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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: |
ChiCTR2600120966 |
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最近更新日期: Date of Last Refreshed on: |
2026-03-23 17:59:04 |
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注册时间: Date of Registration: |
2026-03-23 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: |
一项评估新辅助维迪西妥单抗联合辅助卡介苗灌注治疗 HER2 过表达高危及极高危非肌层浸润性膀胱癌有效性及安 全性的多中心、单臂、前瞻性 II 期临床试验 |
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Public title: |
A multicenter, single-arm, prospective phase II clinical trial evaluating the efficacy and safety of neoadjuvant durvalumab combined with adjuvant BCG instillation for the treatment of high-risk and extremely high-risk non-muscle-invasive bladder cancer with HER2 overexpression |
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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: |
一项评估新辅助维迪西妥单抗联合辅助卡介苗灌注治 疗 HER2 过表达高危及极高危非肌层浸润性膀胱癌有效性及安 全性的多中心、单臂、前瞻性 II 期临床试验 |
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Scientific title: |
A multicenter, single-arm, prospective phase II clinical trial evaluating the efficacy and safety of neoadjuvant durvalumab combined with adjuvant BCG instillation for the treatment of high-risk and extremely high-risk non-muscle-invasive bladder cancer with HER2 overexpression |
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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: |
何旺 |
研究负责人: |
何旺 |
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Applicant: |
Wang He |
Study leader: |
Wang He |
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申请注册联系人电话: Applicant telephone: |
+86 186 6559 9908 |
研究负责人电话: Study leader's telephone: |
+86 186 6559 9908 |
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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: |
hewang525344@126.com |
研究负责人电子邮件: Study leader's E-mail: |
hewang525344@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: |
广东省广州市越秀区沿江西路107号 |
研究负责人通讯地址: |
广东省广州市越秀区沿江西路107号 |
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Applicant address: |
No. 107, Yanjiang West Road, Yuexiu District, Guangzhou City, Guangdong Province |
Study leader's address: |
No. 107, Yanjiang West Road, Yuexiu District, Guangzhou City, Guangdong Province |
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申请注册联系人邮政编码: Applicant postcode: |
510120 |
研究负责人邮政编码: Study leader's postcode: |
510120 |
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申请人所在单位: |
中山大学孙逸仙纪念医院 |
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Applicant's institution: |
Sun Yat-sen Memorial Hospital of Sun Yat-sen University |
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研究负责人所在单位: |
中山大学孙逸仙纪念医院 |
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Affiliation of the Leader: |
Sun Yat-sen Memorial Hospital of Sun Yat-sen University |
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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: |
SYSKY-2026-008-01 |
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: |
中山大学孙逸仙纪念医院医学伦理委员会 |
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Name of the ethic committee: |
Medical Ethics Committee of Sun Yat-sen Memorial Hospital, Sun Yat-sen University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2026-01-23 00:00:00 |
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伦理委员会联系人: |
区柳珊 |
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Contact Name of the ethic committee: |
Liushan Ou |
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伦理委员会联系地址: |
广东省广州市越秀区沿江西路107号 |
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Contact Address of the ethic committee: |
