ChiCTR2500113030 版本V1.0 版本创建时间2025/11/24 11:41:39 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2500113030 

最近更新日期:

Date of Last Refreshed on:

2025-11-24 11:41:33 

注册时间:

Date of Registration:

2025-11-24 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

TOMO联合vNKT细胞过继回输治疗一线治疗失败的结直肠癌术后肝转移的有效性研究

Public title:

Efficacy of Helical Tomotherapy Combined with vNKT-Cell Adoptive Transfer in Postoperative Colorectal Cancer Patients with Liver Metastases After First-Line Therapy Failure

注册题目简写:

English Acronym:

研究课题的正式科学名称:

螺旋断层放疗(TOMO)联合vNKT细胞过继回输治疗一线治疗失败的结直肠癌术后肝转移的有效性:开放标签、单臂、II期临床研究

Scientific title:

Efficacy of Helical Tomotherapy (TOMO) Combined with vNKT-Cell Adoptive Transfer in Postoperative Colorectal Cancer Patients with Liver Metastases After First-Line Therapy Failure: An Open-Label, Single-Arm, Phase II Clinical 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:

王丽 

研究负责人:

王方寒 

Applicant:

Wang Li 

Study leader:

Wang Fanghan 

申请注册联系人电话:

Applicant telephone:

+86 150 5338 5306

研究负责人电话:

Study leader's telephone:

+86 139 6930 1600

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:

827870441@qq.com

研究负责人电子邮件:

Study leader's E-mail:

saisai10@sina.com

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:

中国山东省淄博经开区海岱大道139号

研究负责人通讯地址:

中国山东省淄博经开区海岱大道139号

Applicant address:

No. 139 Haidai Avenue Economic Development Zone, Zibo, Shandong, China

Study leader's address:

No. 139 Haidai Avenue Economic Development Zone, Zibo, Shandong, 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:

淄博市第四人民医院

Applicant's institution:

The Fourth People's Hospital of Zibo City

研究负责人所在单位:

淄博市第四人民医院

Affiliation of the Leader:

The Fourth People's Hospital of Zibo City

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:

SYKYLL-007

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:

淄博市第四人民医院伦理委员会

Name of the ethic committee:

The Ethics Committee of The Fourth People's Hospital of Zibo City

伦理委员会批准日期:

Date of approved by ethic committee:

2025-07-10 00:00:00

伦理委员会联系人:

柳善刚

Contact Name of the ethic committee:

Liu Shangang

伦理委员会联系地址:

中国山东省淄博经开区海岱大道139号

Contact Address of the ethic committee:

No. 139 Haidai Avenue Economic Development Zone, Zibo, Shandong, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 136 2643 2907

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:

淄博市第四人民医院

Primary sponsor:

The Fourth People's Hospital of Zibo City

研究实施负责(组长)单位地址:

中国山东省淄博经开区海岱大道139号

Primary sponsor's address:

No. 139 Haidai Avenue Economic Development Zone, Zibo, Shandong, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

山东

市(区县):

淄博

Country:

China

Province:

Shandong

City:

Zibo

单位(医院):

淄博市第四人民医院

具体地址:

中国山东省淄博张店区山泉路210号

Institution
hospital:

The Fourth People's Hospital of Zibo City

Address:

No. 210, Shanquan Road, Zhangdian District, Zibo, Shandong, China

经费或物资来源:

自筹

Source(s) of funding:

Self-financing

Target disease:

Postoperated colorectal carcinoma liver metastasis

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:

单臂 

Study design:

Single arm 

研究目的:

评估螺旋断层放疗联合vNKT细胞治疗一线治疗失败的结直肠癌术后肝转移pMMR/MSS患者的有效性  

Objectives of Study:

To assess the efficacy of helical tomotherapy combined with vNKT cell adaptive transfer therapy in postoperative colorectal cancer patients with liver metastases and pMMR/MSS status who have failed first-line treatment.

药物成份或治疗方案详述:

干预方案:先进行TOMO放疗;后跟进vNKT细胞过继回输治疗。 1. TOMO放疗方案 针对肝转移灶(单发或多发),采用立体定向放射治疗(SBRT)技术治疗或常规照射。具体放疗时,在肿瘤靶区(Gross Tumor Volume,GTV)外扩3-5 mm形成临床靶区(Clinical Target Volume,CTV),CTV再外扩3-5mm形成计划靶区(Planning Target Volume,PTV),确保精准覆盖病灶并保护正常肝组织。 2. vNKT细胞过继回输治疗方案 在TOMO放疗治疗后的1个月内,开始给予vNKT细胞静脉过继回输治疗。vNKT细胞按1×10^8/kg的剂量(或每疗程细胞总量1×10^10±15%)进行静脉过继回输。后续,vNKT细胞治疗按每月1个疗程的频率及同剂量进行治疗。直至进展,或回输满12个疗程,共12月)后终止。 

