mFOLFOX6联合柑橘黄酮片(爱脉朗)方案新辅助治疗YWHAB高表达型局部进展期直肠癌的开放、双臂、II期临床试验

注册号:

Registration number:

ChiCTR2500107086 

最近更新日期:

Date of Last Refreshed on:

2026-01-14 14:47:40 

注册时间:

Date of Registration:

2025-08-04 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

mFOLFOX6联合柑橘黄酮片(爱脉朗)方案新辅助治疗YWHAB高表达型局部进展期直肠癌的开放、双臂、II期临床试验

Public title:

An Open-Label, Two-Arm, Phase II Clinical Trial of Neoadjuvant mFOLFOX6 Combined with Citrus Flavonoid Tablets (Alvenor) for Locally Advanced Rectal Cancer with High YWHAB Expression

注册题目简写:

mFOLFOX6联合爱脉朗新辅助治疗YWHAB高表达局部进展期直肠癌的II期临床试验

English Acronym:

A Phase II Clinical Trial of Neoadjuvant mFOLFOX6 Combined with Citrus Flavonoid Tablets (Alvenor) for Locally Advanced Rectal Cancer with High YWHAB Expression

研究课题的正式科学名称:

mFOLFOX6联合柑橘黄酮片(爱脉朗)方案新辅助治疗YWHAB高表达型局部进展期直肠癌的开放、双臂、II期临床试验

Scientific title:

An Open-Label, Two-Arm, Phase II Clinical Trial of Neoadjuvant mFOLFOX6 Combined with Citrus Flavonoid Tablets (Alvenor) for Locally Advanced Rectal Cancer with High YWHAB Expression

研究课题代号(代码):

Study subject ID:

E2025123

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:

2025ZSLYEC-287

申请注册联系人:

胡拓 

研究负责人:

何晓生 

Applicant:

Tuo Hu 

Study leader:

Xiaosheng He 

申请注册联系人电话:

Applicant telephone:

+86 137 6338 5541

研究负责人电话:

Study leader's
telephone:

+86 135 4349 0940

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:

hutuo3@mail.sysu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

hexsheng@mail.sysu.edu.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:

中国广东省广州市天河区员村二横路26号中山大学附属第六医院(金融城院区)

研究负责人通讯地址:

中国广东省广州市天河区员村二横路26号中山大学附属第六医院(金融城院区)

Applicant address:

The Sixth Affiliated Hospital of Sun Yat-sen University (Financial City Campus) No. 26 Yuancun Erheng Road, Tianhe District, Guangzhou, Guangdong Province, China

Study leader's address:

The Sixth Affiliated Hospital of Sun Yat-sen University (Financial City Campus) No. 26 Yuancun Erheng Road, Tianhe District, Guangzhou, Guangdong Province, China

申请注册联系人邮政编码:

Applicant postcode:

510150

研究负责人邮政编码:

Study leader's postcode:

510150

申请人所在单位:

中山大学附属第六医院

Applicant's institution:

The Sixth Affiliated Hospital of Sun Yat-sen University

研究负责人所在单位:

中山大学附属第六医院

Affiliation of the Leader:

The Sixth Affiliated Hospital of Sun Yat-sen University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025ZSLYEC-287

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:

中山大学附属第六医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of The Sixth Affiliated Hospital of Sun Yat-sen University

伦理委员会批准日期:

Date of approved by ethic committee:

2025-05-23 00:00:00

伦理委员会联系人:

中山大学附属第六医院医学伦理委员会

Contact Name of the ethic committee:

Medical Ethics Committee of The Sixth Affiliated Hospital of Sun Yat-sen University

伦理委员会联系地址:

中国广东省广州市天河区员村二横路26号中山大学附属第六医院(金融城院区)

Contact Address of the ethic committee:

The Sixth Affiliated Hospital of Sun Yat-sen University (Financial City Campus) No. 26 Yuancun Erheng Road, Tianhe District, Guangzhou, Guangdong Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 20 3837 9764

伦理委员会联系人邮箱:

