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Peri-operative Sintilimab in Combination With SOX in Locally Advanced Gastric Cancer

Primary Purpose

Gastric Cancer, Perioperative, Sintilimab

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Sintilimab
S-1
Oxaliplatin
Sponsored by
Tianjin Medical University Cancer Institute and Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastric Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female, 18 years old ≤ age ≤ 75 years old
  • ECOG PS score 0-1
  • Treatment naive patients diagnosed as gastric adenocarcinoma or gastroesophageal junction adenocarcinoma by histopathology
  • No known HER2-positive status;
  • Clinical stage Ⅱ, Ⅲ (T1-4a N+ M0, T3-4a N0 M0, AJCC 8th)
  • The research center and the surgeon can complete D2 radical gastrectomy
  • Physical condition and organ function allow for larger abdominal surgery
  • Sufficient organ and bone marrow function, which is defined as follows:

    1. Blood routine: absolute neutrophil count (ANC)≥1.5×109/L; platelet count (PLT)≥100×109/L; hemoglobin content (HGB)≥9.0 g/dL.
    2. Liver function: Patients without liver metastasis require serum total bilirubin (TBIL) ≤1.5×upper limit of normal (ULN); alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 ×ULN;
    3. Renal function: Creatinine clearance rate (Ccr) ≥50 mL/min (calculated by Cockcroft/Gault formula):

      1. Female: Ccr= (140-years old) x weight (kg) x 0.85/(72 x serum creatinine (mg/dL))
      2. Male: Ccr= (140-years old) x weight (kg) x 1.00/(72 x serum creatinine (mg/dL))
    4. The coagulation function is adequate, defined as the international normalized ratio (INR) or prothrombin time (PT) ≤ 1.5 times ULN; if the subject is receiving anticoagulation therapy, as long as the PT is within the proposed range of anticoagulation drugs
  • LVEF≥50%;
  • Agree and be able to comply with the plan during the research period;
  • Provide written informed consent before entering the study screening, and the patient has understood that participants can withdraw from the study at any time during the study without any loss;

Exclusion Criteria:

  • Complicated with upper gastrointestinal obstruction/bleeding or abnormal digestive function or malabsorption syndrome;
  • Complicated with severe uncontrolled concurrent infection or other severe uncontrolled concomitant disease, moderate or severe renal injury;
  • Received previous anti-tumor therapy, including chemotherapy, radiotherapy, targeted therapy or immunotherapy, etc.;
  • Suffered from other malignant tumors in the past 5 years (except basal cell or squamous cell carcinoma, superficial bladder cancer, cervical cancer in situ or breast cancer);
  • Uncontrollable pleural effusion, pericardial effusion or ascites;
  • Suffered from severe cardiovascular disease within 12 months before enrollment, such as symptomatic coronary heart disease, congestive heart failure ≥ Grade II, uncontrolled arrhythmia, and myocardial infarction;
  • Allergic reactions to the drugs used in this study;
  • Use steroids or other systemic immunosuppressive therapies 14 days before enrollment;
  • Patients who received study drug treatment within 4 weeks before enrollment (participate in other clinical trials);
  • Active autoimmune diseases;
  • History of primary immunodeficiency;
  • Have used immunosuppressive drugs within 4 weeks before the first dose of study treatment, excluding nasal spray, inhaled or other local glucocorticoids or physiological doses of systemic glucocorticoids (that is, no more than 10 mg/day Pred nisone or other glucocorticoids in equivalent doses), or use hormones to prevent allergy to contrast agents;
  • Within 4 weeks before the first dose of study treatment or plan to receive live attenuated vaccine during the study period;
  • Known to have active tuberculosis;
  • Known history of allogeneic organ transplantation and allogeneic hematopoietic stem cell transplantation;
  • HIV antibody positive, active hepatitis B or C (HBV, HCV);
  • Pregnant or lactating women

Sites / Locations

  • Tianjin Medical University Cancer Institute & HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Experimental Group-Sintilimab in combination with SOX

Active Comparator-SOX

Arm Description

Preoperative treatment: three cycles of sintilimab in combination with SOX. Radical gastrectomy and lymphadenectomy (D2). Postoperative treatment: five cycles of SOX, Sintilimab up to one year.

Preoperative treatment: three cycles of SOX. Radical gastrectomy and lymphadenectomy (D2). Postoperative treatment: five cycles of SOX.

