|
审核状态: Project audit state: |
通过审核 Successful |
|
注册号: Registration number: |
ChiCTR2400081098 |
|
最近更新日期: Date of Last Refreshed on: |
2024-02-22 14:22:55 |
|
注册时间: Date of Registration: |
2024-02-22 00:00:00 |
|
注册号状态: |
预注册 |
|
Registration Status: |
Prospective registration |
|
注册题目: |
围手术期化疗联合 PD-1 抑制剂对比围手术期化疗治疗局部进展期食管胃结合部腺癌患者的 II 期随机对照临床研究 |
|
Public title: |
Perioperative chemotherapy plus PD-1 antibody versus chemotherapy alone for locally advanced gastro-esophageal junction cancer: an open-label, phase 2 trial |
|
注册题目简写: |
|
|
English Acronym: |
|
|
研究课题的正式科学名称: |
围手术期化疗联合 PD-1 抑制剂对比围手术期化疗治疗局部进展期食管胃结合部腺癌患者的 II 期随机对照临床研究 |
|
Scientific title: |
Perioperative chemotherapy plus PD-1 antibody versus chemotherapy alone for locally advanced gastro-esophageal junction cancer: an open-label, phase 2 trial |
|
研究课题代号(代码): Study subject ID: |
|
|
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: |
|
申请注册联系人: |
聂润聪 |
研究负责人: |
陈映波 |
|
Applicant: |
Runcong Nie |
Study leader: |
Yingbo Chen |
|
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 telephone: |
+86 136 0280 4825 |
|
申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
||
|
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: |
chenyb@sysucc.org.cn |
|
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): |
||
|
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,中山大学肿瘤防治中心,胃外科 |
研究负责人通讯地址: |
广东省广州市越秀区东风东路651号,中山大学肿瘤防治中心,胃外科 |
|
Applicant address: |
Department of Gastric Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, Guangdong, China |
Study leader's address: |
Department of Gastric Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, Guangdong, China |
|
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: |
||
|
申请人所在单位: |
中山大学肿瘤防治中心 |
||
|
Applicant's institution: |
Sun Yat‐Sen University Cancer Center |
||
|
研究负责人所在单位: |
中山大学肿瘤防治中心 |
||
|
Affiliation of the Leader: |
Sun Yat‐Sen University Cancer Center |
||
|
是否获伦理委员会批准: |
是/Yes |
||
|
Approved by ethic committee: |
Yes |
||
|
伦理委员会批件文号: Approved No. of ethic committee: |
SL-B2024-002-02 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
|
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 |
||
|
Name of the ethic committee: |
Ethics Committee of Sun Yat-Sen University Cancer Center |
||
|
伦理委员会批准日期: Date of approved by ethic committee: |
2024-02-19 00:00:00 |
||
|
伦理委员会联系人: |
袁中玉 |
||
|
Contact Name of the ethic committee: |
Zhongyu Yuan |
||
|
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 |
||
|
Contact Address of the ethic committee: |
Room 316, Cuiyuan Building, 23 Xianlie Road South, Guangzhou, Guangdong |
||
|
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: |
|
|
研究实施负责(组长)单位: |
中山大学肿瘤防治中心 |
||||||||||||||||||||||
|
Primary sponsor: |
Sun Yat-sen University Cancer Center |
||||||||||||||||||||||
|
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号中山大学肿瘤防治中心 |
||||||||||||||||||||||
|
Primary sponsor's address: |
Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, Guangdong, China |
||||||||||||||||||||||
|
试验主办单位(项目批准或申办者): Secondary sponsor: |
|
||||||||||||||||||||||
|
经费或物资来源: |
百济神州(北京)生物科技有限公司 |
||||||||||||||||||||||
|
Source(s) of funding: |
BeiGene (Beijing) Biotechnology Co., Ltd. |
||||||||||||||||||||||
|
Target disease: |
gastro-esophageal junction cancer |
||||||||||||||||||||||
|
Target disease code: |
|
||||||||||||||||||||||
|
研究类型: |
干预性研究 |
||||||||||||||||||||||
|
Study type: |
Interventional study |
||||||||||||||||||||||
|
研究所处阶段: |
II期临床试验 | ||||||||||||||||||||||
|
Study phase: |
2 |
||||||||||||||||||||||
|
研究设计: |
随机平行对照 |
||||||||||||||||||||||
|
Study design: |
Parallel |
||||||||||||||||||||||
|
研究目的: |
主要目的: 1.评估对比围手术化疗,围手术期化疗联合 PD-1 抑制剂治疗局部进展期食管胃结合部腺癌的安全性和抗肿瘤活性 2.探索对比围手术化疗,长疗程新辅助化疗联合 PD-1 抑制剂治疗局部进展期食管胃结合部腺癌的安全性和抗肿瘤活性 探索性目的: 1.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 2.评估血液中 ctDNA 与抗肿瘤应答情况的相关性 3.评估肿瘤组织突变、单细胞测序、RNA 表达以及蛋白组学与抗肿瘤应答情况的相关性 4.探索免疫相关的其它潜在预测抗肿瘤应答的指标 |
||||||||||||||||||||||
|
Objectives of Study: |