Contact email of the ethic committee:

zslyllb@mail.sysu.edu.cn

研究实施负责(组长)单位:

中山大学附属第六医院

Primary sponsor:

The Sixth Affiliated Hospital of Sun Yat-sen University

研究实施负责(组长)单位地址:

中国广东省广州市天河区员村二横路26号中山大学附属第六医院(金融城院区)

Primary sponsor's address:

The Sixth Affiliated Hospital of Sun Yat-sen University (Financial City Campus) No. 26 Yuancun Erheng Road, Tianhe District, Guangzhou, Guangdong Province, 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):

广东

市(区县):

广州

Country:

China

Province:

Guangdong

City:

Guangzhou

单位(医院):

中山大学附属第六医院

具体地址:

中国广东省广州市天河区员村二横路26号中山大学附属第六医院(金融城院区)

Institution
hospital:

The Sixth Affiliated Hospital of Sun Yat-sen University

Address:

The Sixth Affiliated Hospital of Sun Yat-sen University (Financial City Campus) No. 26 Yuancun Erheng Road, Tianhe District, Guangzhou, Guangdong Province, China

经费或物资来源:

研究者发起的项目,无项目经费

Source(s) of funding:

Investigator-Initiated Study (IIS) Without Project Funding

研究疾病:

直肠恶性肿瘤  

Target disease:

rectal cancer

研究疾病代码:

2B92

Target disease code:

2B92

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:

主要研究目的: 评估mFOLFOX6联合柑橘黄酮片(爱脉朗)方案新辅助治疗YWHAB高表达型局部进展期直肠癌患者,比较各组患者的肿瘤降期(ypTNM 0-I期)比例,为YWHAB高表达型局部进展期直肠癌患者应用联合新辅助化疗方案 (mFOLFOX6联合柑橘黄酮片)获益提供依据。 次要研究目的: 有效性评估:评估mFOLFOX6联合柑橘黄酮片(爱脉朗)方案新辅助治疗YWHAB高表达型局部进展期直肠癌患者的病理完全缓解比例、3年无病生存率(Disease-Free survival, DFS)、总生存时间(Overall survival, OS)和术后肿瘤退缩分级(Tumor Regression Grading, TRG)等。 安全性评估:评估mFOLFOX6联合柑橘黄酮片(爱脉朗)方案新辅助治疗YWHAB高表达型局部进展期直肠癌患者的治疗相关不良反应率(三级以上)。  

Objectives of Study:

Primary Objective To evaluate the tumor downstaging rate (ypTNM 0-I stage) in patients with YWHAB-overexpressing locally advanced rectal cancer (LARC) receiving neoadjuvant therapy with mFOLFOX6 combined with citrus flavonoid tablets (Aimailang), and to establish evidence for the clinical benefits of this combination regimen in this molecularly defined population. Key Terminology: Tumor downstaging rate: Defined as the proportion of patients achieving post-treatment pathological stage ypTNM 0-I. YWHAB-overexpressing LARC: Biomarker-enriched population with immunohistochemistry (IHC) or RNA-seq confirmed YWHAB overexpression. Secondary Objectives 1. Efficacy Assessments Pathological complete response (pCR) rate: Proportion of patients with no residual viable tumor cells in surgical specimens (ypT0N0). 3-year disease-free survival (DFS): Time from surgery to disease recurrence or death from any cause. Overall survival (OS): Time from treatment initiation to death from any cause. Tumor regression grading (TRG): Mandard or Dworak system-based assessment of tumor response in resected specimens. 2. Safety Assessments Incidence of Grade ≥3 treatment-related adverse events (TRAEs): Evaluated per CTCAE v5.0 criteria, focusing on hematologic, gastrointestinal, and neurotoxicities associated with mFOLFOX6 and Aimailang.

