboplastin time (APTT) <= 1.5 × ULN in subjects not receiving anticoagulant therapy. For subjects receiving full-dose or parenteral anticoagulant therapy, if the anticoagulant dose is stable for at least 2 weeks before enrollment in the clinical trial, and the coagulation test results are within the range defined by the local laboratory; 9. Expected survival > 6 months; 10. For patients planned to receive cisplatin therapy: no hearing impairment; 11. Women of childbearing potential must have a serum pregnancy test within 3 days before the first dose of the study drug, with a negative result. Female subjects and male subjects whose partners are women of childbearing potential must agree to use highly effective contraceptive methods during the study period and within 180 days after the last dose of the study drug; 12. Have fully understood the study and voluntarily signed the informed consent form (ICF). |
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排除标准: |
1. 浸润主动脉、食管、心脏和/或其他器官、组织的T4肿瘤;或同侧不同叶肺转移的T4肿瘤; 2. 融合或多站淋巴结包绕或侵犯主动脉、肺动脉、气管、食管、心脏等,MDT评估无法根治性切除; 3. 根据第九版分期,虽然单站N2淋巴结短径超过3cm,但临床分期为IIB期的T1N2a的NSCLC患者; 4. 混合小细胞肺癌、神经内分泌癌、肉瘤成分的受试者; 5. 携带可选择靶向治疗的驱动基因突变(如EGFR、ALK、ROS1、RET); (1) 对于非鳞状细胞癌受试者(包括病理类型不明确的NSCLC),必须提供基于肿瘤组织的EGFR/ALK/ROS1/RET检测结果。若基因状态未知,在入组前必须进行检测EGFR/ALK/ROS1/RET; (2) 对于鳞状非小细胞肺癌受试者,若EGFR/ALK/ROS1/RET基因状态未知,则不要求在筛选时进行检测; 6. 任何治疗当前肺癌的既往抗肿瘤治疗(例如,放射治疗、靶向治疗、消融术或其他全身或局部抗肿瘤治疗); 7. 既往曾接受过胸部放疗的受试者; 8. 有需要类固醇治疗的(非感染性)肺炎/间质性肺病的病史,或者当前有需要类固醇治疗的肺炎/间质性肺病; 9. 已知活动性结核病史; 10. 既往对其他单克隆抗体发生过重度过敏反应; 11. 任何不稳定的全身性疾病,包括活动性感染、不受控制的高血压(收缩压>=140 mmHg或者舒张压>=90 mmHg,尽管进行了最佳药物治疗)、不稳定型心绞痛、近3个月内心绞痛发作、需要药物治疗的肝脏疾病、肾脏疾病或代谢疾病; 12. 心脏功能和疾病符合下述情况之一: (1) 研究者认为具有临床意义,明显异常而不适合入组本试验的心律失常,包括但不限于完全性左束支传导异常,Ⅱ度房室传导阻滞; (2) 12导联心电图(ECG)测量,QTc间期男性>=450ms、女性>=470ms; (3) 美国纽约心脏学会(NYHA)分级>=3级心功能不全或心脏彩超检查:左室射血分数(LVEF)<50%; (4) 筛选前1年内发生过心肌梗死; 13. 确认人类免疫缺陷病毒(HIV)感染; 14. 未经治疗的活动性乙型肝炎; 注:符合下列标准的乙肝受试者也可不排除: (1) 首次给药前HBV病毒载量必须<500 IU/ml或<1000拷贝/ml,研究者可根据受试者的情况决定研究期间是否给予抗HBV治疗; (2) 对于抗HBc(+)、HBsAg(-)、抗HBs(-)和HBV病毒载量(-)的受试者,不需要接受预防性抗HBV治疗,但是需要密切监测病毒再激活; (3) 活动性的HCV感染受试者(HCV抗体阳性且HCV-RNA水平高于检测下限); 15. 首次用药前4周内发生过严重感染(CTCAE>=3级)的受试者,包括但不局限于需要住院治疗的感染并发症、菌血症、重症肺炎等; 16. 首次给药前2个月内发生重大手术或严重损伤的患者; 17. 有严重出血倾向或凝血功能障碍病史;入组前4周内存在具有显著临床意义的出血症状,包括但不限于消化道出血、咳血(定义为咳出或咯出>=1茶匙鲜血或小血块或只咳血无痰液,允许痰中带血者入组)、鼻腔出血(不包括鼻衄出血及回缩性涕血);筛选期影像学显示肿瘤包绕重要血管或存在明显坏死、空洞,且研究者判定进入研究会引起出血风险; 18. 首次给药前10天内接受过持续的抗凝治疗; 19. 妊娠或哺乳期妇女; 20. 首次用药前30天内接种过活/减毒疫苗的受试者; 21. 首次给药前2年内发生过需要全身性治疗(例如使用缓解疾病药物、皮质类固醇或免疫抑制剂)的活动性自身性免疫疾病。允许间歇使用吸入性类固醇或局部注射类固醇。替代疗法(例如甲状腺素、胰岛素或者用于肾上腺或垂体机能不全的生理性皮质类固醇等)不视为全身性治疗; 22. 活动性或既往有明确的炎症性肠病(如克罗恩病、溃疡性结肠炎或慢性腹泻)病史; 23. 诊断为免疫缺陷病史或研究首次给药前7天内正在接受与肿瘤治疗非直接相关的全身性糖皮质激素治疗或任何其他形式的免疫抑制疗法;允许使用生理剂量的糖皮质激素(<=10 mg/天的强的松或等效药物); 24. 5年内患有除NSCLC以外的其他恶性肿瘤的患者,以下情况除外:接受过治愈性治疗且在试验用药品首次给药前>=2年无已知的活动性疾病且复发潜在风险较低的恶性肿瘤;充分治疗的非黑色素瘤皮肤癌或雀斑样痣恶性肿瘤且无疾病证据;充分治疗的原位癌且无疾病证据; 25. 研究者认为受试者不适合入组,如神经或代谢紊乱、体格检查或实验室检查怀疑受试者有可能的疾病或有研究药物使用禁忌症,或治疗相关并发症风险高。 |
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Exclusion criteria: |
