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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: |
ChiCTR2600126593 |
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最近更新日期: Date of Last Refreshed on: |
2026-06-11 17:24:03 |
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注册时间: Date of Registration: |
2026-06-11 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: |
鼻咽癌寡转移灶SBRT联合PD1单抗免疫治疗对比单纯免疫治疗的多中心随机对照临床试验 |
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Public title: |
Camrelizumab Plus Stereotactic Body Radiotherapy vs Camrelizumab Alone For Oligometastatic Nasopharyngeal Carcinoma: A Multicenter Randomized Clinical Phase 3 Trial |
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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: |
鼻咽癌寡转移灶SBRT联合PD1单抗免疫治疗对比单纯免疫治疗的多中心随机对照临床试验 |
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Scientific title: |
Camrelizumab Plus Stereotactic Body Radiotherapy vs Camrelizumab Alone For Oligometastatic Nasopharyngeal Carcinoma: A Multicenter Randomized Clinical Phase 3 Trial |
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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: |
游瑞 |
研究负责人: |
游瑞 |
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Applicant: |
You Rui |
Study leader: |
You Rui |
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申请注册联系人电话: Applicant telephone: |
+86 756 252 6389 |
研究负责人电话:
Study leader's |
+86 756 252 6389 |
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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: |
yourui@sysucc.org.cn |
研究负责人电子邮件: Study leader's E-mail: |
your5@mail.sysu.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: |
广东省珠海市香洲区梅华东路52号 |
研究负责人通讯地址: |
广东省珠海市香洲区梅华东路52号 |
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Applicant address: |
No. 52, Meihe East Road, Xiangzhou District, Zhuhai City, Guangdong Province |
Study leader's address: |
No. 52, Meihe East Road, Xiangzhou District, Zhuhai 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: |
中山大学附属第五医院 |
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Applicant's institution: |
The Fifth Affiliated Hospital, Sun Yat-sen University |
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研究负责人所在单位: |
中山大学附属第五医院 |
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Affiliation of the Leader: |
Fifth Affiliated 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: |
B2021-033-01 |
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: |
Institutional Review Board 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: |
2021-04-12 00:00:00 | ||
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伦理委员会联系人: |
潘旭芝 |
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Contact Name of the ethic committee: |
Pan Xuzhi |
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伦理委员会联系地址: |
广东省珠海市香洲区梅华东路52号 |
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Contact Address of the ethic committee: |
No. 52, Meihe East Road, Xiangzhou District, Zhuhai City, Guangdong Province |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 20 87343009 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
panxzh@sysucc.org.cn |
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研究实施负责(组长)单位: |
中山大学附属第五医院 |
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Primary sponsor: |
Fifth Affiliated Hospital, Sun Yat-Sen University |
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研究实施负责(组长)单位地址: |
广东省珠海市香洲区梅华东路52号 |
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Primary sponsor's address: |
No. 52, Meihe East Road, Xiangzhou District, Zhuhai 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: |
无 |
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Source(s) of funding: |
None |
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研究疾病: |
鼻咽癌寡转移 |
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Target disease: |
Oligometastatic Nasopharyngeal 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: |