Description for medicine or protocol of treatment in detail:

Treatment Protocol: Helical Tomotherapy (TOMO) radiotherapy will be administered first, followed by vNKT cell adoptive transfer therapy. 1. TOMO Radiotherapy Protocol For liver metastases (whether solitary or multiple), stereotactic body radiotherapy (SBRT) technique or conventional irradiation will be used. During the radiotherapy, the clinical target volume (CTV) will be expanded by 3-5 mm from the gross tumor volume (GTV), and the planning target volume (PTV) will be expanded by another 3-5 mm from the CTV to ensure accurate coverage of the lesion and protection of normal liver tissue. 2. vNKT Cell Adoptive Transfer Therapy Protocol Within 1 month after TOMO radiotherapy, vNKT cell adoptive transfer therapy will be initiated via intravenous infusion. The vNKT cells will be administered at a dose of 1×10^8/kg (or a total cell number of 1×10^10±15% per course) for intravenous adoptive transfer. Subsequently, vNKT cell therapy will be continued at a frequency of one course per month and the same dose until disease progression or completion of 12 courses (12 months) 

纳入标准:

1. 年龄18-75岁,ECOG评分0-1或KPS>=70分,预期生存期>=6个月。 2. 病理确诊为结直肠腺癌,术后肝转移一线治疗失败。 3. 蛋白及基因检测表型为pMMR/MSS。RAS/BRAF状态需记录(野生型或突变型均允许)。 4. 肝转移灶数目<=5个,单个病灶最大径<=5 厘米,总肝体积受累<=50%。 5. 原发灶已根治性切除,或无症状未切除但无肠梗阻/出血风险(需MDT评估)。 6. 未接受过肝脏放疗、免疫细胞治疗(如CAR-T/TILs)或免疫检查点抑制剂(如PD-1/PD-L1抑制剂)。 7. 肝功能:Child-Pugh A级,ALT/AST<=3×ULN,总胆红素<=1.5×ULN。 血常规:ANC>=1.5×10^9/L,PLT>=75×10^9/L,Hb>=90g/L。 肾功能:eGFR>=60 mL/min/1.73m2。 8. 无活动性自身免疫性疾病(如类风湿关节炎、系统性红斑狼疮),未长期使用免疫抑制剂。 9. 无严重过敏史或既往免疫治疗相关毒性。 10.自愿签署知情同意书,能配合治疗及定期随访。

Inclusion criteria

1. Age 18-75 years, ECOG performance status 0-1 or KPS>= 70, and an expected survival of >= 6 months. 2. Pathologically confirmed colorectal adenocarcinoma with liver metastasis after failure of first-line therapy. 3. Phenotype of protein and gene testing is pMMR/MSS. The status of RAS/BRAF must be recorded (both wild-type and mutant are allowed). 4. Number of liver metastases <= 5, maximum diameter of a single lesion <= 5 cm, and total liver volume involved <= 50%. 5. The primary tumor has been radically resected, or it has not been resected but is asymptomatic and without risk of bowel obstruction/bleeding (MDT assessment required). 6. No prior liver radiotherapy, immunotherapy (e.g., CAR-T, TILs), or immune checkpoint inhibitors (e.g., PD-1/PD-L1 inhibitors). 7. Liver function: Child-Pugh Class A, ALT/AST <= 3×ULN, total bilirubin <=1.5×ULN. Blood routine: ANC >= 1.5×10^9/L, PLT >= 75×10^9/L, Hb >= 90 g/L. Renal function: eGFR >= 60 mL/min/1.73m2. 8. No active autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus), and no long-term use of immunosuppressive agents. 9. No history of severe allergies or prior immune therapy-related toxicities. 10. Willing to sign the informed consent form and able to comply with treatment and regular follow-up visits.

排除标准:

1. 存在未控制的脑转移、广泛腹膜转移(允许骨转移、可放疗处理的肺转移灶)。 2. 肝功能Child-Pugh B/C级。 3. dMMR/MSI-H患者。 4. HIV活动性感染状态患者。 5. 6个月内有免疫治疗史(含其它过继性免疫细胞治疗,如NK细胞)。 6. 1个月内接受过化疗或大手术,2周内接受过姑息性放疗。 7. 合并症排除。 (1)心肺疾病:NYHA心功能Ⅲ-Ⅳ级、COPD GOLD 3-4级。 (2)消化系统风险:活动性消化道出血、肠梗阻或穿孔风险。 8. 其它排除。 (1)妊娠/哺乳:妊娠或哺乳期女性。 (2)恶性肿瘤史:合并其他恶性肿瘤(非黑色素瘤皮肤癌、原位癌除外)。 (3)无法配合治疗或签署知情同意书。

Exclusion criteria:

