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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: |
ChiCTR2400082466 |
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最近更新日期: Date of Last Refreshed on: |
2024-03-29 15:26:50 |
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注册时间: Date of Registration: |
2024-03-29 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: |
阿得贝利单抗联合伊立替康脂质体或依托泊苷加铂类方案治疗一线标准化疗后进展的 ES-SCLC患者的前瞻性II期临床研究 |
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Public title: |
Prospective Phase II Clinical Study of Adbelizumab Combined With Irinotecan Liposomes or Etoposide Plus Platinum Regimens in Patients With ES-SCLC |
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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: |
阿得贝利单抗联合伊立替康脂质体或依托泊苷加铂类方案治疗一线标准化疗后进展的 ES-SCLC患者的前瞻性II期临床研究 |
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Scientific title: |
Prospective Phase II Clinical Study of Adbelizumab Combined With Irinotecan Liposomes or Etoposide Plus Platinum Regimens in Patients With ES-SCLC |
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研究课题代号(代码): Study subject ID: |
MA-SCLC-Ⅱ-008 |
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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: |
张燕 |
研究负责人: |
张燕 |
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Applicant: |
Zhang Yan |
Study leader: |
Zhang Yan |
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申请注册联系人电话: Applicant telephone: |
+86 190 3081 5651 |
研究负责人电话: Study leader's telephone: |
+86 190 3081 5651 |
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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: |
13315978336@163.com |
研究负责人电子邮件: Study leader's E-mail: |
13315978336@163.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: |
河北省石家庄市建华南大街365号 |
研究负责人通讯地址: |
河北省石家庄市建华南大街365号 |
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Applicant address: |
365 Jianhua South Street, Shijiazhuang City, Hebei Province |
Study leader's address: |
365 Jianhua South Street, Shijiazhuang City, Hebei 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: |
石家庄市人民医院 |
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Applicant's institution: |
Shijiazhuang People's Hospital |
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研究负责人所在单位: |
石家庄市人民医院 |
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Affiliation of the Leader: |
Shijiazhuang People's Hospital |
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是否获伦理委员会批准: |
是/Yes |
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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: |
院科伦审[2023]第(037)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: |
石家庄市人民医院医学科研伦理委员会 |
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Name of the ethic committee: |
Shijiazhuang People's Hospital medical research Ethics Committee |
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伦理委员会批准日期: Date of approved by ethic committee: |
2023-10-10 00:00:00 |
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伦理委员会联系人: |
张汝攒 |
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Contact Name of the ethic committee: |
Zhang Ruzuo |
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伦理委员会联系地址: |
河北省石家庄市范西路36号 |
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Contact Address of the ethic committee: |
36 Fanxi Road, Shijiazhuang City, Hebei Province |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 176 0311 9505 |
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: |
石家庄市人民医院 |
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Primary sponsor: |
Shijiazhuang People's Hospital |
