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GOT Applied as Neoadjuvant Regimen for Patients of Resectable ICC With High-risk Factors of Recurrence (GOT)

Primary Purpose

Intrahepatic Cholangiocarcinoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Tislelizumab combined with GEMOX (GOT) regimen
Sponsored by
Zhejiang Cancer Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intrahepatic Cholangiocarcinoma focused on measuring Tislelizumab, Gemcitabine, Oxaliplatin, cholangiocarcinoma, Neoadjuvant

Eligibility Criteria

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

Inclusion Criteria:

  1. 18-75 yo;
  2. Patients of Pathological confirmed intrahepatic cholangiocarcinoma who has never received systemic therapy including chemotherapy, immunotherapy, target therapy and other anti-cancer therapy;
  3. Patients of resectable ICC with high risk recurrent factors:

    ①Maximum diameter greater than 5cm or multiple tumors.

    ②Preoperative CA19-9 greater than 200 Unit(U)/mL

    ③Tumors invaded adjacent blood vessels

    ④Preoperative radiology hints suspected regional lymph node metastasis.

    ⑤Tumor tissues confirmed by CT or MRI, at least one measurable lesion exists according to RECIST v1.1.

  4. Eastern Cooperative Oncology Group(ECOG)-Performance status(PS) score is 0 before first drug administration;
  5. Child-Pugh classification is class A;
  6. Estimated overall survival is greater than 16 weeks;
  7. The level of organ function meets the criteria and can tolerate surgery before the first treatment. Main organs meet the criteria as below:

    haemoglobin≥90g/L,Neutrophil count≥1.5×10⁹/L,Platelet count≥100×10⁹/L;Aspartate or alanine aminotransferase≤5 upper limits of normal(ULN),alkaline phosphatase≤2.5 ULN,Serum albumin≥30g/L;serum creatinine<1.5 ULN;International normalized ratios(INR)≤2 or Prothrombin time(PT)exceed ULN≤6s;Creatinine clearance≥60 mL/min.

  8. Male and female subjects with potential fertility had to agree to the use of effective contraceptive methods throughout the study period;
  9. Sign an informed consent form agreeing to provide previously preserved specimens of tumor tissue or fresh detection of tumor lesions.

Exclusion Criteria:

  1. Patient with non-intrahepatic cholangiocarcinoma;
  2. Anti-cancer therapy or surgery such as radiotherapy, radiofrequency ablation, interventions in 28 days prior to the first dose of the study (except for previous non-tumor-related surgeries and diagnostic biopsies);
  3. Distant metastasis;
  4. hepatitis B virus (HBV) DNA>2000 copies/ml, hepatitis C virus (HCV) RNA>1000;
  5. Long-term glucocorticoid users require long-term systemic hormones (equivalent to >10 mg Prednisone/day) or any other form of immunosuppressive therapy;
  6. Clinically significant bleeding or bleeding tendencies within 3 months prior to enrollment or on thrombolytic or anticoagulant therapy;
  7. Patients with complete bowel obstruction and incomplete intestinal obstruction that require treatment, but patients who have been relieved of obstruction by ostomy or stent placement can be enrolled;
  8. Active severe clinical infections (> grade 2, NCI-CTCAE version 5.0), including active TB; Have a history of active TB infection at least 1 year before enrolment, have not received regular anti-tuberculosis (TB) treatment or are still active; active, known or suspected autoimmune disease;
  9. Uncontrolled diabetes mellitus (fasting blood glucose ≥10 mmol/L), severe lung disease (eg, acute lung disease, pulmonary fibrosis that affects lung function, interstitial lung disease). except for recovered radiation pneumonia);
  10. Clinically significant cardiovascular diseases; With hypertension, antihypertensive drugs cannot be well controlled (systolic blood pressure≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg);
  11. Patient who are receiving renal replacement therapy;
  12. History of other malignancies in the last 5 years. With the exception of carcinoma of the skin basal cells that have been cured or carcinoma in situ in the cervix;
  13. Others situations are not expected to tolerate surgical treatment;
  14. People with allergic reactions to any component of the drug under study;
  15. There are other unsuitable candidates for clinical trials, such as alcohol dependence, mental illness, pregnancy (or lactation).

Sites / Locations

  • 1# Banshan East Rd. Zhejiang cancer hospital
  • Jia WuRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental arm

Arm Description

Tislelizumab combined with GEMOX (GOT) regimen

Outcomes

Primary Outcome Measures

Objective response rate (ORR)
The proportion of patients who achieved complete response (CR) and partial response(PR) after GOT regimen neoadjuvant treatment according to Response Evaluation Criteria In Solid Tumors (RECIST) v1.1.
R0 resection rate
The proportion of patients who achieved pathological negative surgical margin after GOT regimen neoadjuvant treatment.

