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Sintilimab (IBI308) Combined With Bevacizumab + XELOX Regimen in Metastatic Colorectal Cancer

Primary Purpose

Metastatic Colorectal Cancer, RAS Mutation, Microsatellite Stable

Status
Active
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Sintilimab (IBI308)+bevacizumab+oxaliplatin+capecitabine
Sponsored by
Second Affiliated Hospital, School of Medicine, Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Colorectal Cancer focused on measuring RAS-mutant Metastatic Colorectal Cancer, Immunotherapy, Anti-PD-1, Checkpoint, Efficacy, Safety, Microsatellite stable

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female, age ≥ 18 years old, ≤ 75 years old
  • Metastatic colorectal adenocarcinoma confirmed by histology, metastases cannot be removed
  • RAS mutation
  • ECOG 0 to 1
  • Life expectancy is at least 12 weeks
  • Hematological examination absolute neutrophil count (ANC)>1.5×109/L, hemoglobin>8g/dL and platelet>100×109/L (according to the normal value of clinical trial center)
  • Prothrombin time (PT) < 1.5 times the upper limit of normal value and normal thromboplastin time (APTT) < 1.5 times the upper limit of normal value
  • Laboratory examination, serum creatinine is less than or equal to 1.5 times the upper limit of the normal reference range (if serum creatinine is elevated, 24 hours of urine must be collected, except for 24 hours creatinine clearance > 50ml/min)
  • When there is no liver metastasis, ALT or AST is less than or equal to 2.5 times the upper limit of the normal value reference range, serum total bilirubin is less than or equal to 1.5 times the upper limit of the normal value reference range; for patients with liver metastasis, ALT or AST is less than or equal to 5 times the upper limit of the normal value reference range, serum total bilirubin is less than or equal to 3 times the upper limit of the normal value reference range
  • Women of childbearing age must be willing to use adequate contraception during study drug treatment
  • Informed consent has been signed
  • According to the definition of RECIST 1.1, the investigator determined that the patient had a measurable disease. Tumor lesions located in previous radiotherapy areas are considered measurable if they demonstrate progression.

Exclusion Criteria:

  • Active autoimmune disease requiring systemic treatment occurred in the previous 2 years.
  • Diagnosed as immunodeficiency or experimental treatment is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose. After consultation with the sponsor, the use of a physiological dose of corticosteroids may be approved.
  • Adverse events caused by anti-tumor monoclonal antibodies (mAbs) within 4 weeks prior to study day 1 or drugs received 4 weeks prior to the study have not recovered.
  • Adverse events caused by chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study day 1, or previously received drugs, have not recovered (ie, ≤1 or reached baseline levels).

Other malignancies that are progressing or require active treatment are known. Except for basal cell carcinoma, cutaneous squamous cell carcinoma, or cervical carcinoma in situ that have undergone radical treatment.

  • Active central nervous system (CNS) metastasis and/or cancerous meningitis are known to exist.

There are active infections that require systemic treatment.

  • It is possible to confuse the test results, the medical history or disease evidence, the treatment or laboratory value abnormalities that hinder the subject's full participation in the study, or the investigator believes that participating in the study is not in the best interests of the subject.
  • There are known mental or substance abuse disorders that may have an impact on compliance with test requirements.
  • Female subjects who are pregnant or lactating, or who are expected to be pregnant during the planned trial period (from 120 days after screening visits to 120 days after the last dose of study treatment, or 180 days after the last dose of study treatment), or Male subjects whose spouse is pregnant.
  • A history of infection with human immunodeficiency virus (HIV) (HIV 1/2 antibody) is known.
  • Active hepatitis B or C.
  • Live vaccines were vaccinated within 30 days of the start date of the study treatment plan.
  • RAS wild type

Sites / Locations

  • the Second Affiliated Hospital of Medical College of Zhejiang University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sintilimab (IBI308) plus Bevacizumab, Oxaliplatin and Capecitabine

Arm Description

Sintilimab (IBI308):200MG, once every three weeks; Bevacizumab:7.5mg/kg, once every three weeks; oxplatin: 135 mg per square meter body surface, once every three weeks; Capecitabine : Capecitabine 1 gram per square meter body surface area, from the first day to the 14th day

Outcomes

Primary Outcome Measures

Objective Response Rate
Objective Response Rate was defined as the proportion of patients with a best objective response of complete response (CR) or partial response (PR) according to RECIST criteria (version 1.1).
Adverse Events and Serious Adverse Events
Safety and tolerance will be evaluated by incidence, severity and outcomes of adverse events (AEs) and categorized by severity in accordance with the NCI CTC AE Version 5.0.

Secondary Outcome Measures

Disease Control Rate
Disease Control Rate was defined as the proportion of patients with CR, PR, or SD according to RECIST criteria (version 1.1)
Progression free survival
Progression-free survival is defined as the time from enrollment to the first documented disease progression according to RECIST version 1.1, or to death from any cause, whichever occurred first.