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研究实施负责(组长)单位地址: |
河北省石家庄市建华南大街365号 |
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Primary sponsor's address: |
365 Jianhua South Street, Shijiazhuang City, Hebei 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: |
江苏恒瑞医药股份有限公司 |
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Source(s) of funding: |
Jiangsu Hengrui Pharmaceutical Co., LTD |
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Target disease: |
small cell lung cancer |
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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: ?评价阿得贝利单抗联合伊立替康脂质体或依托泊苷联合铂类方案治疗经一线化疗后进展的广泛期小细胞肺癌的有效性和安全性 探索性目的: ?评价生物标志物( 包括但不限于程序性死亡因子配体[programmed death-ligand 1, PD-L1],肿瘤突变负荷[tumor mutation burden, TMB],微卫星稳定性 (MSI, Microsatellite Instability等)与疗效相关性 长生存人群的特征分析。 |
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Objectives of Study: |
Main purpose: ? To evaluate the efficacy and safety of adbelizumab combined with irinotecan liposome or etoposide combined with platinum in the treatment of extensive small cell lung cancer advanced after first-line chemotherapy Exploratory purpose: ? Evaluation of biomarkers (including but not limited to programmed death-ligand 1, PD-L1), tumor mutation burden (TMB), Microsatellite stability (MSI, Microsatellite Instability, etc.) is associated with efficacy Analysis of the characteristics of long-lived population |
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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.所有受试者在开始研究相关操作前均需签署知情同意书(Inform consent form, ICF) 2.≥18 岁且≤70 岁 3.组织学或细胞学证实的 SCLC 4.按照美国退伍军人肺癌协会(Veterans Administration Lung Study Group, VALG)分期为 ES-SCLC 5.既往接受过一线铂类为基础的针对ES-SCLC 治疗,且客观影像学进展(按照RECIST 1.1 标准判定)。包括: ?距离末次化疗 ≥180 天进展 ?敏感复发:距离末次化疗 ≥ 90 天并且<180天进展 ?耐药复发:距离末次化疗 < 90 天进展 6.ECOG PS 0~1 分 7.预计生存时间≥12周 8.首剂研究药物前≤28 天,CT 或 MRI 扫描,至少有一个既往未经放疗的靶病灶(RECIST v1.1) 9.有生育能力的女性受试者必须在首次给药前72小时内进行血妊娠试验且结果为阴性,且不在哺乳期,必须同意在试验期间和末次给予阿得贝利单抗后2个月或末次给予化疗药物后6个月(以时间长者为准)内采用有效避孕措施;对于伴侣为有生育能力女性的男性受试者,应为手术绝育或同意在试验期间和末次给予阿得贝利单抗后2个月或末次给予化疗药物后3个月(以时间长者为准)内采用有效避孕措施,研究期间不允许捐精 10.首剂研究药物前,实验室检查值满足以下条件: (1)血常规:白细胞计数(white blood cell, WBC)≥3.0 × 10^9/L;绝对中性粒细胞计数(absolute neutrophil count, ANC)≥1.5 × 10^9/L;血小板(platelet, PLT)≥100 × 10^9/L;血红蛋白含量(hemoglobin, HGB)≥9.0 g/dL (2)肝功能: 无肝转移受试者天门冬氨酸氨基转移酶(aspartate transferase, AST)、丙氨酸肝氨基转移酶(alanine aminotransferase, ALT)≤2.5 x ULN,碱性磷酸酶(alkaline phosphatase,ALP)≤ 2.5×ULN(正常值上限,upper limit of normal); 肝转移受试者其ALT 和 AST<5 x ULN; 有肝转移或骨转移者:ALP ≤5 ULN; 血清总胆红素(total bilirubin, TBIL)≤1.5 x ULN (除外 Gilbert 综合征总胆红素< 3.0 mg/dL) ; 白蛋白(albumin, ALB)≥3 g/dL (3)肾功能:血清肌酐≤1.5 x ULN 或 肌酐清除率 (creatinine clearance rate, CrCl) ≥50 mL/minute (使用 Cockcroft/Gault 公式) ;尿蛋白(urine protein, UPRO)阴性 (4)凝血功能:国际标准化比率(international normalized ratio, INR)≤1.5,活化部分凝血活酶时间(activated partial thromboplastin time, APTT)≤1.5 x ULN (5)其他:淀粉酶 ≤1.5 x ULN。若淀粉酶>1.5 x ULN 无临床或影像学证实胰腺炎的情况可以入组 |
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Inclusion criteria |
1. All subjects are required to sign the Inform consent form (ICF) before starting the study related procedures. 