1. T4 tumors invading the aorta, esophagus, heart, and/or other organs or tissues; or T4 tumors with ipsilateral intrapulmonary metastasis in different lobes; 2. Fusion or multi-station lymph nodes encasing or invading the aorta, pulmonary artery, trachea, esophagus, heart, etc., and MDT evaluation deems radical resection impossible; 3. According to the 9th edition staging, NSCLC patients with clinical stage IIB T1N2a, despite the short-axis diameter of single-station N2 lymph nodes exceeding 3 cm; 4. Subjects with mixed small cell lung cancer, neuroendocrine carcinoma, or sarcoma components; 5. Subjects harboring driver gene mutations for which targeted therapy is available (e.g., EGFR, ALK, ROS1, RET); (1) For non-squamous cell carcinoma subjects (including NSCLC with unclear pathological type), EGFR/ALK/ROS1/RET test results based on tumor tissue must be provided. If the gene status is unknown, testing for EGFR/ALK/ROS1/RET must be performed before enrollment; (2) For squamous non-small cell lung cancer subjects, if the EGFR/ALK/ROS1/RET gene status is unknown, testing at screening is not required; 6. Any prior anti-tumor therapy for current lung cancer (e.g., radiation therapy, targeted therapy, ablation, or other systemic or local anti-tumor treatment); 7. Subjects who have previously received thoracic radiotherapy; 8. History of (non-infectious) pneumonia/interstitial lung disease requiring steroid therapy, or current pneumonia/interstitial lung disease requiring steroid therapy; 9. Known history of active tuberculosis; 10. Previous history of severe allergic reaction to other monoclonal antibodies; 11. Any unstable systemic disease, including active infection, uncontrolled hypertension (systolic blood pressure >=140 mmHg or diastolic blood pressure >=90 mmHg despite optimal medical therapy), unstable angina pectoris, angina pectoris attacks within the last 3 months, liver disease, kidney disease, or metabolic disease requiring medication; 12. Cardiac function and disease meeting one of the following conditions: (1) Arrhythmias considered clinically significant by the investigator, with obvious abnormalities and unsuitable for enrollment in this trial, including but not limited to complete left bundle branch block, second-degree atrioventricular block; (2) 12-lead electrocardiogram (ECG) measurement showing QTc interval >=450 ms in males and >=470 ms in females; (3) New York Heart Association (NYHA) classification >= grade 3 cardiac insufficiency or echocardiographic examination: left ventricular ejection fraction (LVEF) <50%; (4) Myocardial infarction occurring within 1 year before screening; 13. Confirmed human immunodeficiency virus (HIV) infection; 14. Untreated active hepatitis B; Note: Hepatitis B subjects meeting the following criteria may not be excluded: (1) HBV viral load must be <500 IU/ml or <1000 copies/ml before the first administration; the investigator may decide whether to administer anti-HBV therapy during the study according to the subject's condition; (2) For subjects who are anti-HBc (+), HBsAg (-), anti-HBs (-), and HBV viral load (-), prophylactic anti-HBV therapy is not required, but close monitoring for viral reactivation is necessary; (3) Subjects with active HCV infection (HCV antibody positive and HCV-RNA level above the lower limit of detection); 15. Subjects who experienced severe infection (CTCAE >= grade 3) within 4 weeks before the first medication, including but not limited to infectious complications requiring hospitalization, bacteremia, severe pneumonia, etc.; 16. Patients who underwent major surgery or suffered severe injury within 2 months before the first administration; 17. History of severe bleeding tendency or coagulation dysfunction; presence of clinically significant bleeding symptoms within 4 weeks