No. 107, Yanjiang West Road, Yuexiu District, Guangzhou City, Guangdong Province |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 81332587 |
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: |
中山大学孙逸仙纪念医院 |
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Primary sponsor: |
Sun Yat-sen Memorial Hospital of Sun Yat-sen University |
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研究实施负责(组长)单位地址: |
广东省广州市越秀区沿江西路107号 |
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Primary sponsor's address: |
No. 107, Yanjiang West Road, Yuexiu District, Guangzhou 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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Target disease: |
Bladder 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: |
1.主要目的 评估“维迪西妥单抗新辅助联合术后辅助及BCG灌注”全程管理方案在HER2过表达HR/VHR-NMIBC患者中的有效性,其主要疗效终点指标为2年无事件生存率(EFS)。 2.次要目的 1)评估近期疗效:评估本治疗方案新辅助治疗后的临床完全缓解(cCR)率。 2)评估长期生存获益:评估膀胱完整无病生存期(BI-DFS)和总生存期(OS)。 3)评估安全性与耐受性:全面评估本方案的安全性特征及患者耐受性,详细记录不良事件(AEs)的类型、发生率及严重程度。 4)评估患者在治疗全程中的生活质量(QoL)变化。 3.探索性目的 通过收集并分析患者的生物学样本(肿瘤组织、血液、尿液等),探索可能预测本治疗方案疗效或与预后相关的生物标志物(包括但不限于ctDNA、utDNA、FGFR3、尿DNA甲基化、HER2通路相关基因等),为精准治疗及后续研究提供线索。 |
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Objectives of Study: |
1. Primary Objective To evaluate the efficacy of the full management regimen of "vedicitumab neoadjuvant therapy combined with postoperative adjuvant therapy and BCG instillation" in HER2-overexpressing HR/VHR-NMIBC patients, with the primary efficacy endpoint being the 2-year event-free survival (EFS) rate. 2. Secondary Objectives 1) To evaluate short-term efficacy: Assess the clinical complete response (cCR) rate after neoadjuvant therapy under this treatment regimen. 2) To evaluate long-term survival benefit: Assess bladder-intact disease-free survival (BI-DFS) and overall survival (OS). 3) To evaluate safety and tolerability: Conduct a comprehensive assessment of the safety profile and patient tolerability of this regimen, with detailed recording of the type, incidence, and severity of adverse events (AEs). 4) To evaluate changes in patient quality of life (QoL) throughout the treatment course. 3. Exploratory Objectives By collecting and analyzing patients’ biological samples (tumor tissue, blood, urine, etc.), explore biomarkers that may predict the efficacy of this treatment regimen or relate to prognosis (including but not limited to ctDNA, utDNA, FGFR3, urinary DNA methylation, HER2 pathway-related genes, etc.), providing clues for precision therapy and future research. |
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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.自愿参加本试验,能够提供书面版知情同意书,并且能理解并同意依从本项研究的要求以及评估时间表。 2.签署知情同意书之日年龄为18岁以上的男性或女性。 3.经组织学确诊为膀胱尿路上皮癌,分期为Ta、T1期或伴有原位癌(CIS)。组织学为混合型的肿瘤患者,要求尿路上皮癌成分占主导地位(>=70%)。 4.根据EAU NMIBC预后因素风险分层标准(基于WHO 2004/2016或1973分级系统),患者必须精确符合“高危(High Risk)”或“极高危(Very High Risk)”组的定义。具体标准如下(满足其一即可): 首先,定义临床风险因素为以下三项: (1)肿瘤多发(数量 > 2个) (2)肿瘤直径 > 3 cm (3)肿瘤复发 (4)年龄>70岁 符合以下任一分期、分级与风险因素组合的患者,可被纳入: (1)存在高风险病理特征者: 1)任何T1期、高级别/G3肿瘤(T1 HG/G3)。 2)尿道前列腺部伴有原位癌。 3)存在尿路上皮癌的变异亚型。 4)存在淋巴血管侵犯(LVI)。 (2)存在原位癌(CIS)者(除上述a点以外的情况)。 (3)不伴有CIS,但分期、分级与风险因素组合符合以下任一情况者: 1)T1期、G2肿瘤(T1G2),并具备至少1个临床风险因素。 2)Ta期、高级别/G3或T1期、低级别肿瘤(TaHG/G3或T1LG),并具备至少2个临床风险因素。 3)Ta期、低级别/G2或T1期、G1肿瘤(TaLG/G2或T1G1),并具备全部3个临床风险因素。 5.在开始新辅助治疗前,须提供诊断性活检或电切获取的肿瘤组织标本,经中心实验室或具备资质的当地实验室检测,确认为HER2过表达(定义为免疫组化IHC评分为2+或3+)。 6.新辅助治疗前有影像可评估病灶,或尿FISH/脱落细胞学阳性/DNA甲基化阳性。 7.美国东部肿瘤协作组(ECOG)体能状态评分为0或1。 8.患者的器官功能良好,由以下筛选期实验室检查值(入组前≤14天获得)衡量: (1)在筛选以下项目时, 患者不得在采集样本前≤14天使用生长因子支持: 1)中性粒细胞绝对计数≥1.5x109/L 2)血小板≥90×10^9/L 3)血红蛋白≥90g/L (2)国际标准化比值或活化部分凝血活酶时间≤1.5 正常值上限(ULN) (3)血清总胆红素≤1.5×ULN(如果是 Gilbert 综合征或间接胆红素浓度显示为肝外源性升高,则应≤3×ULN) (4)AST、ALT 和碱性磷酸酶≤2.5×ULN (5)肺功能提示可耐受手术 9.未受孕或有生育能力的女性必须愿意在研究期间、以及维迪西妥单抗末次给药后≥180天内采取高效避孕措施,并且在入组前≤7天内尿液或血清妊娠试验结果呈阴性。未绝育的男性必须愿意在研究期间、以及维迪西妥单抗末次给药后≥180天内采取高效避孕措施。 |