2. ≥18 years old and ≤70 years old 3. Histologically or cytologically proven SCLC 4. The stage was ES-SCLC according to the Veterans Administration Lung Study Group (VALG) 5. Previous first-line platinum-based treatment for ES-SCLC, and objective imaging progress (as determined by RECIST 1.1 criteria). Includes: ? Progress ≥180 days from the last chemotherapy ? Sensitive recurrence: ≥ 90 days from the last chemotherapy and < 180 days from progression ? Drug resistance relapse: distance from the last chemotherapy < 90-day progress 6.ECOG PS 0 to 1 points 7. Expected survival ≥12 weeks 8. CT or MRI scan showing at least one previously untreated target lesion ≤28 days before the first dose of the investigational drug (RECIST v1.1) 9. Fertile female subjects must have a negative blood pregnancy test within 72 hours before the first dose, are not breastfeeding, and must agree to use effective contraception during the trial period and 2 months after the last dose of adabiliumab or 6 months after the last dose of chemotherapy drugs, whichever is longer; Male subjects whose partners are fertile women should be surgically sterilized or agree to use effective contraception during the trial period and 2 months after the last administration of adbelizumab or 3 months after the last administration of chemotherapy drugs, whichever is longer. Sperm donation is not allowed during the study period 10. Before the first dose of the investigational drug, the laboratory test value meets the following conditions: (1) blood routine: white blood cell (WBC) ≥3.0 × 10^9/L; absolute neutrophil count (ANC) ≥1.5 × 10^9/L; platelet (PLT) ≥100 × 10^9/L; hemoglobin content (HGB) ≥9.0 g/dL (2) Liver function: Subjects without liver metastasis aspartate transferase (AST) and alanine aminotransferase (ALT) ≤2.5 x ULN, alkaline phosphatase (ALP) ≤ 2.5×ULN (upper limit of normal); ALT and AST< in subjects with liver metastasis; 5 x ULN; Patients with liver or bone metastasis: ALP ≤5 ULN; Serum total bilirubin (TBIL) ≤1.5 x ULN (except Gilbert syndrome total bilirubin < 3.0 mg/dL); albumin (ALB) ≥3 g/dL (3) Renal function: serum creatinine ≤1.5 x ULN or creatinine clearance rate (CrCl) ≥50 mL/minute (using Cockcroft/Gault formula); urine protein (UPRO) negative (4) Coagulation function: international normalized ratio (INR) ≤1.5, activated partial thromboplastin time (APTT) ≤1.5 x ULN (5) Other: amylase ≤ 1.5x ULN. If amylase; 1.5 x ULN without clinical or radiological evidence of pancreatitis could be enrolled |
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排除标准: |
受试者若符合以下任何一种情况,将不得进入本项研究: 1.组织学或细胞学确认的混合 SCLC 和 NSCLC 2.既往接受过抗肿瘤病毒治疗。既往接受过任何 T 细胞共刺激或免疫检查点治疗,包括但不限于细胞毒性T 淋巴细胞相关抗原-4(cytotoxic T lymphocyte-associated antigen-4,CTLA-4)抑制剂、PD-1 抑制剂、PD-L1/2 抑制剂、CD137激动剂或其他靶向T 细胞的药物 3.既往接受过拓扑替康、伊立替康或其他拓扑异构酶 I 抑制剂治疗 4.有临床症状/未经治疗的脑转移或脑膜转移。经治疗的脑转移受试者需要满足以下条件方可入组: ?治疗结束后≥4 周没有MRI 证明的进展 ?首剂研究药物前≥28 天内完成治疗 ?首剂研究药物前≤14 天不需要接受系统性皮质类固醇激素(>10mg/天强的松或等效剂量)的治疗 5.针对胸部和全脑的放疗在首剂研究药物前<4 周完成(骨病灶的姑息性放疗在首剂研究药物前完成允许入组) 6.有临床症状的第三间隙积液,如经抽水或其他治疗仍无法控制的心包积液、胸腔积液和腹腔积液 7.接受过实体脏器或血液系统移植 8.活动性、已知或怀疑自身免疫性疾病。允许白癜风、I 型糖尿病、仅需要激素替代疗法治疗的因自身免疫性甲状腺炎导致的残留甲状腺功能减退,或缺乏外因刺激的情况下预期不会复发的情况可以入组 9.首剂研究药物前≤14 天内使用皮质类固醇激素(>10 mg/天强的松或等效剂量)或其他免疫抑制剂。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肾上腺替代类固醇 10.首次研究药物前≤4 周内接种过或计划接种活疫苗的受试者(注:允许首次给药30天内接受针对季节性流感的注射用灭活病毒疫苗;但是不允许接受鼻内用药的减毒活疫苗) 11.间质性肺炎(interstitial pneumonia, ILD)病、药物诱导的肺炎、需要类固醇治疗的放射性肺炎或有临床症状的活动性肺炎 12.活动性肺结核(tuberculosis, TB)或筛选前≤48 周内有活动性肺结核感染病史的受试者,无论是否治疗 13.除脱发和乏力外,其他因既往抗肿瘤治疗导致的毒性需要在首剂研究用药前恢复至 CTCAE 4.03≤ 1 级。其他一些因既往抗肿瘤治疗导致的毒性预期内不能解决且有长期持续的后遗症,如铂类为基础的治疗导致的神经毒性,允许入组 14.在首次接受研究药物前 48 小时内进行过小手术(包括置管) 15.当前或近期(接受首剂研究药物前 10 天内)使用阿司匹林(> 325 mg/天) 或其他已知可以抑制血小板功能的非甾体抗炎药 16.当前或近期(接受首剂研究药物前 10 天内)使用全剂量口服或胃肠外抗凝血药或血栓溶解剂进行治疗。但允许预防性使用抗凝血药 17.有遗传性出血倾向或凝血功能障碍。筛选 12 周内出现过有临床意义的出血症状或具有明确的出血倾向,如消化道出血、出血性胃溃疡、基线期大便潜血++及以上,或患有脉管炎等 18.签署 ICF 前 24 周内发生过动/静脉血栓事件,如脑血管意外(包括暂时性缺血性发作、脑出血、脑梗塞)、深静脉血栓及肺栓塞等 19.未控制的高血压(收缩压≥140 mmHg 和/或舒张压≥90 mmHg)、有高血压危象或高血压脑病史 20.签署 ICF 前 24 周内有以下病史:消化道溃疡、胃肠道穿孔、腐蚀性食管炎或胃炎、炎性肠病或憩室炎、腹瘘、气管-食管瘘或腹腔内脓肿 21.有未能良好控制的心脏临床症状或疾病,如:(1)纽约心脏病协会(New York Heart Association, NYHA)2 级以上心力衰竭(2)不稳定型心绞痛(3)24 周内发生过心肌梗死(4)有临床意义的室上性或室性心律失常需要治疗或干预 22.已知对药物或辅料过敏,已知对任何一种单抗发生严重过敏反应 23.首剂用药前≤5 年并发其他恶性肿瘤,可以充分治疗的宫颈原位癌、基底细胞或鳞状上皮细胞皮肤癌、根治术后的局部前列腺癌、根治术后的导管原位癌除外 24.已知有精神疾病、酗酒、无法戒烟、吸毒或药物滥用等情况 25.HBsAg 阳性且HBV DNA 检测值超过正常值上限(1000 拷贝数/ml 或500IU/ml ),或 HCV 阳性(HCV RNA 或HCV Ab 检测提示急慢性感染);已知HIV 阳性病史或已知的获得性免疫缺陷综合征(Acquired Immune Deficiency Syndrome, AIDS) 26.签署 ICF 前 4 周内曾接受其它任何试验药物治疗或参加过另一项干预性临床研究 27.经研究者判断,受试者有其他可能导致本研究被迫中途终止的因素,如,不依从方案、其他的严重疾病(含精神疾病)需要合并治疗,有严重的实验室检查异常,伴有家庭或社会等因素,会影响到受试者的安全,或资料及样品的收集 |