药物成份或治疗方案详述:

本研究为前瞻性、开放、双臂、II期临床试验,将术前诊断为YWHAB高表达型局部进展期直肠癌患者纳入本研究,使用mFOLFOX6联合柑橘黄酮片(爱脉朗)方案进行新辅助化疗及术后辅助化疗。 mFOLFOX6方案联合柑橘黄酮片(爱脉朗)×术前4-6周期和术后6-8周期,每14天为1个治疗周期。奥沙利铂 85 mg/m²静脉滴注180分钟,第1天;亚叶酸 400 mg/m²静脉滴注120分钟,第1天; 5-氟尿嘧啶 2400 mg/m²,持续静脉滴注46h;联合或不联合柑橘黄酮片(爱脉朗)500mg,每日口服3次,在每个14天周期的第1 ~ 14天给药。本试验允许调整剂量,接受新辅助治疗期间发生疾病进展的患者停止研究治疗,直接接受手术治疗或根据当地指南进行治疗。如果患者无法耐受计划的6个周期的新辅助治疗,也可以提前进行手术。任何在手术前接受了其他方案抗癌治疗的患者均停止研究治疗,并按照相应的指南进行管理。两组患者的术后治疗由研究者决定,包括继续接受mFOLFOX6方案联合柑橘黄酮片(爱脉朗)治疗,需注意的是所有入组的对照组患者在试验期间均不能擅自服用柑橘黄酮片(爱脉朗),因各种原因需口服该药物,应与主诊医师沟通并由主诊医师决定是否使用其他药物代替或者中止该患者的试验。 

Description for medicine or protocol of treatment in detail:

This study is a prospective, open-label, two-arm, phase II clinical trial involving patients preoperatively diagnosed with YWHAB-high locally advanced rectal cancer. The trial evaluates a regimen combining mFOLFOX6 chemotherapy with citrus flavonoid tablets (Aimailang) for neoadjuvant therapy (pre-surgery) and postoperative adjuvant therapy. Treatment Protocol Preoperative (4–6 cycles) and Postoperative (6–8 cycles): Each 14-day cycle includes: Oxaliplatin: 85 mg/m² via 180-minute intravenous infusion on Day 1. Leucovorin: 400 mg/m² via 120-minute intravenous infusion on Day 1. 5-Fluorouracil: 2400 mg/m² via continuous intravenous infusion over 46 hours. Citrus flavonoid tablets (Aimailang): 500 mg orally three times daily (Days 1–14), administered with or without the chemotherapy regimen (depending on group assignment). Key Trial Design Features Dose Adjustments: Permitted during the trial based on patient tolerance. Discontinuation Criteria: Patients with disease progression during neoadjuvant therapy will cease study treatment and proceed to surgery or alternative therapies per local guidelines. Surgery may be initiated early if patients cannot tolerate the planned 6 cycles of neoadjuvant therapy. Patients receiving non-protocol anticancer therapies preoperatively will be withdrawn from the study. Postoperative Management: Post-treatment plans (e.g., continuation of mFOLFOX6 + Aimailang) are determined by the investigator. Control Group Restriction: Patients in the control arm are not permitted to self-administer citrus flavonoid tablets (Aimailang) during the trial. Any requirement for this medication must be discussed with the treating physician, who will decide on alternative therapies or trial withdrawal. 

纳入标准:

Inclusion criteria

排除标准:

(1)全身CT、MR或PET-CT(至少包括胸部、全腹部和盆腔)证实有远处转移; (2)全基因组检测DPD酶缺陷或UGT1A1*28位点7/7型纯合子的患者; (3)患者合并完全性肠梗阻、活动性出血或穿孔并且需行急诊手术; (4)既往或同时存在其他活动性恶性肿瘤(曾接受治愈性治疗且超过5年无复发的恶性肿瘤或可通过充分治疗治愈的原位癌除外); (5)入组研究前12个月内发生过血栓或栓塞事件,例如脑血管意外(包括一过性脑缺血发作)、肺栓塞、深静脉血栓; (6)入组研究前12个月内,出现以下情况:心肌梗死、严重/不稳定型心绞痛、NYHA 2级以上心功能不全、有临床意义的室上性或室性心律失常以及症状性充血性心力衰竭; (7)入组研究前4周内全身性使用抗生素≥ 7天,或在筛选期间/首次给药前出现不明原因的发热>38.5°C(经研究者判断,因肿瘤原因导致的发热可以入组); (8)入组研究前2个月内接受过例如剖腹术、开胸术、通过腹腔镜手术切除脏器等大手术或严重外伤(入组本临床试验前手术切口应当完全愈合); (9)已知存在人免疫缺陷病毒(HIV)感染或获得性免疫缺陷综合症(AIDS)相关性疾病; (10)存在间质性肺病、非感染性肺炎或无法控制的系统性疾病(如:糖尿病、高血压、肺纤维化和急性肺炎等); (11)未经治疗的活动性肝炎(乙型肝炎,定义为HBV-DNA ≥ 500 IU/mL;丙型肝炎,定义为HCV-RNA高于分析方法的检测下限)或合并乙肝和丙肝共同感染; (12)已知或怀疑对研究中使用的任何相关药物过敏的病史; 研究者认为不适合参与本研究的患者。