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Inclusion criteria |
1. Voluntarily participate in this trial, able to provide a written informed consent form, and can understand and agree to comply with the requirements and assessment schedule of this study. 2. Male or female aged 18 years or older on the day of signing the informed consent form. 3. Histologically confirmed urothelial carcinoma of the bladder, staged as Ta, T1, or with carcinoma in situ (CIS). For patients with mixed-type tumors, the urothelial carcinoma component must be predominant (>=70%). 4. According to the EAU NMIBC prognostic risk stratification standards (based on WHO 2004/2016 or 1973 grading system), patients must precisely meet the definition of 'High Risk' or 'Very High Risk.' The specific criteria are as follows (meeting any one is sufficient): First, define clinical risk factors as the following four items: (1) Multiple tumors (number > 2) (2) Tumor diameter > 3 cm (3) Tumor recurrence (4) Age > 70 years Patients meeting any of the following combinations of stage, grade, and risk factors can be included: (1) Presence of high-risk pathological features: 1) Any T1, high-grade/G3 tumor (T1 HG/G3). 2) Urethral prostatic involvement with carcinoma in situ. 3) Presence of variant subtypes of urothelial carcinoma. 4) Presence of lymphovascular invasion (LVI). (2) Presence of carcinoma in situ (CIS) (excluding the situations mentioned in point a above). (3) No CIS, but the combination of stage, grade, and risk factors meets any of the following conditions: 1) T1, G2 tumor (T1 G2), with at least one clinical risk factor. 2) Ta, high-grade/G3 or T1, low-grade tumor (Ta HG/G3 or T1 LG), with at least two clinical risk factors. 3) Ta, low-grade/G2 or T1, G1 tumor (Ta LG/G2 or T1 G1), with all three clinical risk factors. 5. Before starting neoadjuvant therapy, provide tumor tissue specimens obtained through diagnostic biopsy or transurethral resection. The specimens must be tested at a central laboratory or a qualified local laboratory and confirmed as HER2 overexpression (defined as immunohistochemistry IHC score of 2 or 3). 6. Before neoadjuvant therapy, imaging must allow for lesion assessment, or urine FISH/cytology positive/DNA methylation positive. 7. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. 8. The patient's organ function is adequate, as measured by the following screening laboratory test values (obtained <=14 days before enrollment): (1) During screening for the following items, the patient must not have used growth factor support within <=14 days before sample collection: 1) Absolute neutrophil count >=1.5×10^9/L 2) Platelets >=90×10^9/L 3) Hemoglobin >=90 g/L (2) International normalized ratio or activated partial thromboplastin time ≤1.5 times the upper limit of normal (ULN) (3) Serum total bilirubin <=1.5×ULN (if Gilbert's syndrome or indirect bilirubin elevation is of extrinsic hepatic origin, it should be <=3×ULN) (4) AST, ALT, and alkaline phosphatase <=2.5×ULN (5) Pulmonary function indicating the patient can tolerate surgery 9. Women who are not pregnant or of childbearing potential must be willing to use effective contraception during the study and for ≥180 days after the last dose of vidacizumab, and must have a negative urine or serum pregnancy test within <=7 days before enrollment. Men who have not undergone sterilization must be willing to use effective contraception during the study and for ≥180 days after the last dose of vidacizumab. |
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排除标准: |