before enrollment, including but not limited to gastrointestinal bleeding, hemoptysis (defined as coughing up >=1 teaspoon of fresh blood or small blood clots, or coughing only blood without sputum; subjects with blood-tinged sputum are allowed to enroll), nasal bleeding (excluding epistaxis and retracted nasal bleeding); imaging examination during the screening period shows that the tumor encases major blood vessels or has obvious necrosis and cavitation, and the investigator determines that enrollment in the study will cause bleeding risk; 18. Received continuous anticoagulant therapy within 10 days before the first administration; 19. Pregnant or lactating women; 20. Subjects who received live/attenuated vaccines within 30 days before the first medication; 21. Active autoimmune diseases requiring systemic therapy (e.g., disease-modifying antirheumatic drugs, corticosteroids, or immunosuppressants) within 2 years before the first administration. Intermittent use of inhaled corticosteroids or local steroid injections is allowed. Replacement therapy (e.g., thyroxine, insulin, or physiological corticosteroids for adrenal or pituitary insufficiency) is not considered systemic therapy; 22. Active or previous history of confirmed inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis, or chronic diarrhea); 23. History of diagnosed immunodeficiency or receiving systemic glucocorticoid therapy or any other form of immunosuppressive therapy not directly related to tumor treatment within 7 days before the first administration of the study drug; Use of physiological doses of glucocorticoids (<=10 mg/day of prednisone or equivalent drugs) is allowed; 24. Patients with other malignant tumors except NSCLC within 5 years, excluding the following cases: malignant tumors that received curative treatment and had no known active disease and low potential risk of recurrence for >=2 years before the first administration of the investigational product; adequately treated non-melanoma skin cancer or lentigo maligna with no evidence of disease; adequately treated carcinoma in situ with no evidence of disease; 25. The investigator deems the subject unsuitable for enrollment, such as neurological or metabolic disorders, physical examination or laboratory tests suggesting potential diseases of the subject, contraindications to the use of the study drug, or high risk of treatment-related complications. |
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研究实施时间: Study execute time: |
从 From 2025-06-01 00:00:00至 To 2027-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2025-08-27 00:00:00 至 To 2026-12-31 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: |
正在进行 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: |
无 |
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Blinding: |
None |
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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): |
研究结束后半年;国家生物信息中心(https://www.cncb.ac.cn/) |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
Six months after the completion of the research; China National Center for Bioinformation (https://www.cncb.ac.cn/) |
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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: |
病例记录表 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Case Record Form |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |