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Tirelizumab in Combination With Chemoradiation in Patients With Unresectable Gastric Cancer or Gastroesophageal Junction Adenocarcinoma

Primary Purpose

Locally Advanced Gastric Cancer

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Nab-PTX,S-1,Tirelizumab
Chemoradiation
Sponsored by
Zhejiang Cancer Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Locally Advanced Gastric Cancer focused on measuring chemoradiotherapy, tirelizumab

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female patients, aged ≥ 18 years; ≤ 75 years old;
  2. The histopathology confirmed the diagnosis of previously untreated locally advanced unresectable HER2 negative gastric or gastroesophageal junction adenocarcinoma (imaging evaluation showed that the primary tumor was severely invaded, could not be separated from the surrounding normal tissue, or had surrounded large blood vessels, or regional lymph nodes were fixed and fused, or the metastatic lymph nodes were not within the scope of surgical clearance), and there was no peritoneal metastasis during laparoscopic exploration;
  3. There is no serious liver and kidney function damage, and the functional level of organs must meet the following requirements: ANC ≥ 1.5 × 109/L; PLT ≥ 90 × 109/L; Hb ≥ 90 g/L; TBIL ≤ 1 × ULN; ALT and AST ≤ 1.5 × ULN,ALP ≤ 2.5 × ULN; Bun and Cr ≤ 1 × ULN and creatinine clearance ≥ 50 ml / min (Cockcroft Gault formula); LVEF ≥ 50%; The QT interval (QTCF) corrected by fridericia method was < 450 ms in males and < 470 MS in females; INR ≤ 1.5 × ULN,APTT ≤ 1.5 × ULN;
  4. The patient has at least one measurable lesion, which is evaluated by the investigator according to (RECIST) v1.1;
  5. ECoG PS score 0 or 1;
  6. Life expectancy ≥ 6 months;
  7. The investigator assessed that the patient could comply with the protocol requirements;
  8. Sign the informed consent document.

Exclusion Criteria:

  1. Received systemic cytotoxic drug chemotherapy;
  2. Patients with hypersensitivity or hypersensitivity to therapeutic drugs and patients with autoimmune diseases; Have received allogeneic tissue / solid organ transplantation;
  3. There is third space effusion (such as pleural fluid and ascites) that cannot be controlled by drainage or other methods;
  4. Use steroids for more than 50 days, or need to use steroids for a long time;
  5. Uncontrolled symptomatic brain metastases or mental disorders cannot correctly express subjective symptoms;
  6. The abnormal coagulation function has clinical significance, has bleeding tendency or is receiving thrombolytic or anticoagulant treatment;
  7. Unable to swallow, chronic diarrhea and intestinal obstruction, and there are many factors affecting drug taking and absorption;
  8. Other malignant tumors occurred within 5 years before enrollment, except for cervical carcinoma in situ or skin squamous or basal cell carcinoma that had been treated for radical cure before;
  9. Pregnant or lactating women who have fertility but refuse to take contraceptive measures;
  10. Those with serious heart disease or medical history, including: recorded history of congestive heart failure, high-risk uncontrollable arrhythmia, angina pectoris requiring medical treatment, clinically clear heart valve disease, history of serious myocardial infarction and stubborn hypertension;
  11. According to the judgment of the investigator, there are concomitant diseases (such as uncontrolled hypertension, diabetes, thyroid disease, etc.) that seriously endanger the patient's safety or affect the patient's completion of the study;
  12. The investigator determines that other conditions are not suitable for inclusion in the study.

Sites / Locations

  • Liu luyingRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CRT with Tirelizumab

Arm Description

Chemotherapy+Tirelizumab:PS regimen:S-1:BSA <=1.25 m2 ,80 mg daily; 1.25 m2 <BSA <1.5 m2,100 mg daily; BSA>=1.5 m2 ,120 mg daily. Nab-PTX:preoperation:130mg/m2,d1,8,q3w;adjuvant:100mg/m2,d1,8,q3w; Tirelizumab:200mg d1 q3w. Concurrent Chemoradiotherapy: Radiation: 45-50Gy/25Fx;During radiation: Nab-PTX:100mg qw,Tirelizumab:200mg d1 q3w. Chemotherapy+Tirelizumab:PS regimen:S-1:BSA <=1.25 m2 ,80 mg daily; 1.25 m2 <BSA <1.5 m2,100 mg daily; BSA>=1.5 m2 ,120 mg daily. Nab-PTX:preoperation:130mg/m2,d1,8,q3w; Tirelizumab:200mg d1 q3w. We will evaluate whether the tumor could be resectable through CT scan and Endoscope after two cycles of Chemotherapy+Tirelizumab and CRT.If it could be resctable,three cycles of adjuvant chemotherapy+Tirelizumab will be arranged;If not,another three cycles of chemotherapy+Tirelizumab will be arranged,then evaluate again.