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Exclusion criteria: |
Subjects will not be admitted to the study if they: 1. Histologically or cytologically confirmed mixed SCLC with NSCLC 2. Previously received anti-tumor virus therapy. Prior treatment with any T cell co-stimulation or immune checkpoint, including but not limited to cytotoxic T lymphocyte-associated antigen-4, CTLA-4) inhibitors, PD-1 inhibitors, PD-L1/2 inhibitors, CD137 agonists, or other drugs that target T cells 3. Previous treatment with topotecan, irinotecan, or other topoisomerase I inhibitors 4. There are clinical symptoms/untreated brain or meningeal metastases. Treated subjects with BMS were required to meet the following criteria to be enrolled: ? No MR-demonstrated progression ≥4 weeks after completion of treatment ? Completion of treatment ≥28 days before the first dose of the study drug ? Systemic corticosteroid therapy (> 10mg/ day prednisone or equivalent) is not required for ≤14 days prior to the first dose of the study drug 5. Radiotherapy for the chest and the whole brain should be completed < 4 weeks before the first dose of the study drug (palliative radiotherapy for bone lesions should be completed before the first dose of the study drug to allow inclusion) 6. Third space effusion with clinical symptoms, such as pericardial effusion, pleural effusion, and abdominal effusion that cannot be controlled by pumping or other treatment 7. Have received a solid organ or blood system transplant 8. Active, known, or suspected autoimmune disease. Vitiligo, type I diabetes, residual hypothyroidism due to autoimmune thyroiditis requiring treatment only with hormone replacement therapy, or conditions that are not expected to recur in the absence of external stimuli may be admitted 9. Use of corticosteroids (> 10 mg/ day prednisone or equivalent dose) or other immunosuppressants within ≤14 days prior to the first dose of the study drug. Inhaled or topical use of steroids and adrenal replacement steroids are permitted in the absence of active autoimmune disease 10. Subjects who have received or plan to receive live vaccine within ≤4 weeks prior to the initial study drug (Note: injectable inactivated virus vaccine against seasonal influenza is allowed within 30 days of the first dose; However, live attenuated vaccines for intranasal use are not allowed) 11. interstitial pneumonia (ILD), drug-induced pneumonia, radiation pneumonia requiring steroid treatment, or active pneumonia with clinical symptoms 12. Subjects with active tuberculosis (TB) or a history of active tuberculosis infection within 48 weeks or less before screening, with or without treatment 13. Except for alopecia and fatigue, other toxicities due to previous antitumor therapy should be restored to CTCAE 4.03≤ grade 1 before the first dose of study medication. Other toxicities due to previous antitumor therapy that are not expected to resolve and have long-lasting sequelae, such as neurotoxicity due to platinum-based therapy, are allowed to be included 14. Minor surgery (including catheterization) within 48 hours before first receiving the investigational drug 15. Current or recent use (within 10 days before