Outcomes

Primary Outcome Measures

Pathological complete response (pCR) rate
Pathological complete response (pCR) rate is defined as the proportion of participants whose tumor in the stomach and lymph node completely disappeared, as determined by a pathologist.

Secondary Outcome Measures

Tumor down-staging rate
Tumor down-staging is defined as any stage reduction between clinical and pathologic stage
Major pathological response (MPR) rate
Major pathological response (MPR) rate is defined as the proportion of participants whose percentage of residual tumor in the stomach and lymph node decreased to < 10%, as determined by a pathologist.
3 years disease-free survival (DFS) rate
3 years disease-free survival (DFS) rate is defined as proportion of participants who have no recurrence or metastasis after 3 years of radical treatment
5 years overall survival (OS) rate
5 years overall survival (OS) rate is defined as proportion of participants who survived 5 years after radical treatment
Adverse event
All grades of adverse events, all grades of treatment related adverse events, serious of adverse events
Overall response rate ( ORR)
Overall response rate ( ORR) is defined as proportion of participants who have a best response of CR or PR
Disease Control Rate (DCR)
Disease Control Rate (DCR) is defined as proportion of participants who have a best response of CR、PR or SD

Full Information

First Posted
July 23, 2021
Last Updated
August 25, 2021
Sponsor
Tianjin Medical University Cancer Institute and Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04982939
Brief Title
Peri-operative Sintilimab in Combination With SOX in Locally Advanced Gastric Cancer
Official Title
Efficacy and Safety of Peri-operative Sintilimab in Combination With SOX in Resectable Locally Advanced Gastric Cancer: a Multiple-center Open-label Randomized Phase II Trial.
Study Type
Interventional

2. Study Status

Record Verification Date
July 2021
Overall Recruitment Status
Recruiting
Study Start Date
June 21, 2021 (Actual)
Primary Completion Date
June 21, 2023 (Anticipated)
Study Completion Date
June 21, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tianjin Medical University Cancer Institute and Hospital

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
To evaluate efficacy and safety of peri-operative sintilimab in combination with SOX in resectable locally advanced gastric or gastroesophageal junction adenocarcinoma

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Cancer, Perioperative, Sintilimab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
210 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Experimental Group-Sintilimab in combination with SOX
Arm Type
Experimental
Arm Description
Preoperative treatment: three cycles of sintilimab in combination with SOX. Radical gastrectomy and lymphadenectomy (D2). Postoperative treatment: five cycles of SOX, Sintilimab up to one year.
Arm Title
Active Comparator-SOX
Arm Type
Active Comparator
Arm Description
Preoperative treatment: three cycles of SOX. Radical gastrectomy and lymphadenectomy (D2). Postoperative treatment: five cycles of SOX.
Intervention Type
Drug
Intervention Name(s)
Sintilimab
Other Intervention Name(s)
IBI308
Intervention Description
Sintilimab, 200mg IV d1 Q3W
Intervention Type
Drug
Intervention Name(s)
S-1
Intervention Description
S-1, 40-60mg BID d1-14 Q3W
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin
Intervention Description
Oxaliplatin,130mg/m2 d1 Q3W
Primary Outcome Measure Information:
Title
Pathological complete response (pCR) rate
Description
Pathological complete response (pCR) rate is defined as the proportion of participants whose tumor in the stomach and lymph node completely disappeared, as determined by a pathologist.
Time Frame
up to 8 weeks after surgery
Secondary Outcome Measure Information:
Title
Tumor down-staging rate
Description
Tumor down-staging is defined as any stage reduction between clinical and pathologic stage
Time Frame
up to 8 weeks after surgery
Title
Major pathological response (MPR) rate
Description
Major pathological response (MPR) rate is defined as the proportion of participants whose percentage of residual tumor in the stomach and lymph node decreased to < 10%, as determined by a pathologist.
Time Frame
up to 8 weeks after surgery
Title
3 years disease-free survival (DFS) rate
Description
3 years disease-free survival (DFS) rate is defined as proportion of participants who have no recurrence or metastasis after 3 years of radical treatment
Time Frame
up to 4 years
Title
5 years overall survival (OS) rate
Description
5 years overall survival (OS) rate is defined as proportion of participants who survived 5 years after radical treatment
Time Frame
up to 6 years
Title
Adverse event
Description
All grades of adverse events, all grades of treatment related adverse events, serious of adverse events
Time Frame
up to 30 days after last treatment administration
Title
Overall response rate ( ORR)
Description
Overall response rate ( ORR) is defined as proportion of participants who have a best response of CR or PR
Time Frame
up to 30 days after last preoperative treatment administration
Title
Disease Control Rate (DCR)
Description
Disease Control Rate (DCR) is defined as proportion of participants who have a best response of CR、PR or SD
Time Frame
up to 30 days after last preoperative treatment administration

