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Camrelizumab in Combination With Apatinib in Advanced ICC: A Single-arm Phase II Study

Primary Purpose

Intrahepatic Cholangiocarcinoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Camrelizumab
Apatinib
Sponsored by
Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intrahepatic Cholangiocarcinoma

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histopathologically confirmed advanced ICC, or combined hepatocellular and cholangiocarcinoma (cHCC-CC, composition of cholangiocarcinoma >50%). nonresectable or metastatic cholangiocarcinoma and are not eligible for curative resection, transplantation, or ablative therapies.
  • Have at least one measurable lesion (in accordance with RECIST v1.1); the measurable lesion has a long diameter ≥ 10 mm or lymphadenopathy has a short diameter ≥ 15 mm in spiral CT scan.
  • Child-Pugh Class: Grade A
  • ECOG-PS score 0 or 1
  • Life Expectancy of at least 3 months
  • Have the required screening laboratory values

Exclusion Criteria:

  • Extrahepatic cholangiocarcinoma (EHCC) and primary liver cancer. other active malignant tumors except for ICC within 3 years or simultaneously. Cured localized tumor, for example, basal cell carcinoma of skin, squamous cell carcinoma of skin, superficial bladder cancer, carcinoma in situ of prostate, carcinoma in situs of cervix, breast cancer in situ may be enrolled.
  • Any active autoimmune disease or history of autoimmune disease and expected recurrence (including but not limited to autoimmune hepatitis, interstitial pneumonia, uveitis, enteritis, hypophysitis, vasculitis, nephritis, hyperthyroidism, hypothyroidism [subjects that can be controlled with hormone replacement therapy only can be enrolled]); subjects with skin diseases that does no need systemic treatment, for example, leukoderma, psoriasis, alopecia, those with controlled type I diabetes by insulin or those with asthma that has been completely resolved in childhood and with no need of any intervention can be enrolled; while subjects with asthma who need bronchodilator for medical intervention cannot be enrolled;
  • Use of strong CYP3A4/CYP2C19 inducers, including rifampicin (and its analogues) and St. John's Wort, or strong CYP3A4/CYP2C19 inhibitors within two weeks prior to signing informed consent form.
  • Previous treatment with other immune checkpoint inhibitors (include PD-1 antibody or other immunotherapy against PD-1/PD-L1), or previous use of Apatinib.
  • Known history of serious allergy to any monoclonal antibody or Apatinib.
  • Inability or unwilling to swallow tablets, malabsorption syndrome or any condition affecting gastrointestinal absorption.
  • Previous or current presence of metastasis to central nervous system.
  • Severe infection within 4 weeks prior to the start of study treatment, including but not limited to hospitalization for infection, bacteremia or complications of severe pneumonia; oral or intravenous therapeutic antibiotics within two weeks prior to the start of study treatment (for example, subjects who are given with preventive antibiotics for prevention of urinary tract infection or exacerbation of chronic obstructive pulmonary disease are eligible for participation in the study);
  • Other factors that may affect the study results or lead to forced termination of the study early as judged by investigators, such as alcoholism, drug abuse, other serious diseases (including mental disorders) requiring concomitant therapy, with serious laboratory examination abnormality, with family or social factors, that may affect subject's safety.

Sites / Locations

  • Li XuRecruiting
  • Sun Yat-sen University Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Camrelizumab combination with Apatinib

Arm Description

Camrelizumab 200mg, every 3 weeks, intravenous infused. Apatinib 250mg, once a day, orally. Until progression or unacceptable toxicity events develop.

Outcomes

Primary Outcome Measures

Progression-free Survival (PFS)
A duration from the date of initial treatment to disease progression (defined by RECIST 1.1) or death of any cause.

Secondary Outcome Measures

Objective Response Rate (ORR)
Proportion of patients whose tumor volume has reached a predetermined value and can maintain a minimum time limit, including complete response and partial response patients.
Overall Survival (OS)
Duration from the date of initial treatment to the date of death due to any cause.
Disease Control Rate (DCR)
Proportion of patients whose tumor volume control (reduced or enlarged) reaches a predetermined value and can maintain a minimum time limit.
Duration of Response (DoR)
Duration from the first time reported partial response or complete response to the first time of disease progression or death.
Time to Progression (TTP)
A duration from the date of initial treatment to disease progression (defined by RECIST 1.1)
Adverse events (AE)
Any adverse events related with treatment drugs and details include adverse events type, frequency and severity.

