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A Study to Explore the Third-line Treatment of Fruquintinib Combined With Serplulimab in Advanced Non-isolated Hepatic Metastatic Colorectal Cancer: a Single-center, Phase 2 Study

Primary Purpose

Colorectal Cancer

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
serplulimab
Fruquintinib
Sponsored by
Junjie Peng
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring MSS, serplulimab, fruquintinib

Eligibility Criteria

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

Inclusion Criteria: Age ≥18 years old, both sexes; Patients with histologically or cytologically confirmed unresectable and metastatic CRC Non-isolated hepatic metastasis: including no liver metastasis or liver metastasis accompanied by other metastatic lesions, such as lung metastasis, peritoneal metastasis, etc Before enrollment, the tumor tissue was pMMR by immunohistochemistry, or MSS or MSI-L by PCR or NGS; Have received standard treatment in the past and developed disease progression or intolerance to standard treatment based on RECIST 1.1 during or after standard treatment. Standard treatment should include: Fluorouracil, oxaliplatin and irinotecan With or without anti-VEGF monoclonal antibody For RAS wild-type patients, combined with anti-EGFR monoclonal antibody For patients with BRAF mutations, BRAF inhibitor therapy is recommended when drugs are available Patients with ECOG score of 0-2 and expected survival time ≥3 months, patients who can cooperate to observe adverse reactions and efficacy; At least one measurable tumor lesion according to RECIST 1.1 criteria Good organ function: neutrophil ≥1.5*109/L; Platelet ≥100*109/L; Hemoglobin ≥9g/dl; Serum albumin ≥3g/dl; Thyroid stimulating hormone (TSH) ≤ 1 times the upper limit of normal, T3 and T4 in the normal range; bilirubin ≤ 1.5 times the upper limit of normal value; ALT and AST≤ 2 times the upper limit of normal; Serum creatinine ≤ 1.5 times the upper limit of normal, creatinine clearance ≥60ml/min; International normalized ratio (INR) or prothrombin time (PT) ≤ 1.5 times the upper limit of the normal range, unless the patient is receiving anticoagulant therapy and the PT value is within the intended range for anticoagulant therapy; Activated partial thromboplastin time (aPTT) ≤ 1.5 times the upper limit of normal; There were no serious concomitant diseases that could make the survival time less than 5 years; Negative pregnancy test in female subjects (for female patients of childbearing potential); Infertile female patients; Male patients of childbearing potential and female patients of childbearing potential and at risk of pregnancy must agree to use adequate contraception for the entire duration of the study and for 12 months after receiving treatment with the protocol; Signed and dated informed consent indicating that the patient has been informed about all relevant aspects of the study; Patients who are willing and able to comply with the visit schedule, treatment plan, laboratory tests, and other study procedures; Willing to comply with the arrangement during the study period can not participate in any other clinical research on drugs and medical devices Exclusion Criteria: Pathological diagnosis of other intestinal tumors, such as gastrointestinal stromal tumor; Tumor tissues were dMMR detected by immunohistochemistry, or MSI-H detected by PCR or NGS Prior treatment with PD-1 antibody, PD-L1 antibody, or CTLA-4 antibody; Previous or concurrent history of other malignant tumors, excluding adequately treated non-melanoma skin cancer, cervical carcinoma in situ and thyroid papillary carcinoma; Active autoimmune disease, history of autoimmune disease (such as interstitial pneumonia, colitis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism, hypothyroidism, including but not limited to these diseases or syndromes); It does not include autoimmune-mediated hypothyroidism treated with stable doses of thyroid replacement hormone; Type I diabetes on stable doses of insulin; Vitiligo or cured childhood asthma/allergy without any intervention in adulthood; A history of immunodeficiency, including HIV positive, other acquired or congenital immunodeficiency diseases, or organ transplantation or allogeneic bone marrow transplantation; Contraindications to antiangiogenic drugs (such as active bleeding, gastrointestinal bleeding, hemoptysis, etc.); History of interstitial lung disease (excluding radiation pneumonitis without steroid treatment) and non-infectious pneumonia; Patients with active pulmonary tuberculosis infection detected by medical history or CT examination, or with a history of active pulmonary tuberculosis infection within 1 year before enrollment, or with a history of active pulmonary tuberculosis infection more than 1 year before enrollment but without regular treatment; The subject has active hepatitis B (HBV DNA ≥2000 IU/mL or 104 copies/mL), hepatitis C (hepatitis C antibody positive and HCV-RNA above the detection limit of the assay) Severe cardiopulmonary and renal dysfunction; Have hypertension that is not well controlled with antihypertensive medication (systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90mmHg); A history of psychotropic substance abuse, alcohol or drug abuse; Other factors that may affect subject safety or trial compliance as judged by the investigator. Severe medical conditions requiring concomitant treatment (including mental illness), serious laboratory abnormalities, or other family or social factors

Sites / Locations

  • Fudan University Shanghai Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Serplulimab+Fruquintinib

Arm Description

Participants will receive serplulimab 300 mg every 3 weeks (Q3W) concurrently with fruquintinib regimen: 5mg (QD) orally for 2 weeks, 1 week off, repeated every 3 weeks. Treatment repeats every 3 weeks until disease progression or intolerable toxicity.

