Clinical Study of Apatinib Combined With Second - Line Chemotherapy for Metastatic Colorectal Cancer
Colorectal Neoplasms
About this trial
This is an interventional treatment trial for Colorectal Neoplasms
Eligibility Criteria
Inclusion Criteria:
- Male or female aged 18 to 70 years old;
- Histologically or cytologically proven patients with metastatic colorectal cancer have undergone a first-line standard regimen recommended by the NCCN guidelines for progression;
- According to the RECIST 1.1 criteria, the patient has at least one target lesion that can measure the diameter;
- ECOG PS ≤ 2;
- Expected survival time of more than 12 weeks.
The level of organ function must meet the following requirements:
Bone marrow: neutrophil count (ANC) ≥ 1.5 × 10^9/L, platelet ≥ 75 × 10^9/L, hemoglobin ≥ 90g/L.
Liver: serum bilirubin ≤ 2 times the upper limit of normal, aminotransferase AST and ALT ≤ 2.5 times the normal upper limit.
Kidney: Serum creatinine ≤1.5 times upper limit of normal.
- Patient compliance is good;
- Understand and voluntarily sign a written informed consent.
Exclusion Criteria:
- Other previous or concurrent malignancy, except cured skin basal cell carcinoma and cervical carcinoma in situ;
- Already known to be allergic to apatinib or any excipient;
- Use unapproved drugs or other test medications within 4 weeks prior to enrollment;
- There are many factors that affect oral medications (such as inability to swallow, chronic diarrhea and intestinal obstruction);
- Patients with a history of CNS metastases or CNS metastases;
- A history of bleeding, with any serious grading within 4 weeks prior to screening reaching a bleeding event of 3 degrees Celsius or greater in CTCAE4.0;
- Serious infection;
- Serious cardiovascular disease: uncontrolled hypertension, unstable angina, grade 3-4 heart failure (NYHA standard), congestive heart failure;
- urinary routine urinary protein ≥ ++ and confirmed 24-hour urinary protein quantitation> 1.0 g;
- Within 30 days after major surgery;
- Thrombotic disease. Anemia or venous thrombosis occurred in the previous year, such as cerebrovascular accident (including transient ischemic attack), deep vein thrombosis, pulmonary embolism, etc.;
- Those with history of psychotropic substance abuse who can not be abstinent or have mental disorders;
- Have clinical symptoms, need clinical intervention pleural effusion or ascites;
- At the investigator's discretion, there is a serious concomitant condition that compromises the patient's safety or affects the patient in completing the study.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Apatinib group
Control group
Apatinib combined with second-line chemotherapy (5-Fu combined with irinotecan or oxaliplatin standard regimen ) Apatinib tablets: 500 mg po qd . Continuous medication, the cycle is consistent with the chemotherapy cycle. Oxaliplatin: Day 1, 130mg/m2, IV infusion. Capecitabine: Day 1-14, 1000mg/m2 Twice Daily, po. A total of 6 cycles, 3 weeks apart of chemotherapy.(Take CAPEOX for example)
Oxaliplatin: Day 1, 130mg/m2, IV infusion. Capecitabine: Day 1-14, 1000mg/m2 Twice Daily, po. A total of 6 cycles, 3 weeks apart of chemotherapy.(Take CAPEOX for example)