Full Information

First Posted
June 29, 2020
Last Updated
April 17, 2023
Sponsor
Sun Yat-sen University
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04454905
Brief Title
Camrelizumab in Combination With Apatinib in Advanced ICC: A Single-arm Phase II Study
Official Title
A Single-arm Phase II Study to Evaluate Camrelizumab in Combination With Apatinib in Patients With Advanced Intrahepatic Cholangiocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 1, 2020 (Actual)
Primary Completion Date
July 1, 2024 (Anticipated)
Study Completion Date
July 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-sen University
Collaborators
Jiangsu HengRui Medicine Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a single arm, open-label, non-randomized and single-center phase II clinical study, to evaluate the safety, tolerance, and efficacy of Camrelizumab in combination with Apatinib in patients with advanced intrahepatic cholangiocarcinoma (ICC).
Detailed Description
It is estimated that 50 patients who met the study criteria will be enrolled in 3 years and treated with Camrelizumab plus Apatinib in SYSUCC. The investigators will follow up and collect subjects' data to evaluate the efficacy and safety of treatment, including objective response rate (ORR) and Progression-free Survival (PFS) and Overall Survival (OS), until disease progression or death. Histopathology and multi-omics data analysis will be used to explore potential biomarkers of treatment response.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intrahepatic Cholangiocarcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Camrelizumab combination with Apatinib
Arm Type
Experimental
Arm Description
Camrelizumab 200mg, every 3 weeks, intravenous infused. Apatinib 250mg, once a day, orally. Until progression or unacceptable toxicity events develop.
Intervention Type
Drug
Intervention Name(s)
Camrelizumab
Other Intervention Name(s)
Camrelizumab for Injection
Intervention Description
Camrelizumab (Jiangsu HengRui Medicine Co., Ltd.) is a recombinant anti-human PD-1 IgG4 monoclonal antibody.
Intervention Type
Drug
Intervention Name(s)
Apatinib
Other Intervention Name(s)
Rivoceranib
Intervention Description
Apatinib is a novel angiogenesis inhibitor vascular endothelial growth factor 2.
Primary Outcome Measure Information:
Title
Progression-free Survival (PFS)
Description
A duration from the date of initial treatment to disease progression (defined by RECIST 1.1) or death of any cause.
Time Frame
Three years
Secondary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
Proportion of patients whose tumor volume has reached a predetermined value and can maintain a minimum time limit, including complete response and partial response patients.
Time Frame
Three years
Title
Overall Survival (OS)
Description
Duration from the date of initial treatment to the date of death due to any cause.
Time Frame
Three years
Title
Disease Control Rate (DCR)
Description
Proportion of patients whose tumor volume control (reduced or enlarged) reaches a predetermined value and can maintain a minimum time limit.
Time Frame
Two years
Title
Duration of Response (DoR)
Description
Duration from the first time reported partial response or complete response to the first time of disease progression or death.
Time Frame
Two years
Title
Time to Progression (TTP)
Description
A duration from the date of initial treatment to disease progression (defined by RECIST 1.1)
Time Frame
Two years
Title
Adverse events (AE)
Description
Any adverse events related with treatment drugs and details include adverse events type, frequency and severity.
Time Frame
Two years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histopathologically confirmed advanced ICC, or combined hepatocellular and cholangiocarcinoma (cHCC-CC, composition of cholangiocarcinoma >50%). nonresectable or metastatic cholangiocarcinoma and are not eligible for curative resection, transplantation, or ablative therapies. Have at least one measurable lesion (in accordance with RECIST v1.1); the measurable lesion has a long diameter ≥ 10 mm or lymphadenopathy has a short diameter ≥ 15 mm in spiral CT scan. Child-Pugh Class: Grade A ECOG-PS score 0 or 1 Life Expectancy of at least 3 months Have the required screening laboratory values Exclusion Criteria: Extrahepatic cholangiocarcinoma (EHCC) and primary liver cancer. other active malignant tumors except for ICC within 3 years or simultaneously. Cured localized tumor, for example, basal cell carcinoma of skin, squamous cell carcinoma of skin, superficial bladder cancer, carcinoma in situ of prostate, carcinoma in situs of cervix, breast cancer in situ may be enrolled. Any active autoimmune disease or history of autoimmune disease and expected recurrence (including but not limited to autoimmune hepatitis, interstitial pneumonia, uveitis, enteritis, hypophysitis, vasculitis, nephritis, hyperthyroidism, hypothyroidism [subjects that can be controlled with hormone replacement therapy only can be enrolled]); subjects with skin diseases that does no need systemic treatment, for example, leukoderma, psoriasis, alopecia, those with controlled type I diabetes by insulin or those with asthma that has been completely resolved in childhood and with no need of any intervention can be enrolled; while subjects with asthma who need bronchodilator for medical intervention cannot be enrolled; Use of strong CYP3A4/CYP2C19 inducers, including rifampicin (and its analogues) and St. John's Wort, or strong CYP3A4/CYP2C19 inhibitors within two weeks prior to signing informed consent form. Previous treatment with other immune checkpoint inhibitors (include PD-1 antibody or other immunotherapy against PD-1/PD-L1), or previous use of Apatinib. Known history of serious allergy to any monoclonal antibody or Apatinib. Inability or unwilling to swallow tablets, malabsorption syndrome or any condition affecting gastrointestinal absorption. Previous or current presence of metastasis to central nervous system. Severe infection within 4 weeks prior to the start of study treatment, including but not limited to hospitalization for infection, bacteremia or complications of severe pneumonia; oral or intravenous therapeutic antibiotics within two weeks prior to the start of study treatment (for example, subjects who are given with preventive antibiotics for prevention of urinary tract infection or exacerbation of chronic obstructive pulmonary disease are eligible for participation in the study); Other factors that may affect the study results or lead to forced termination of the study early as judged by investigators, such as alcoholism, drug abuse, other serious diseases (including mental disorders) requiring concomitant therapy, with serious laboratory examination abnormality, with family or social factors, that may affect subject's safety.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Li Xu, MD., PhD.
Phone
+862087343582
Email
xuli@sysucc.org.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Zhishan Lin
Phone
862087343437
Email
linzhsh@sysucc.org.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Minshan Chen, MD., PhD.
Organizational Affiliation
Sun Yat-sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Li Xu
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li Xu, MD.,PhD.
Phone
862087343582
Email
xuli@sysucc.org.cn
Facility Name
Sun Yat-sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li Xu, MD., PhD.
Phone
8620-87343115
Email
xuli@sysucc.org.cn
First Name & Middle Initial & Last Name & Degree
Zhishan Lin
Phone
8620-87343437
Email
linzhsh@sysucc.org.cn
First Name & Middle Initial & Last Name & Degree
Minshan Chen, M.D.

12. IPD Sharing Statement

Learn more about this trial

Camrelizumab in Combination With Apatinib in Advanced ICC: A Single-arm Phase II Study

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