Outcomes

Primary Outcome Measures

objective response rate (ORR)
The proportion of participants whose best outcome is complete remission or partial remission

Secondary Outcome Measures

overall survival (OS)
The time between the start of the participants' treatment and their death from any cause
progression-free survival (PFS)
Time from initiation of treatment to disease progression or death from any cause
adverse events
Assessment of the safety profile of regimen according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 (NCI CTCAE v 5.0).

Full Information

First Posted
July 13, 2023
Last Updated
July 13, 2023
Sponsor
Junjie Peng
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1. Study Identification

Unique Protocol Identification Number
NCT05954429
Brief Title
A Study to Explore the Third-line Treatment of Fruquintinib Combined With Serplulimab in Advanced Non-isolated Hepatic Metastatic Colorectal Cancer: a Single-center, Phase 2 Study
Official Title
A Study to Explore the Third-line Treatment of Fruquintinib Combined With Serplulimab in Advanced Non-isolated Hepatic Metastatic Colorectal Cancer: a Single-center, Phase 2 Study
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
July 20, 2023 (Anticipated)
Primary Completion Date
February 28, 2026 (Anticipated)
Study Completion Date
August 31, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Junjie Peng

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
The aim of this clinical trial is to learn about efficacy of fruquintinib combined with serplulimab in patients with microsatellite stabilized mCRC who have failed standard therapy. The main purpose is to explore efficacy, safety and tolerability of the treatment. At the same time, the correlation between biomarkers (including ctDNA, TPS, CPS, tumor mutation burden, lymphocyte subpopulation, cytokines, TCR, intestinal microbes, etc.) and the efficacy and drug resistance mechanism will be analyzed, which could provide reference for determining the advantaged group.
Detailed Description
Serplulimab is an anti-PD-1 monoclonal antibody, and fruquintinib is a tyrosine kinase inhibitor that inhibits tumor angiogenesis. Studies have shown that immunotherapy combined with fruquintinib has preliminary efficacy in the treatment of colorectal cancer. Whether serplulimab combined with fruquintinib can improve the prognosis of patients with colorectal cancer remains to be determined. Therefore, the study is to evaluate the efficacy and safety of serplulimab combination with fruquintinib in patients with microsatellite stabilized mCRC who have failed standard therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer
Keywords
MSS, serplulimab, fruquintinib