Secondary Outcome Measures

Disease control rate (DCR)
The proportion of patients who achieved complete response (CR), partial response (PR) and stable disease (SD) after GOT regimen neoadjuvant treatment according to RECIST v1.1.
Recurrence free survival
The time between the date of patients underwent radical resection and the date of radiographic recurrence as defined by RECIST1.1.
Overall survival
The time between the date of patients underwent radical resection and death from any cause.

Full Information

First Posted
September 19, 2022
Last Updated
September 6, 2023
Sponsor
Zhejiang Cancer Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05557578
Brief Title
GOT Applied as Neoadjuvant Regimen for Patients of Resectable ICC With High-risk Factors of Recurrence
Acronym
GOT
Official Title
Tislelizumab Combined With GEMOX (GOT) Applied as Neoadjuvant Regimen for Patients of Resectable Intrahepatic Cholangiocarcinoma With High-risk Factors of Recurrence: a Single Arm, Single Center, Prospective, Explorative Clinical Trail.
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 5, 2023 (Actual)
Primary Completion Date
October 2024 (Anticipated)
Study Completion Date
December 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
Data Monitoring Committee
No

5. Study Description

Brief Summary
Intrahepatic cholangiocarcinoma (ICC) arises from the epithelial cells of bile ducts and occurs proximal to the segmental biliary ducts. ICC is highly aggressive, long-term survival only can be achieved in patients with R0 surgical resection. Large diameter of tumor, multiple tumors, preoperative carbohydrate antigen(CA)19-9 elevated, tumors invaded adjacent blood vessels and preoperative radiology hints suspected regional lymph node metastasis were considered as high-risk factors of recurrence in the previous study. Chemotherapy can trigger antigen release and induces strong anti-tumor effects of T cells due to cytotoxic cell death. Immune checkpoint inhibitors can relieve tumor immunosuppressive microenvironment. Hence, we aim to investigate objective response rate and R0 resection rate and survival rate of patients with high-risk factors of recurrence who receives Tislelizumab combined with GEMOX regimen(GOT) as a neoadjuvant therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intrahepatic Cholangiocarcinoma
Keywords
Tislelizumab, Gemcitabine, Oxaliplatin, cholangiocarcinoma, Neoadjuvant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Patients of Resectable ICC With High-risk Factors of Recurrence
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Experimental arm
Arm Type
Experimental
Arm Description
Tislelizumab combined with GEMOX (GOT) regimen
Intervention Type
Drug
Intervention Name(s)
Tislelizumab combined with GEMOX (GOT) regimen
Other Intervention Name(s)
Gemcitabine, Oxaliplatin
Intervention Description
Tislelizumab 200mg on day 1;Gemcitabine 1000mg/m2 on day 1、8;Oxaliplatin 135mg/m2 on day 1;cycle 3 weeks
Primary Outcome Measure Information:
Title
Objective response rate (ORR)
Description
The proportion of patients who achieved complete response (CR) and partial response(PR) after GOT regimen neoadjuvant treatment according to Response Evaluation Criteria In Solid Tumors (RECIST) v1.1.
Time Frame
Up to 6 cycle treatment (each cycle is 21 days), an average of 18 weeks.
Title
R0 resection rate
Description
The proportion of patients who achieved pathological negative surgical margin after GOT regimen neoadjuvant treatment.
Time Frame
Up to pathological report come out, an average of 20 weeks.
Secondary Outcome Measure Information:
Title
Disease control rate (DCR)
Description
The proportion of patients who achieved complete response (CR), partial response (PR) and stable disease (SD) after GOT regimen neoadjuvant treatment according to RECIST v1.1.
Time Frame
Up to 6 cycle treatment (each cycle is 21 days), an average of 18 weeks.
Title
Recurrence free survival
Description
The time between the date of patients underwent radical resection and the date of radiographic recurrence as defined by RECIST1.1.
Time Frame
From date when patients are received radical resection until the date of first documented recurrence radiologically, assessed at least 12 months.
Title
Overall survival
Description
The time between the date of patients underwent radical resection and death from any cause.
Time Frame
From date when patients are received radical resection until the date of death from any cause, assessed at least 12 months.
Other Pre-specified Outcome Measures:
Title
Time to response (TTR)
Description
The time between the date of patients received first treatment and the date of first documented complete or partial response.
Time Frame
From date of received first treatment to first achieved complete or partial response, up to 18 weeks.
Title
Time to operation (TTO)
Description
The time between the date of patients received first treatment and the date of patients received operation.
Time Frame
From date of received first treatment to date of surgery, an average of 20 weeks.