1.根据EAU风险分层,符合“低危(Low Risk)”或“中危(Intermediate Risk)”定义的患者。 (1)“低危”定义包括: 1)原发、单发、TaT1 LG/G1肿瘤,直径<3cm,无CIS,且患者年龄≤70岁。 2)原发、Ta LG/G1肿瘤,无CIS,且最多只具备1个额外的临床风险因素。 (2)“中危”定义为: 1)不伴有CIS,且不符合“低危”、“高危”或“极高危”标准的任何患者。 2.确诊或疑似存在肌层浸润性(>=T2期)、淋巴结转移(N+)或远处转移(M1)的膀胱癌。 3.既往接受过以PD-1,、PD-L1、PD-L2、CTLA4、LAG-3、HER2、Nectin-4为靶点的疗法或其他专门以T细胞协同刺激或检查点通道为靶点的抗体或药物治疗。 4.入组前28天内接受其他已批准的全身性抗癌治疗或全身性免疫调节剂(包括但不限于干扰素、白介素2和肿瘤坏死因子)。 5.既往接受过针对膀胱癌放疗。 6.既往接受过针对肿瘤的药物治疗,以下除外: (1)对于既往接受过全身化疗的患者,自末次治疗后到新辅助药物治疗开始前至少 12 个月的无治疗间隔期; (2)局部膀胱腔内化疗或免疫治疗至少在研究新辅助药物治疗开始前 2 周结束治疗 7.入组前28天内曾进行过大型手术或出现重大外伤(植入血管通路装置和TURBT不视为大型手术)。 8.入组前14天内需要接受全身抗细菌、抗真菌或抗病毒治疗的严重慢性或活动性感染(HBV 感染按照 排除标准11的说明执行)。 9.入组前28天内接种过活疫苗(季节性注射的流感疫苗通常是灭活疫苗,因此允许使用。鼻内疫苗属于活体疫苗,所以不允许使用)。 10.需要全身治疗的活动性自身免疫性疾病,研究者评估认为对研究治疗有影响的。 11.需要长期大量使用激素或使用其它免疫抑制剂,研究者评估认为对研究治疗有影响的。 12.研究者认定可能影响治疗的钾、钠、钙异常或低白蛋白血症、间质性肺病、非感染性肺炎或其他不受控的全身疾病史,包括糖尿病、高血压、心血管疾病 (如入组前6个月内存在活动性的心脏疾病,包括:重度/不稳定性心绞痛、心肌梗死、有症状的充血性心力衰竭和需药物治疗的室性心律失常等)等。 13.HBV DNA>=500 IU/mL(2500 拷贝/mL)的未经治疗的慢性乙型肝炎受试者或乙型肝炎病毒携带者不得进入研究。注:非活动性乙型肝炎表面抗原携带者或经持续抗病毒治疗后稳定的活动性 HBV 感染(HBV DNA<500 IU/mL)的患者可以入组。 HBV DNA 检测只在针对乙型肝炎 核心抗原的抗体为阳性的患者中进行。 14.活动性丙型肝炎的患者不得入组。患者在筛选期 HCV 抗体检测阴性的,或 HCV 抗体检测阳性后 HCV RNA 检测阴性的患者可以入组。仅 HCV 抗体检测阳性的患者需要进行 HCV RNA 检测。 15.有免疫缺陷病史(包括人类免疫缺陷病毒HIV 检测阳性,其他获得性、先天性免疫缺陷疾病)或异基因 干细胞移植或器官移植史。 16.已知对其他单克隆抗体过敏。 17.已知对任何研究药物或者辅料过敏。 18.毒副作用(由于任何治疗)未恢复到基线或稳定水平的患者,除非研究者不认为这种毒副作用可能带 来安全性风险(例如脱发、神经病和特定实验室异常)。 19.存在不利于研究药物给药、或可能影响结果解读、或导致患者有发生治疗并发症的高风险的基础医学状况或酒精/药物滥用或依赖。 20.同时参加另一项治疗性临床研究。 |
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Exclusion criteria: |
1. According to the EAU risk stratification, patients who meet the definition of "Low Risk" or "Intermediate Risk". (1) "Low Risk" is defined as: 1) Primary, single, TaT1 LG/G1 tumor, diameter <3 cm, no CIS, and patient age ≤70 years. 2) Primary Ta LG/G1 tumor, no CIS, and at most only 1 additional clinical risk factor. (2) "Intermediate Risk" is defined as: 1) Any patient without CIS who does not meet the criteria for "Low Risk," "High Risk," or "Very High Risk." 2. Diagnosed or suspected muscle-invasive (≥T2), lymph node metastasis (N), or distant metastasis (M1) of bladder cancer. 3. Previously received therapies targeting PD-1, PD-L1, PD-L2, CTLA4, LAG-3, HER2, Nectin-4, or other antibodies or drugs specifically targeting T-cell co-stimulation or checkpoint pathways. 4. Received other approved systemic anticancer therapy or systemic immunomodulators (including but not limited to interferon, interleukin-2, and tumor necrosis factor) within 28 days before enrollment. 5. Previously received radiotherapy for bladder cancer. 6. Previously received drug treatment for tumors, except for the following: (1) For patients who have previously undergone systemic chemotherapy, a treatment-free period of at least 12 months from the last treatment to the start of neoadjuvant drug therapy; (2) Local intravesical chemotherapy or immunotherapy completed at least 2 weeks before the start of the study neoadjuvant drug therapy. 7. Underwent major surgery or experienced major trauma within 28 days before enrollment (implantation of vascular access devices and TURBT are not considered major surgery). 8. Severe chronic or active infection requiring systemic antibacterial, antifungal, or antiviral treatment within 14 days before enrollment (HBV infection is handled according to Exclusion Criterion 11). 9. Received a live vaccine within 28 days before enrollment (seasonal injected influenza vaccines are usually inactivated and therefore allowed; intranasal vaccines are live vaccines and not allowed). 10. Active autoimmune disease requiring systemic treatment that, in the investigator's assessment, may affect the study treatment. 