Primary Objective: To assess the safety and antitumor activity of perioperative chemotherapy compared with perioperative chemotherapy combined with PD-1 inhibitor treatment for locally advanced gastro-esophageal junction cancer. Additionally, to explore the safety and antitumor activity of long-course neoadjuvant chemotherapy combined with PD-1 inhibitor treatment compared with perioperative chemotherapy for locally advanced esophagogastric junction adenocarcinoma. Exploratory Objectives: 1.To evaluate the correlation between the expression of Programmed Death-Ligand 1 (PD-L1) in tumor tissue, Epstein-Barr Virus (EBV) expression in tumor tissue, Microsatellite Instability (MSI) status, and the antitumor response. 2.To assess the correlation between circulating tumor DNA (ctDNA) in blood and antitumor response. 3.To evaluate the correlation between tumor tissue mutations, single-cell sequencing, RNA expression, and proteomics with the antitumor response. 4.To explore other potential immune-related biomarkers predictive of antitumor response. |
||||||||||||||||||||||
|
药物成份或治疗方案详述: |
|
||||||||||||||||||||||
|
Description for medicine or protocol of treatment in detail: |
|
||||||||||||||||||||||
|
纳入标准: |
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,分期为 cT1-2N+M0 或 cT3-4aNanyM0; 3. 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 PD-L1、EBV、MSI 免疫组化验查(IHC)检测; 4. 性别不限,年龄 18-75 周岁; 5. 一般状况好,ECOG 评分在 0-1 分,无手术禁忌症; 6. 体力状况及脏器功能允许接受较大的腹部手术; 7. 预期生存期 ≥ 3 月; 8. 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×正常值高限,AST、ALT ≤ 2.5×正常值高限; c. 肌酐 ≤ 1.5×正常值高限或血清清除率 > 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, μmol/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 9. 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; 10. 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。 |
||||||||||||||||||||||
|
Inclusion criteria |
1.The subject has fully understood the study and voluntarily signed the Informed Consent Form (ICF). 2.Histologically confirmed adenocarcinoma of the esophagogastric junction, clinically staged as II/III based on enhanced CT/MRI, classified as cT1-2N+M0 or cT3-4aNanyM0. 3.Agrees to provide previously stored tumor tissue samples or to undergo a biopsy for the collection of tumor lesion tissue to be sent to the central laboratory for PD-L1, EBV, and MSI immunohistochemistry (IHC) testing. 4.Gender is unrestricted, aged 18-75 years. 5.Good general condition, with an ECOG performance status of 0-1, without contraindications to surgery. 6.Physical condition and organ functions are adequate for major abdominal surgery. 7.Expected survival of ≥ 3 months. 8.Laboratory test values within 7 days prior to enrollment must meet the following criteria:a. WBC > 4.0×10^9/L and < 15×10^9/L, ANC > 1.5×10^9/L, Hb ≥ 80g/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 > 60ml/min, according to the Cockcroft-Gault glomerular filtration rate estimate: (140 - age) × (weight, kg) × (0.85 if female) / 72 × (serum creatinine, mg/dL) or: (140 - age) × (weight, kg) × (0.85 if female) / 0.818 × (serum creatinine, μmol/L);d. INR and aPTT ≤ 1.5 × ULN, applicable only to subjects not receiving anticoagulant therapy; subjects on anticoagulant therapy should use a stable dose. 9.Good compliance, able to cooperate with the protocol's laboratory, auxiliary examinations, and corresponding specimen collection. 10.Females of childbearing potential (including those with chemically induced amenorrhea or other medical reasons for amenorrhea) must agree to use contraception from signing the informed consent form until at least 5 months after the last administration of study treatment or accompanying chemotherapy, whichever is later. Females must also agree not to breastfeed from signing the informed consent form until at least 5 months after the last administration of study drug or accompanying chemotherapy, whichever is later. Males must agree to use contraception from the administration of the study drug until at least 7 months after the last administration of the study drug or accompanying chemotherapy, whichever is later. |
||||||||||||||||||||||
|
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 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. 根据影响(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、替吉奥或卡培他滨使用禁忌; 17. 妊娠或哺乳期妇女或可能妊娠; 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。 |
||||||||||||||||||||||
|
Exclusion criteria: |