Exclusion criteria:

1.Distant Metastasis: Confirmed by systemic imaging (CT, MR, or PET-CT) encompassing at least the chest, abdomen, and pelvis; 2.Pharmacogenetic Deficiency: Known complete DPD (dihydropyrimidine dehydrogenase) enzyme deficiency or homozygous UGT1A1*28 (7/7) genotype identified by whole-genome testing; 3.Acute Surgical Complications: Presence of complete intestinal obstruction, active bleeding, or perforation requiring emergency surgery; 4.Other Active Malignancies: History or concurrent presence of other active malignancies, except for malignancies treated with curative intent with no recurrence for >5 years, or adequately treated carcinoma in situ (e.g., cervical carcinoma in situ, non-melanoma skin cancer); 5.Thromboembolic Events: History of thromboembolic events (e.g., cerebrovascular accident [including transient ischemic attack], pulmonary embolism, deep vein thrombosis) within 12 months prior to study enrollment; 6.Significant Cardiac Disease: Occurrence of any of the following within 12 months prior to enrollment: myocardial infarction, severe/unstable angina, heart failure of NYHA class 2 or higher, clinically significant supraventricular or ventricular arrhythmia requiring treatment, or symptomatic congestive heart failure; 7.Recent Infection/Fever: Systemic antibiotic use for >=7 days within 4 weeks prior to enrollment, OR unexplained fever >38.5°C during screening or prior to the first dose (fever attributed to the tumor by the investigator is allowed); 8.Major Surgery/Trauma: Undergone major surgery (e.g., laparotomy, thoracotomy, organ resection via laparoscopy) or experienced significant trauma within 2 months prior to enrollment. The surgical incision must be fully healed before study entry; 9.HIV/AIDS: Known HIV infection or AIDS-related illness; 10.Significant Pulmonary/Systemic Disease: Presence of interstitial lung disease, non-infectious pneumonitis, OR uncontrolled systemic diseases (e.g., diabetes mellitus, hypertension, pulmonary fibrosis, acute pneumonitis); 11.Untreated Active Hepatitis: Untreated active hepatitis B (defined as HBV-DNA >= 500 IU/mL) or hepatitis C (defined as HCV-RNA above the lower limit of quantification), OR known co-infection with HBV and HCV; 12.Drug Hypersensitivity: Known or suspected history of hypersensitivity to any of the drugs related to the study treatment; 13.Investigator Discretion: Any other condition that, in the judgment of the investigator, would make the patient unsuitable for participation in the study.