Outcomes

Primary Outcome Measures

the rate of resectable patients with negative incisal margin R0 resection rate
the rate of resectable patients with negative incisal margin

Secondary Outcome Measures

Full Information

First Posted
September 1, 2022
Last Updated
September 2, 2022
Sponsor
Zhejiang Cancer Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05528367
Brief Title
Tirelizumab in Combination With Chemoradiation in Patients With Unresectable Gastric Cancer or Gastroesophageal Junction Adenocarcinoma
Official Title
Tirelizumab in Combination With Chemoradiation in Patients With Unresectable Gastric Cancer or Gastroesophageal Junction Adenocarcinoma:A Single Arm Phase II Clinical Study
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Recruiting
Study Start Date
January 1, 2022 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Zhejiang Cancer Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
To evaluate the efficacy and safety of chemoradiotherapy combined with tirelizumab in the treatment of initial unresectable locally advanced gastric cancer or gastroesophageal junction cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Locally Advanced Gastric Cancer
Keywords
chemoradiotherapy, tirelizumab

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CRT with Tirelizumab
Arm Type
Experimental
Arm Description
Chemotherapy+Tirelizumab:PS regimen:S-1:BSA <=1.25 m2 ,80 mg daily; 1.25 m2 <BSA <1.5 m2,100 mg daily; BSA>=1.5 m2 ,120 mg daily. Nab-PTX:preoperation:130mg/m2,d1,8,q3w;adjuvant:100mg/m2,d1,8,q3w; Tirelizumab:200mg d1 q3w. Concurrent Chemoradiotherapy: Radiation: 45-50Gy/25Fx;During radiation: Nab-PTX:100mg qw,Tirelizumab:200mg d1 q3w. Chemotherapy+Tirelizumab:PS regimen:S-1:BSA <=1.25 m2 ,80 mg daily; 1.25 m2 <BSA <1.5 m2,100 mg daily; BSA>=1.5 m2 ,120 mg daily. Nab-PTX:preoperation:130mg/m2,d1,8,q3w; Tirelizumab:200mg d1 q3w. We will evaluate whether the tumor could be resectable through CT scan and Endoscope after two cycles of Chemotherapy+Tirelizumab and CRT.If it could be resctable,three cycles of adjuvant chemotherapy+Tirelizumab will be arranged;If not,another three cycles of chemotherapy+Tirelizumab will be arranged,then evaluate again.
Intervention Type
Drug
Intervention Name(s)
Nab-PTX,S-1,Tirelizumab
Intervention Description
S-1:BSA <=1.25 m2 ,80 mg daily; 1.25 m2 <BSA <1.5 m2,100 mg daily; BSA>=1.5 m2 ,120 mg daily. Nab-PTX:130mg/m2,d1,8,q3w;100mg qw(during radiation) Tirelizumab:200mg d1 q3w.
Intervention Type
Radiation
Intervention Name(s)
Chemoradiation
Intervention Description
45-50Gy/25F
Primary Outcome Measure Information:
Title
the rate of resectable patients with negative incisal margin R0 resection rate
Description
the rate of resectable patients with negative incisal margin
Time Frame
18 weeks after treatment completion

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 patients, aged ≥ 18 years; ≤ 75 years old; The histopathology confirmed the diagnosis of previously untreated locally advanced unresectable HER2 negative gastric or gastroesophageal junction adenocarcinoma (imaging evaluation showed that the primary tumor was severely invaded, could not be separated from the surrounding normal tissue, or had surrounded large blood vessels, or regional lymph nodes were fixed and fused, or the metastatic lymph nodes were not within the scope of surgical clearance), and there was no peritoneal metastasis during laparoscopic exploration; There is no serious liver and kidney function damage, and the functional level of organs must meet the following requirements: ANC ≥ 1.5 × 109/L; PLT ≥ 90 × 109/L; Hb ≥ 90 g/L; TBIL ≤ 1 × ULN; ALT and AST ≤ 1.5 × ULN,ALP ≤ 2.5 × ULN; Bun and Cr ≤ 1 × ULN and creatinine clearance ≥ 50 ml / min (Cockcroft Gault formula); LVEF ≥ 50%; The QT interval (QTCF) corrected by fridericia method was < 450 ms in males and < 470 MS in females; INR ≤ 1.5 × ULN,APTT ≤ 1.5 × ULN; The patient has at least one measurable lesion, which is evaluated by the investigator according to (RECIST) v1.1; ECoG PS score 0 or 1; Life expectancy ≥ 6 months; The investigator assessed that the patient could comply with the protocol requirements; Sign the informed consent document. Exclusion Criteria: Received systemic cytotoxic drug chemotherapy; Patients with hypersensitivity or hypersensitivity to therapeutic drugs and patients with autoimmune diseases; Have received allogeneic tissue / solid organ transplantation; There is third space effusion (such as pleural fluid and ascites) that cannot be controlled by drainage or other methods; Use steroids for more than 50 days, or need to use steroids for a long time; Uncontrolled symptomatic brain metastases or mental disorders cannot correctly express subjective symptoms; The abnormal coagulation function has clinical significance, has bleeding tendency or is receiving thrombolytic or anticoagulant treatment; Unable to swallow, chronic diarrhea and intestinal obstruction, and there are many factors affecting drug taking and absorption; Other malignant tumors occurred within 5 years before enrollment, except for cervical carcinoma in situ or skin squamous or basal cell carcinoma that had been treated for radical cure before; Pregnant or lactating women who have fertility but refuse to take contraceptive measures; Those with serious heart disease or medical history, including: recorded history of congestive heart failure, high-risk uncontrollable arrhythmia, angina pectoris requiring medical treatment, clinically clear heart valve disease, history of serious myocardial infarction and stubborn hypertension; According to the judgment of the investigator, there are concomitant diseases (such as uncontrolled hypertension, diabetes, thyroid disease, etc.) that seriously endanger the patient's safety or affect the patient's completion of the study; The investigator determines that other conditions are not suitable for inclusion in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Liu Lu ying, MD
Phone
0571-88128142
Ext
+86
Email
luyingliu@163.com
Facility Information:
Facility Name
Liu luying
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310022
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Liu Lu ying, MD
Phone
571-88128142
Ext
+86
Email
luyingliu@163.com

12. IPD Sharing Statement

Learn more about this trial

Tirelizumab in Combination With Chemoradiation in Patients With Unresectable Gastric Cancer or Gastroesophageal Junction Adenocarcinoma

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