1. Presence of uncontrolled brain metastases or extensive peritoneal metastases (bone metastases and pulmonary metastases amenable to radiotherapy are allowed). 2. Liver function classified as Child-Pugh grade B or C. 3. Patients with dMMR/MSI-H tumors. 4. Patients with active HIV infection. 5. History of immunotherapy within the past 6 months, including other adoptive cellular immunotherapies (e.g., NK cell therapy). 6. Receipt of chemotherapy or major surgery within 1 month, or palliative radiotherapy within 2 weeks prior to enrollment. 7. Comorbidities: (1)Cardiopulmonary conditions: NYHA Class III–IV heart failure or COPD GOLD stage 3–4. (2)Gastrointestinal risks: Active gastrointestinal bleeding, or risk of bowel obstruction or perforation. 8. Other exclusions: (1)Pregnancy/lactation: Pregnant or breastfeeding women. (2)History of malignancy: Concurrent malignancies other than non-melanoma skin cancer or carcinoma in situ. (3)Inability to comply with treatment or provide informed consent.

研究实施时间:

Study execute time:

From 2025-07-01 00:00:00 To 2028-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-12-29 00:00:00 To 2027-12-28 00:00:00  

干预措施:

Interventions:

组别:

治疗组

样本量:

40

Group:

Treatment Group

Sample size:

干预措施:

在TOMO放疗基础上,跟进vNKT细胞过继回输治疗。即针对肝转移灶(单发或多发),采用立体定向放射治疗(SBRT)技术治疗或常规照射。具体放疗时,在肿瘤靶区(Gross Tumor Volume,GTV)外扩3-5 mm形成临床靶区(Clinical Target Volume,CTV),CTV再外扩3-5mm形成计划靶区(Planning Target Volume,PTV),确保精准覆盖病灶并保护正常肝组织。在TOMO放疗治疗后的1个月内,开始给予vNKT细胞静脉过继回输治疗。vNKT细胞按1×10^8/kg的剂量(或每疗程细胞总量1×10^10±15%)进行静脉过继回输。后续,vNKT细胞治疗按每月1个疗程的频率及同剂量进行治疗。直至进展,或回输满12个疗程,共12月)后终止。

干预措施代码:

Intervention:

On the foundation of TOMO radiotherapy, patients will receive adjuvant adoptive transfer of vNKT cells. For liver metastases (solitary or multiple), stereotactic body radiation therapy (SBRT) or conventionally fractionated irradiation will be delivered. During planning, the Clinical Target Volume (CTV) is generated by adding a 3–5 mm isotropic margin to the Gross Tumor Volume (GTV), and the Planning Target Volume (PTV) is subsequently created by an additional 3–5 mm expansion on the CTV, ensuring precise coverage of the lesion while maximally sparing normal hepatic parenchyma. Within one month after completion of TOMO-based radiotherapy, intravenous adoptive transfer of vNKT cells will be initiated. The prescribed dose is 1×10^8 vNKT cells per kilogram of body weight (or 1×10^10±15% total cells per course). Thereafter, identical-dose vNKT-cell infusions will be repeated every four weeks (one course per month) until radiologic progression, or until 12 courses have been administered over a maximum of 12 months, whichever occurs first.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China 

Province:

Shandong 

City:

 

单位(医院):

淄博市第四人民医院 

单位级别:

三级 

Institution
hospital:

The Fourth People's Hospital of Zibo City

Level of the institution:

Tertiary

测量指标:

Outcomes:

指标中文名:

客观缓解率

指标类型:

主要指标

Outcome:

Objective Response Rate

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

疾病控制率

指标类型:

次要指标

Outcome:

Disease Control Rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

无进展生存期

指标类型:

次要指标

Outcome:

Progression-Free Survival

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

局部控制率

指标类型:

次要指标

Outcome:

Local Control Rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

总生存期

指标类型:

次要指标

Outcome:

Overall Survival

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

健康相关生命质量(KPS评分,EORTC量表)

指标类型:

附加指标

Outcome:

Health Related Quality of Life (KPS, EORTC)

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

实验室指标检查(血清肿瘤标志物; RAS、BRAF 和 MMR; 免疫学检测和ctDNA检测)

指标类型:

附加指标

Outcome:

Laboratory Markers (Serum Tumor Marker, RAS/BRAF/MMR, Immune analysis )and ctDNA

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

安全性指标

指标类型:

附加指标

Outcome:

Safety Index

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 75 years

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):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

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:

Blinding:

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

Yes

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):

研究结果发表后6个月内,采用使用ResMan平台(http://www.medresman.org.cn)进行数据共享。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Data sharing will be conducted via the ResMan platform (http://www.medresman.org.cn) within six months after the publication of study results.

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:

电子采集和管理系统

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Electronic Data Capture, EDC

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2025-11-24 11:41:33