receiving the first dose of the study drug) of aspirin (> 325 mg/ day) or other NSaids known to inhibit platelet function 16. Current or recent (within 10 days before receiving the first dose of the study drug) treatment with a full dose of oral or parenteral anticoagulants or thrombolytic agents. But prophylactic use of anticoagulants is permitted 17. Hereditary bleeding tendency or blood clotting dysfunction. Within 12 weeks of screening, there were clinically significant bleeding symptoms or definite bleeding tendencies, such as gastrointestinal bleeding, hemorrhagic gastric ulcer, stool occult blood ++ or above at baseline, or vasculitis 18. Arteriovenous thrombosis events occurred within 24 weeks prior to signing the ICF, such as cerebrovascular accidents (including transient ischemic attacks, cerebral hemorrhage, cerebral infarction), deep vein thrombosis, pulmonary embolism, etc 19. Uncontrolled hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg), hypertensive crisis, or hypertensive encephalopathy 20. In the 24 weeks prior to signing the ICF, there was a history of the following: digestive ulcer, gastrointestinal perforation, corrosive esophagitis or gastritis, inflammatory bowel disease or diverticulitis, abdominal fistula, tracheal oesophageal fistula, or intraperitoneal abscess 21. Have clinical symptoms or diseases of the heart that are not well controlled, such as: (1) New York Heart Association (NYHA) Grade 2 or higher heart failure (2) unstable angina pectoris (3) myocardial infarction within 24 weeks (4) Clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention 22. Known allergy to drugs or excipients, known severe allergic reactions to any monoclonal antibody 23. Other malignancies developed less than 5 years before the first dose, except for adequately treatable cervical carcinoma in situ, basal cell or squamous cell skin cancer, local prostate cancer after radical surgery, and ductal carcinoma in situ after radical surgery 24. Mental illness, alcoholism, inability to quit smoking, drug or substance abuse are known 25.HBsAg positive and HBV DNA test value exceeding the upper limit of normal (1000 copy number /ml or 500IU/ml), or HCV positive (HCV RNA or HCV Ab test indicating acute or chronic infection); Known HIV positive history or known Acquired Immune Deficiency Syndrome (AIDS) 26. Received any other investigational drug treatment or participated in another interventional clinical study within 4 weeks prior to signing the ICF 27.In the investigator's judgment, the subjects had other factors that might have led to the forced termination of the study, such as non-adherence to the protocol, other serious medical conditions (including mental illness) requiring combined treatment, serious laboratory abnormalities, family or social factors that would have affected the safety of the subjects, or the collection of data and samples |
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研究实施时间: Study execute time: |
从 From 2023-10-10 00:00:00至 To 2025-08-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2024-04-10 00:00:00 至 To 2025-06-01 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 |
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): |
N/A |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
N/A |
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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,https://medical.jianfancloud.com/#/login |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
EDC,https://medical.jianfancloud.com/#/login |
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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 |