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, 18 years old ≤ age ≤ 75 years old ECOG PS score 0-1 Treatment naive patients diagnosed as gastric adenocarcinoma or gastroesophageal junction adenocarcinoma by histopathology No known HER2-positive status; Clinical stage Ⅱ, Ⅲ (T1-4a N+ M0, T3-4a N0 M0, AJCC 8th) The research center and the surgeon can complete D2 radical gastrectomy Physical condition and organ function allow for larger abdominal surgery Sufficient organ and bone marrow function, which is defined as follows: Blood routine: absolute neutrophil count (ANC)≥1.5×109/L; platelet count (PLT)≥100×109/L; hemoglobin content (HGB)≥9.0 g/dL. Liver function: Patients without liver metastasis require serum total bilirubin (TBIL) ≤1.5×upper limit of normal (ULN); alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 ×ULN; Renal function: Creatinine clearance rate (Ccr) ≥50 mL/min (calculated by Cockcroft/Gault formula): Female: Ccr= (140-years old) x weight (kg) x 0.85/(72 x serum creatinine (mg/dL)) Male: Ccr= (140-years old) x weight (kg) x 1.00/(72 x serum creatinine (mg/dL)) The coagulation function is adequate, defined as the international normalized ratio (INR) or prothrombin time (PT) ≤ 1.5 times ULN; if the subject is receiving anticoagulation therapy, as long as the PT is within the proposed range of anticoagulation drugs LVEF≥50%; Agree and be able to comply with the plan during the research period; Provide written informed consent before entering the study screening, and the patient has understood that participants can withdraw from the study at any time during the study without any loss; Exclusion Criteria: Complicated with upper gastrointestinal obstruction/bleeding or abnormal digestive function or malabsorption syndrome; Complicated with severe uncontrolled concurrent infection or other severe uncontrolled concomitant disease, moderate or severe renal injury; Received previous anti-tumor therapy, including chemotherapy, radiotherapy, targeted therapy or immunotherapy, etc.; Suffered from other malignant tumors in the past 5 years (except basal cell or squamous cell carcinoma, superficial bladder cancer, cervical cancer in situ or breast cancer); Uncontrollable pleural effusion, pericardial effusion or ascites; Suffered from severe cardiovascular disease within 12 months before enrollment, such as symptomatic coronary heart disease, congestive heart failure ≥ Grade II, uncontrolled arrhythmia, and myocardial infarction; Allergic reactions to the drugs used in this study; Use steroids or other systemic immunosuppressive therapies 14 days before enrollment; Patients who received study drug treatment within 4 weeks before enrollment (participate in other clinical trials); Active autoimmune diseases; History of primary immunodeficiency; Have used immunosuppressive drugs within 4 weeks before the first dose of study treatment, excluding nasal spray, inhaled or other local glucocorticoids or physiological doses of systemic glucocorticoids (that is, no more than 10 mg/day Pred nisone or other glucocorticoids in equivalent doses), or use hormones to prevent allergy to contrast agents; Within 4 weeks before the first dose of study treatment or plan to receive live attenuated vaccine during the study period; Known to have active tuberculosis; Known history of allogeneic organ transplantation and allogeneic hematopoietic stem cell transplantation; HIV antibody positive, active hepatitis B or C (HBV, HCV); Pregnant or lactating women
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xuewei ding, PhD.
Phone
18622220158
Email
xding@tmu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Han Liang, PhD.
Organizational Affiliation
Tianjin Medical University Cancer Institute & Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Xuewei Ding, PhD.
Organizational Affiliation
Tianjin Medical University Cancer Institute & Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tianjin Medical University Cancer Institute & Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xuewei Ding, PhD.
Phone
18622220158
Email
xding@tmu.edu.cn

12. IPD Sharing Statement

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Peri-operative Sintilimab in Combination With SOX in Locally Advanced Gastric Cancer

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