1.Known allergies to monohydrate citric acid, sodium citrate dihydrate, mannitol, polysorbate (components of the trial medication). 2.Past or present malignancies other than completely excised basal cell carcinoma, stage I squamous cell carcinoma, carcinoma in situ, mucosal carcinoma, superficial bladder cancer, or any other cancer that has been in remission for at least 5 years. 3.Uncontrollable pericardial effusion, pleural effusion, or ascites, gastrointestinal bleeding, or high risk of bleeding within 2 weeks of enrollment. 4.Weight loss exceeding 20% within 2 weeks of enrollment. 5.Inability to take oral medication. 6.History of chemotherapy, radiotherapy, immunotherapy, or surgical treatment for gastric cancer. 7.Prior use of anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 antibodies, or any other antibodies that act on T-cell co-stimulatory or checkpoint pathways. 8.Treatment with tyrosine kinase inhibitors within 2 weeks prior to enrollment. 9.Conditions requiring long-term use of immunosuppressive medication, or systemic or local use of corticosteroids in immunosuppressive doses (dose > 10mg/day of prednisone or equivalent) for comorbidities. 10.Vaccination against any infection within 4 weeks before enrollment (e.g., influenza, varicella vaccines). 11.Uncontrolled systemic diseases such as diabetes, hypertension. 12.Receiving or requiring anticoagulant therapy (excluding low-dose aspirin for antiplatelet therapy). 13.Any active autoimmune disease or history of autoimmune disease (including, but not limited to: interstitial lung disease, uveitis, enteritis, hepatitis, hypophysitis, nephritis, hyperthyroidism, hypothyroidism; participants with vitiligo or childhood asthma that has fully resolved and does not require any intervention in adulthood can be included; participants requiring medical intervention with bronchodilators for asthma cannot be included). 14.Participants with active tuberculosis (TB), undergoing anti-TB treatment, or who have received anti-TB treatment within 1 year prior to screening. 15.History of lung diseases confirmed by imaging (preferably CT) or clinical outcomes: interstitial lung disease, non-infectious pneumonia, pulmonary fibrosis, acute lung diseases. 16.Contraindications to the use of oxaliplatin, tegafur, or capecitabine. 17.Pregnant or breastfeeding women or women who may become pregnant. 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 disease or condition that, in the investigator's opinion, could affect compliance with the protocol, impact the ability of the subject to give informed consent, or not be suitable for participation in this clinical trial. |
||||||||||||||||||||||
|
研究实施时间: Study execute time: |
从 From 2024-02-22 00:00:00至 To 2027-01-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2024-02-22 00:00:00 至 To 2027-01-01 00:00:00 |
|
干预措施: Interventions: |
|
|
研究实施地点: Countries of recruitment and research settings: |
|
||||||||||||||||||||||||||||
|
测量指标: Outcomes: |
|
|
采集人体标本:
Collecting sample(s)
|
|
|
征募研究对象情况: Recruiting status: |
正在进行 Recruiting |
年龄范围: Participant age: |
|
||||||
|
性别: |
男女均可 |
Gender: |
Both |
||||||
|
随机方法(请说明由何人用什么方法产生随机序列): |
根据肿瘤部位(Siewert I 型 vs Siewert II/III 型)及 Lauren 分型(弥漫型vs 肠型/混合型)分层因素,根据临床试验随机化系统(IWRS),将按照 1:1:1 比例随机分组,受试者将接受围手术期化疗(A 组)、常规新辅助的围手术期化疗联合 PD-1 抑制剂治疗(B 组)或者长程新辅助的围手术期化疗联合 PD-1 抑制剂治疗(C 组)。 |
||||||||
|
Randomization Procedure (please state who generates the random number sequence and by what method): |
Based on tumor location (Siewert Type I vs Siewert Type II/III) and Lauren classification (diffuse type vs intestinal/mixed type) as stratification factors, subjects will be randomized in a 1:1:1 ratio according to the Interactive Web Response System (IWRS). Subjects will receive perioperative chemotherapy (Group A), standard neoadjuvant perioperative chemotherapy combined with PD-1 inhibitor treatment (Group B), or long-course neoadjuvant perioperative chemotherapy combined with PD-1 inhibitor treatment (Group C). |
||||||||
|
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 |
|
盲法: |
开放 |
|
Blinding: |
open |
|
试验完成后的统计结果(上传文件): |
|
|
Calculated Results after
|
|
|
是否共享原始数据: IPD sharing |
No |
|
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): |
不共享 |
|
The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
None |
|
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 |
|
Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
case report form (CRF) |
|
数据与安全监察委员会: Data and Safety Monitoring Committee: |
暂未确定/Not yet |