11. Requires long-term use of high-dose hormones or other immunosuppressants, which the investigator deems may affect the study treatment. 12. Investigator-identified abnormalities in potassium, sodium, calcium, hypoalbuminemia, interstitial lung disease, non-infectious pneumonia, or other uncontrolled systemic diseases that may affect treatment, including diabetes, hypertension, cardiovascular diseases (such as active heart disease within 6 months prior to enrollment, including severe/unstable angina, myocardial infarction, symptomatic congestive heart failure, and ventricular arrhythmias requiring medication), etc. 13. Subjects with untreated chronic hepatitis B with HBV DNA ≥500 IU/mL (2500 copies/mL) or hepatitis B virus carriers are not allowed to enter the study. Note: Inactive hepatitis B surface antigen carriers or patients with active HBV infection stabilized after continuous antiviral treatment (HBV DNA <500 IU/mL) may be enrolled. HBV DNA testing is only performed in patients who are positive for antibodies against hepatitis B core antigen. 14. Patients with active hepatitis C are not eligible for enrollment. Patients who test negative for HCV antibodies during the screening period, or those who test positive for HCV antibodies but HCV RNA negative, may be enrolled. Only patients positive for HCV antibodies require HCV RNA testing. 15. History of immunodeficiency (including HIV-positive status, other acquired or congenital immunodeficiency diseases) or history of allogeneic stem cell transplantation or organ transplantation. 16. Known allergy to other monoclonal antibodies. 17. Known allergy to any investigational drug or excipient. 18. Patients whose toxic side effects (from any treatment) have not returned to baseline or stable levels, unless the investigator does not consider such toxic effects may pose a safety risk (e.g., alopecia, neuropathy, and certain laboratory abnormalities). 19. Presence of underlying medical conditions or alcohol/drug abuse or dependence that are unfavorable for administration of the study drug, may affect result interpretation, or pose a high risk of treatment-related complications. 20. Participation in another therapeutic clinical study at the same time. |
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研究实施时间: Study execute time: |
从 From 2026-03-23 00:00:00至 To 2031-03-22 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2026-03-23 00:00:00 至 To 2027-03-22 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: |
尚未开始 Not yet 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: |
公开/Public |
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盲法: |
无 |
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Blinding: |
None |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
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): |
无 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
None |
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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: |
本研究采用电子数据采集系统(EDC)进行数据的录入和管理。研究中心授权人员将源数据及时、准确录入电子病例报告表(eCRF),系统设置自动逻辑核查功能。数据管理员定期进行数据清理和核查,临床监查员(CRA)定期进行源数据核对(SDV)。在确认数据完整、准确且无疑问后,经主要研究者签字确认,执行数据库锁定。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
An Electronic Data Capture (EDC) system is utilized for data entry and management. Authorized personnel enter source data into eCRFs accurately and timely, with built-in logical checks. Data managers perform regular cleaning and verification, and Clinical Research Associates (CRAs) conduct periodic Source Data Verification (SDV). The database will be locked after data completeness and accuracy are confirmed by the Principal Investigator. |
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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 |