研究实施时间:

Study execute time:

From 2025-08-05 00:00:00 To 2030-11-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-08-05 00:00:00 To 2027-11-01 00:00:00

干预措施:

Interventions:

组别:

mFOLFOX6方案新辅助治疗组

样本量:

118

Group:

mFOLFOX6 regimen neoadjuvant therapy group

Sample size:

干预措施:

mFOLFOX6方案

干预措施代码:

Intervention:

mFOLFOX6 regimen

Intervention code:

组别:

mFOLFOX6方案联合柑橘黄酮片(爱脉朗)新辅助治疗组

样本量:

118

Group:

mFOLFOX6 regimen combined with Citrus Flavone Tablets (Alvenor) neoadjuvant treatment group

Sample size:

干预措施:

mFOLFOX6方案联合柑橘黄酮片(爱脉朗)

干预措施代码:

Intervention:

mFOLFOX6 regimen combined with Citrus Flavonoid Tablets (Alvenor)

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广东 

市(区县):

广州市 

Country:

China

Province:

Guangdong

City:

Guangzhou

单位(医院):

中山大学附属第六医院 

单位级别:

三甲 

Institution
hospital:

The Sixth Affiliated Hospital of Sun Yat-sen University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

肿瘤降期率(ypTNM 0-I期)

指标类型:

主要指标

Outcome:

Tumor downstaging rate (to ypTNM stage 0-I)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

病理缓解程度

指标类型:

次要指标

Outcome:

Degree of Pathological Response

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

3年无病生存率

指标类型:

次要指标

Outcome:

Three-year disease-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:

总生存时间

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:

肿瘤消退分级

指标类型:

次要指标

Outcome:

Tumor regression grade

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

治疗相关不良反应率(三级以上)

指标类型:

次要指标

Outcome:

Rate of Treatment-Related Adverse Events (Grade 3 or Higher)

Type:

Secondary 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:

直肠癌组织

组织:

直肠癌

Sample Name:

Tissue of rectal cancer

Tissue:

rectal cancer

人体标本去向

使用后保存  

说明

制备成石蜡保存

Fate of sample:

Preservation after use  

Note:

Prepared and stored in paraffin

标本中文名:

血液

组织:

血液

Sample Name:

Blood

Tissue:

Blood

人体标本去向

使用后保存  

说明

提取血浆后保存在-80摄氏度冰箱,长期保存

Fate of sample:

Preservation after use  

Note:

Plasma was collected and stored at –80?°C for long-term preservation.

标本中文名:

尿液

组织:

尿液

Sample Name:

Urine

Tissue:

Urine

人体标本去向

使用后销毁  

说明

使用后销毁,不保存

Fate of sample:

Destruction after use  

Note:

Destruction after use; not stored

征募研究对象情况:

Recruiting status:

正在进行

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):

采用区组随机方法,由独立的统计学人员使用SAS软件生成随机序列,区组长度为4,确保分组过程的随机性和客观性。随机分配序列在试验开始前完成,并由非参与临床实施的第三方进行保密和保管。

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

Block randomization was used, with a block size of 4. The randomization sequence was generated by an independent statistician using SAS software to ensure randomness and objectivity in the allocation process. The randomization sequence was completed prior to trial initiation and was kept confidential by a third party not involved in the clinical conduct of the study.

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

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

是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):

本研究所涉及的原始数据包含受试者隐私及敏感临床信息,暂不通过公共平台公开。若第三方基于科学研究目的提出合理的数据共享需求,可通过联系项目负责人(hexsheng@mail.sysu.edu.cn)提出申请,经研究团队审核同意并签署数据使用协议后,方可获取相关原始数据。

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

The raw data of this study contain participants’ privacy and sensitive clinical information and will not be made publicly available via open-access platforms at this stage. Third parties with reasonable requests for scientific research purposes may contact the principal investigator (hexsheng@mail.sysu.edu.cn). Access to the data will be granted upon approval by the research team and the signing of a data use agreement.

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:

本研究采用纸质病例报告表(CRF)进行数据采集。数据将由专门的数据管理人员双人独立录入电子表格,录入过程设有逻辑核查与一致性校验,确保数据的准确性与完整性。所有数据将定期备份,并在数据库锁定前由独立质控人员审核确认。

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

Data collection in this study will be conducted using paper-based Case Report Forms (CRFs). The data will be independently entered into electronic spreadsheets by two trained data management personnel. Logical checks and consistency validations will be implemented during the data entry process to ensure accuracy and completeness. All data will be backed up regularly and reviewed by independent quality control personnel prior to database lock.

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:

 2025-08-04 10:08:32