鼻咽癌是我国常见的恶性肿瘤之一,放化疗是其主要治疗手段,复发和转移是鼻咽癌治疗失败的主要原因,其中,远处转移约占70%。目前远处转移性鼻咽癌被认为是无法治愈的。姑息性全身系统治疗仍是其主要治疗方法。 根据目前NCCN指南推荐,PD-1单抗免疫治疗已经成为远转鼻咽癌的后线标准治疗方案,然而,总体有效率仅为20%-30%。既往有研究发现,针对寡转移实体瘤患者,可通过以寡转移灶为导向的疗法(如手术、消融、放疗)联合化疗,实现寡转移性肿瘤的临床治愈。2019年Palma等发表在the lancet的前瞻性研究发现,Stereotactic body radiation therapy (SBRT) 将寡转移患者(原发肿瘤不限)的中位OS、PFS分别延长13、6个月。同时,亦有研究发现,SBRT联合免疫治疗具有协同增效的作用。 因此,我们拟开展“鼻咽癌寡转移灶SBRT联合PD-1单抗免疫治疗对比单纯免疫治疗的多中心随机对照临床试验”,以积极清除残留病灶为导向,明确在免疫维持治疗的基础上添加寡转移灶根治性SBRT能否进一步提高寡转移患者的生存获益。 |
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Objectives of Study: |
Nasopharyngeal carcinoma (NPC) is a common malignancy in China, and chemoradiotherapy remains its main treatment modality. Recurrence and metastasis are the principal causes of treatment failure, with distant metastasis accounting for approximately 70% of cases. Metastatic NPC is currently regarded as incurable, and palliative systemic therapy remains the mainstay of treatment.According to the current NCCN Guidelines, PD-1 inhibitor immunotherapy has become the standard later-line treatment for metastatic NPC; however, the overall response rate is only 20%–30%. Previous studies have shown that, in patients with oligometastatic solid tumors, metastasis-directed therapies, such as surgery, ablation, or radiotherapy, combined with chemotherapy, may achieve clinical cure in selected cases. In 2019, Palma et al. reported in The Lancet that stereotactic body radiation therapy (SBRT) prolonged median overall survival and progression-free survival by 13 and 6 months, respectively, in oligometastatic patients regardless of primary tumor type. In addition, studies have suggested a synergistic effect between SBRT and immunotherapy.Therefore, we plan to conduct a multicenter randomized controlled trial, “SBRT for Oligometastatic Lesions Combined with PD-1 Inhibitor Immunotherapy versus Immunotherapy Alone in Nasopharyngeal Carcinoma,” to determine whether, with active eradication of residual lesions as the treatment goal, the addition of definitive SBRT to oligometastatic NPC. |
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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岁-70岁。 2.原发灶及颈部淋巴结已行根治剂量放疗,距离入组行SBRT时间3个月以上且疾病控制良好。 3.至少接受一线系统性化疗,无论化疗方案及疗效。 4.影像学上发现寡转移病灶(转移组织活检是首选,但非必要)。转移灶总数不超过5个,且单器官转移病灶数目<=3个。 5.ECOG评分为0-1分。 6.所有转移灶经多学科会诊均可行SBRT治疗。 7.若转移灶已接受过局部治疗的患者(如手术、射频消融、放疗); 8.脑转移灶最大径<=3cm。 9.脑以外转移灶最大径<=5cm。 |
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Inclusion criteria |
1. Age: 18 years - 70 years. 2. The primary lesion and cervical lymph nodes have undergone radical dose radiotherapy. The time elapsed since the start of SBRT treatment is more than 3 months and the disease control is good. 3. At least received first-line systemic chemotherapy, regardless of the chemotherapy regimen and efficacy. 4. On imaging, oligometastatic lesions were detected (biopsy of metastatic tissue is preferred but not mandatory). The total number of metastatic lesions does not exceed 5, and the number of single-organ metastatic lesions is <= 3. 5. ECOG score is 0-1. 6. All metastatic lesions can be treated with SBRT through multidisciplinary consultation. 7. For patients who have received local treatment for metastatic lesions (such as surgery, radiofrequency ablation, radiotherapy); 8. The maximum diameter of brain metastases <= 3 cm. 9. The maximum diameter of metastatic lesions outside the brain <= 5 cm. |
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排除标准: |
1.免疫治疗失败(抗PD-1/PD-L1抗体或抗CTLA-4抗体免疫治疗)的患者。 2.患有>=Ⅱ级的冠心病、心律失常(包括QTc间期延长男性>450 ms,女性>470 ms)及心功能不全。 3.既往对PD-1/PD-L1单抗或其他单克隆抗体的任何成分有重度超敏反应史。 4.SBRT治疗前4周内接受化学治疗(细胞毒性或分子靶向药物)。 5.临床或放射学证据表明脊髓受压,或肿瘤距脊髓距离<3mm。 6.需要手术减压的脑转移患者。 7.恶性胸腔积液或合并其他恶性肿瘤患者。 8.患有已知或可疑的自身免疫性疾病者,包括痴呆和癫痫发作。 9.入组前4周内接受过大剂量糖皮质激素治疗。 10.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的皮质类固醇的合并症。 11.患有活动性肺结核(TB)的患者,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。 12.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患者可纳入;患有需要支气管扩张剂进行医学干预的哮喘则不能纳入)。 13.HIV阳性者;HBsAg阳性同时检测到HBV DNA拷贝数阳性(定量检测≥1000cps/ml);慢性丙型肝炎血液筛查阳性(HCV抗体阳性)。 14.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)。 15.育龄期女性妊娠试验阳性者和哺乳期妇女。 16.其他经治医师认为不适合纳入的患者。 |