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
Serplulimab+Fruquintinib
Arm Type
Experimental
Arm Description
Participants will receive serplulimab 300 mg every 3 weeks (Q3W) concurrently with fruquintinib regimen: 5mg (QD) orally for 2 weeks, 1 week off, repeated every 3 weeks. Treatment repeats every 3 weeks until disease progression or intolerable toxicity.
Intervention Type
Drug
Intervention Name(s)
serplulimab
Intervention Description
Serplulimab is an innovative monoclonal antibody targeting PD-1, developed by Shanghai Henlius Biotech, Inc. 300 mg, q3w Other name: HLX10
Intervention Type
Drug
Intervention Name(s)
Fruquintinib
Intervention Description
5mg (QD) orally for 2 weeks, 1 week off, repeated every 3 weeks until disease progression or intolerable toxicity.
Primary Outcome Measure Information:
Title
objective response rate (ORR)
Description
The proportion of participants whose best outcome is complete remission or partial remission
Time Frame
3 years
Secondary Outcome Measure Information:
Title
overall survival (OS)
Description
The time between the start of the participants' treatment and their death from any cause
Time Frame
3 years
Title
progression-free survival (PFS)
Description
Time from initiation of treatment to disease progression or death from any cause
Time Frame
3 years
Title
adverse events
Description
Assessment of the safety profile of regimen according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 (NCI CTCAE v 5.0).
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years old, both sexes; Patients with histologically or cytologically confirmed unresectable and metastatic CRC Non-isolated hepatic metastasis: including no liver metastasis or liver metastasis accompanied by other metastatic lesions, such as lung metastasis, peritoneal metastasis, etc Before enrollment, the tumor tissue was pMMR by immunohistochemistry, or MSS or MSI-L by PCR or NGS; Have received standard treatment in the past and developed disease progression or intolerance to standard treatment based on RECIST 1.1 during or after standard treatment. Standard treatment should include: Fluorouracil, oxaliplatin and irinotecan With or without anti-VEGF monoclonal antibody For RAS wild-type patients, combined with anti-EGFR monoclonal antibody For patients with BRAF mutations, BRAF inhibitor therapy is recommended when drugs are available Patients with ECOG score of 0-2 and expected survival time ≥3 months, patients who can cooperate to observe adverse reactions and efficacy; At least one measurable tumor lesion according to RECIST 1.1 criteria Good organ function: neutrophil ≥1.5*109/L; Platelet ≥100*109/L; Hemoglobin ≥9g/dl; Serum albumin ≥3g/dl; Thyroid stimulating hormone (TSH) ≤ 1 times the upper limit of normal, T3 and T4 in the normal range; bilirubin ≤ 1.5 times the upper limit of normal value; ALT and AST≤ 2 times the upper limit of normal; Serum creatinine ≤ 1.5 times the upper limit of normal, creatinine clearance ≥60ml/min; International normalized ratio (INR) or prothrombin time (PT) ≤ 1.5 times the upper limit of the normal range, unless the patient is receiving anticoagulant therapy and the PT value is within the intended range for anticoagulant therapy; Activated partial thromboplastin time (aPTT) ≤ 1.5 times the upper limit of normal; There were no serious concomitant diseases that could make the survival time less than 5 years; Negative pregnancy test in female subjects (for female patients of childbearing potential); Infertile female patients; Male patients of childbearing potential and female patients of childbearing potential and at risk of pregnancy must agree to use adequate contraception for the entire duration of the study and for 12 months after receiving treatment with the protocol; Signed and dated informed consent indicating that the patient has been informed about all relevant aspects of the study; Patients who are willing and able to comply with the visit schedule, treatment plan, laboratory tests, and other study procedures; Willing to comply with the arrangement during the study period can not participate in any other clinical research on drugs and medical devices Exclusion Criteria: Pathological diagnosis of other intestinal tumors, such as gastrointestinal stromal tumor; Tumor tissues were dMMR detected by immunohistochemistry, or MSI-H detected by PCR or NGS Prior treatment with PD-1 antibody, PD-L1 antibody, or CTLA-4 antibody; Previous or concurrent history of other malignant tumors, excluding adequately treated non-melanoma skin cancer, cervical carcinoma in situ and thyroid papillary carcinoma; Active autoimmune disease, history of autoimmune disease (such as interstitial pneumonia, colitis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism, hypothyroidism, including but not limited to these diseases or syndromes); It does not include autoimmune-mediated hypothyroidism treated with stable doses of thyroid replacement hormone; Type I diabetes on stable doses of insulin; Vitiligo or cured childhood asthma/allergy without any intervention in adulthood; A history of immunodeficiency, including HIV positive, other acquired or congenital immunodeficiency diseases, or organ transplantation or allogeneic bone marrow transplantation; Contraindications to antiangiogenic drugs (such as active bleeding, gastrointestinal bleeding, hemoptysis, etc.); History of interstitial lung disease (excluding radiation pneumonitis without steroid treatment) and non-infectious pneumonia; Patients with active pulmonary tuberculosis infection detected by medical history or CT examination, or with a history of active pulmonary tuberculosis infection within 1 year before enrollment, or with a history of active pulmonary tuberculosis infection more than 1 year before enrollment but without regular treatment; The subject has active hepatitis B (HBV DNA ≥2000 IU/mL or 104 copies/mL), hepatitis C (hepatitis C antibody positive and HCV-RNA above the detection limit of the assay) Severe cardiopulmonary and renal dysfunction; Have hypertension that is not well controlled with antihypertensive medication (systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90mmHg); A history of psychotropic substance abuse, alcohol or drug abuse; Other factors that may affect subject safety or trial compliance as judged by the investigator. Severe medical conditions requiring concomitant treatment (including mental illness), serious laboratory abnormalities, or other family or social factors
Facility Information:
Facility Name
Fudan University Shanghai Cancer Center
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200000
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Junjie Peng
Phone
021-64175590
Email
pengjj67@hotmail.com

12. IPD Sharing Statement

Learn more about this trial

A Study to Explore the Third-line Treatment of Fruquintinib Combined With Serplulimab in Advanced Non-isolated Hepatic Metastatic Colorectal Cancer: a Single-center, Phase 2 Study

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