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: 18-75 yo; Patients of Pathological confirmed intrahepatic cholangiocarcinoma who has never received systemic therapy including chemotherapy, immunotherapy, target therapy and other anti-cancer therapy; Patients of resectable ICC with high risk recurrent factors: ①Maximum diameter greater than 5cm or multiple tumors. ②Preoperative CA19-9 greater than 200 Unit(U)/mL ③Tumors invaded adjacent blood vessels ④Preoperative radiology hints suspected regional lymph node metastasis. ⑤Tumor tissues confirmed by CT or MRI, at least one measurable lesion exists according to RECIST v1.1. Eastern Cooperative Oncology Group(ECOG)-Performance status(PS) score is 0 before first drug administration; Child-Pugh classification is class A; Estimated overall survival is greater than 16 weeks; The level of organ function meets the criteria and can tolerate surgery before the first treatment. Main organs meet the criteria as below: haemoglobin≥90g/L,Neutrophil count≥1.5×10⁹/L,Platelet count≥100×10⁹/L;Aspartate or alanine aminotransferase≤5 upper limits of normal(ULN),alkaline phosphatase≤2.5 ULN,Serum albumin≥30g/L;serum creatinine<1.5 ULN;International normalized ratios(INR)≤2 or Prothrombin time(PT)exceed ULN≤6s;Creatinine clearance≥60 mL/min. Male and female subjects with potential fertility had to agree to the use of effective contraceptive methods throughout the study period; Sign an informed consent form agreeing to provide previously preserved specimens of tumor tissue or fresh detection of tumor lesions. Exclusion Criteria: Patient with non-intrahepatic cholangiocarcinoma; Anti-cancer therapy or surgery such as radiotherapy, radiofrequency ablation, interventions in 28 days prior to the first dose of the study (except for previous non-tumor-related surgeries and diagnostic biopsies); Distant metastasis; hepatitis B virus (HBV) DNA>2000 copies/ml, hepatitis C virus (HCV) RNA>1000; Long-term glucocorticoid users require long-term systemic hormones (equivalent to >10 mg Prednisone/day) or any other form of immunosuppressive therapy; Clinically significant bleeding or bleeding tendencies within 3 months prior to enrollment or on thrombolytic or anticoagulant therapy; Patients with complete bowel obstruction and incomplete intestinal obstruction that require treatment, but patients who have been relieved of obstruction by ostomy or stent placement can be enrolled; Active severe clinical infections (> grade 2, NCI-CTCAE version 5.0), including active TB; Have a history of active TB infection at least 1 year before enrolment, have not received regular anti-tuberculosis (TB) treatment or are still active; active, known or suspected autoimmune disease; Uncontrolled diabetes mellitus (fasting blood glucose ≥10 mmol/L), severe lung disease (eg, acute lung disease, pulmonary fibrosis that affects lung function, interstitial lung disease). except for recovered radiation pneumonia); Clinically significant cardiovascular diseases; With hypertension, antihypertensive drugs cannot be well controlled (systolic blood pressure≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg); Patient who are receiving renal replacement therapy; History of other malignancies in the last 5 years. With the exception of carcinoma of the skin basal cells that have been cured or carcinoma in situ in the cervix; Others situations are not expected to tolerate surgical treatment; People with allergic reactions to any component of the drug under study; There are other unsuitable candidates for clinical trials, such as alcohol dependence, mental illness, pregnancy (or lactation).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Chaoqun Fei
Phone
+086-0571-88122564
Email
ec@zjcc.org.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yuhua Zhang, M.D.
Organizational Affiliation
Zhejiang Cancer Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
1# Banshan East Rd. Zhejiang cancer hospital
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310022
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yuhua Zhang, M.D.
Phone
+86-0571-88128058
Email
drzhangyuhua@126.com
First Name & Middle Initial & Last Name & Degree
Jia Wu
Phone
+86-0571-88128052
Email
tkds123@qq.com
Facility Name
Jia Wu
City
Hanzhou
State/Province
Zhejiang
ZIP/Postal Code
310000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jia Wu
Phone
086-0571-88128058
Email
tkds123@qq.com

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

GOT Applied as Neoadjuvant Regimen for Patients of Resectable ICC With High-risk Factors of Recurrence

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