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Exclusion criteria: |
1. Patients who failed immunotherapy (anti-PD-1/PD-L1 antibody or anti-CTLA-4 antibody immunotherapy). 2. Patients with coronary heart disease of grade >= II, arrhythmia (including QTc interval prolongation in males > 450 ms, females > 470 ms) and cardiac insufficiency. 3. Those with a history of severe hypersensitivity reaction to any component of PD-1/PD-L1 monoclonal antibodies or other monoclonal antibodies. 4. Those who received chemotherapy (cytotoxic or molecular targeted drugs) within 4 weeks before SBRT treatment. 5. Patients with spinal cord compression indicated by clinical or radiological evidence, or with tumor distance from the spinal cord < 3 mm. 6. Patients with brain metastases requiring surgical decompression. 7. Patients with malignant pleural effusion or with other malignant tumors. 8. Patients with known or suspected autoimmune diseases, including dementia and seizure. 9. Those who received high-dose glucocorticoid treatment within 4 weeks before enrollment. 10. Patients with comorbidities requiring long-term use of immunosuppressive drugs, or requiring systemic or local use of corticosteroids at immunosuppressive doses. 11. Patients with active pulmonary tuberculosis (TB), who are undergoing anti-TB treatment or have received anti-TB treatment within 1 year before screening. 12. Subjects with any active autoimmune disease or with a history of autoimmune disease (including but not limited to: interstitial pneumonia, uveitis, enteritis, hepatitis, pituitaryitis, nephritis, hyperthyroidism, hypothyroidism; patients with vitiligo or who had completely resolved childhood asthma and do not require any intervention after adulthood can be included; patients with asthma requiring medical intervention with bronchodilators cannot be included). 13. HIV-positive individuals; HBsAg-positive and HBV DNA copy number positive (quantitative detection ≥ 1000 cps/ml); positive for chronic hepatitis C blood screening (HCV antibody positive). 14. Those who received any anti-infective vaccine (such as influenza vaccine, varicella vaccine, etc.) within 4 weeks before enrollment. 15. Pregnant women with positive pregnancy test and lactating women. 16. Other patients considered unsuitable for inclusion by the treating physician. |
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研究实施时间: Study execute time: |
从 From 2021-02-01 00:00:00至 To 2029-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2021-08-30 00:00:00 至 To 2029-12-31 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): |
符合入排标准的受试者将被随机人员随机分配到实验组与对照组,各中心采取竞争入组。随机化采用中央分层随机,分层因素为是否为一线治疗,转移灶个数(1-3 vs 4-5个),是否合并肝转移,及中心。 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Eligible participants who meet the inclusion and exclusion criteria will be randomly assigned by designated randomization personnel to either the experimental group or the control group. Competitive enrollment will be adopted across participating centers. Central stratified randomization will be used, with stratification factors including line of therapy (first-line vs non-first-line), number of metastatic lesions (1–3 vs 4–5), presence or absence of liver metastases, and study center. |
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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: |
开放标签,对评估者隐藏分组 |
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Blinding: |
Open-label study with blinded-evaluators |
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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): |
研究结束后半年内,通过ResMan(www.medresman.org.cn)方式共享 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
Within six months after the completion of the research, the results will be shared via the ResMan platform (www.medresman.org.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: |
EDC |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
EDC |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
无/No |