Full Information

First Posted
December 9, 2019
Last Updated
March 14, 2023
Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT04194359
Brief Title
Sintilimab (IBI308) Combined With Bevacizumab + XELOX Regimen in Metastatic Colorectal Cancer
Official Title
Evaluation on the Tolerance and Preliminary Efficacy of Sintilimab (IBI308) Combined With Bevacizumab, Oxaliplatin and Capecitabine Regimen for Ras Gene Mutant and Microsatellite Stable Unresectable Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 4, 2021 (Actual)
Primary Completion Date
November 30, 2022 (Actual)
Study Completion Date
December 12, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A phase II clinical study of Sintilimab (IBI308) combined with Bevacizumab, Oxaliplatin and Capecitabine regimen as first-line treatment in patients with RAS-mutant and microsatellite stable metastatic colorectal cancer. A total of 25 patients are planned to be enrolled.
Detailed Description
This study is a phase II clinical study of Sintilimab (IBI308) combined with bevacizumab + XELOX regimen as first-line treatment in patients with RAS-mutant and microsatellite stable metastatic colorectal cancer. The study treatment took 21 days as a treatment cycle. Sintilimab (IBI308), bevacizumab and oxaliplatin were given intravenously on the first day of each cycle, and capecitabine was given from the first day to the 14th day. All adverse events will be graded according to NCI CTCAE (version 5.0). Up to 8 courses of inductive therapy would be given. During the treatment, CT was rechecked every 2 courses to evaluate the curative effect. Patients with objective response or stable disease (SD) would continue to receive sintilimab plus bevacizumab and oral capecitabine in each 21-day cycle as maintenance therapy until the confirmation of disease progression, death, unacceptable toxicity, or withdrawal of consent. A total of 25 patients are planned to be enrolled. When the number of subjects reaches 25 respectively, the enrollment ends to inquire about the safety and efficacy of Sintilimab (IBI308) combined with bevacizumab + XELOX.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Colorectal Cancer, RAS Mutation, Microsatellite Stable
Keywords
RAS-mutant Metastatic Colorectal Cancer, Immunotherapy, Anti-PD-1, Checkpoint, Efficacy, Safety, Microsatellite stable

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Sintilimab (IBI308) plus Bevacizumab, Oxaliplatin and Capecitabine
Arm Type
Experimental
Arm Description
Sintilimab (IBI308):200MG, once every three weeks; Bevacizumab:7.5mg/kg, once every three weeks; oxplatin: 135 mg per square meter body surface, once every three weeks; Capecitabine : Capecitabine 1 gram per square meter body surface area, from the first day to the 14th day
Intervention Type
Drug
Intervention Name(s)
Sintilimab (IBI308)+bevacizumab+oxaliplatin+capecitabine
Intervention Description
Humanized PD-1 antibody (Sintilimab, IBI308)+bevacizumab+oxaliplatin+capecitabine
Primary Outcome Measure Information:
Title
Objective Response Rate
Description
Objective Response Rate was defined as the proportion of patients with a best objective response of complete response (CR) or partial response (PR) according to RECIST criteria (version 1.1).
Time Frame
From Baseline to disease progress, up to 18 months
Title
Adverse Events and Serious Adverse Events
Description
Safety and tolerance will be evaluated by incidence, severity and outcomes of adverse events (AEs) and categorized by severity in accordance with the NCI CTC AE Version 5.0.
Time Frame
From Baseline to primary completion date, about 2 years
Secondary Outcome Measure Information:
Title
Disease Control Rate
Description
Disease Control Rate was defined as the proportion of patients with CR, PR, or SD according to RECIST criteria (version 1.1)
Time Frame
From Baseline to disease progress, up to 18 months
Title
Progression free survival
Description
Progression-free survival is defined as the time from enrollment to the first documented disease progression according to RECIST version 1.1, or to death from any cause, whichever occurred first.
Time Frame
From Baseline to primary completion date, about 2 years

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, age ≥ 18 years old, ≤ 75 years old; Metastatic colorectal adenocarcinoma confirmed by histology and unresectable metastatic colorectal cancer confirmed by a multidisciplinary team; RAS gene mutation, BRAF wild-type and microsatellite stable confirmed by polymerase chain reaction using a panel of six mononucleotide repeat markers (BAT-25, BAT-26, NR-21, NR-24, NR-27, and MONO-27); ECOG performance status of 0-1; Life expectancy≥3 months; Adequate organ and bone marrow functions: absolute neutrophil count >1.5×109/L, hemoglobin >8 g/dL, platelet count >100×109/L, prothrombin time <1.5 upper limit of normal (ULN), activated partial thromboplastin time <1.5 ULN, bilirubin ≤1.5×ULN (could be extended to 3×ULN in case of liver metastasis), blood aspartate aminotransferase and alanine aminotransferase ≤2.5×ULN (could be extended to 5×ULN in case of liver metastasis), serum creatinine level ≤1.5×ULN or creatinine clearance ≥50 mL/min, urinary protein / creatinine ratio < 1 (or urine analysis < 1 + or 24-hour urinary protein < 1g / 24 h; Informed consent has been signed; The presence of at least one measurable lesion assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1; Exclusion Criteria: received previous treatment with any anti-programmed cell death protein 1 (PD-1) or anti-PD-L1 antibody; received treatment with corticosteroids or other immunosuppressive agents within 14 days prior to study drug administration; presence of autoimmune disease, known interstitial lung disease; those with previous or concurrent malignancies expect for basal cell carcinoma, cutaneous squamous cell carcinoma, or cervical carcinoma in situ that have undergone radical treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ying Yuan, MD
Organizational Affiliation
The Second Affiliated Hospital of Medical College of Zhejiang University
Official's Role
Study Chair
Facility Information:
Facility Name
the Second Affiliated Hospital of Medical College of Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310000
Country
China

12. IPD Sharing Statement

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Sintilimab (IBI308) Combined With Bevacizumab + XELOX Regimen in Metastatic Colorectal Cancer

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