Conversion Therapy of Fruquintinib in Combination With Sintilimab and SOX in Unresectable Gastric Cancer
Primary Purpose
Gastric Cancer
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
fruquintinib + sintilimab + SOX
Sponsored by
About this trial
This is an interventional treatment trial for Gastric Cancer
Eligibility Criteria
Inclusion Criteria:
- Signed the Informed Consent Form
- Ages: 18-75 Years (concluding 18 and 75 Years)
- Pathologically confirmed gastric/gastroesophageal junction adenocarcinoma, and meets one of the following conditions: invasion of adjacent organs such as colon, tail of pancreas and spleen; localized peritoneal metastasis; positive exfoliative cytology of ascites; class I, class II, part of class III and very few class IV stage IV gastric adenocarcinoma according to biological behavior; N3; extensive or fused lymph node metastasis; Krukenberg tumor; Liver metastasis limited to one lobe, less than 5cm in diameter, isolated abdominal aortic metastasis, etc;
- Untreated(e.g. radiotherapy, chemotherapy, target therapy and immunotherapy)
- Life expectancy greater than 3 months
- ECOG(Eastern Cooperative Oncology Group) :0~1
Sufficient organ and bone marrow functions as follows:
- Absolute Neutrophil Count (ANC) ≥1.5×109/L, White Blood Cell≥3.5×109/L;
- Platelet Count of ≥100×109/L;
- Hemoglobin≥90g/L;
- Total Bilirubin (TBIL) ≤1.5 x ULN;
- ALT and AST<2.5 x ULN, GPT≤1.5×ULN; If there is liver metastasis, then ALT and AST<5.0 x ULN, GPT≤3.0×ULN;
- Serum Creatinine (SCr) ≤1.0×ULN;
- Endogenous creatinine clearance rate > 60ml / min (Cockcroft Gault formula);
- No severe dysfunction of heart, lung and liver; No jaundice and gastrointestinal obstruction; No acute infection
- Not participating in other clinical trials 4 weeks before and during the treatment
Exclusion Criteria:
- Known HER-2 positive
- Distal metastasis to lung, brain, and bone
- Have received operation on the stomach
- A history of other malignancies within 5 years prior to inclusion, except for cervical carcinoma in situ, basal or squamous cell skin cancer
- Patients with any active autoimmune disease or a documented history of autoimmune disease within 4 weeks prior to enrollment
- Previously received allogeneic bone marrow transplantation or organ transplantation
- Known hypersensitivity to any of the study drugs or excipients
- Hypertension that is not controlled by the drug, and is defined as: SBP ≥150 mmHg and/or DBP ≥90 mmHg
- International normalized ratio (INR) > 1.5 or partially activated prothrombin time (APTT) > 1.5 × ULN
- Poorly controlled diabetes before enrollment
- Clinically significant electrolyte abnormalities judged by researchers
- With any diseases or conditions that affected drug absorption, or the patient could not take drugs orally
- Patients with obvious evidence of bleeding tendency or medical history within 3 months before enrollment, hemoptysis or thromboembolism within 12 months
- Cardiovascular diseases with significant clinical significance, including but not limited to acute myocardial infarction, severe / unstable angina pectoris or coronary artery bypass grafting within 6 months before enrollment; Congestive heart failure, New York Heart Association (NYHA) grade > 2; ventricular arrhythmia requiring drug treatment; LVEF (left ventricular ejection fraction) < 50%
- Active infection or serious infection that is not controlled by drug (≥CTCAE v5.0 Grade 2)
- History of clinically significant hepatic disease, including, but not limited to, known hepatitis B virus (HBV) infection with HBV DNA positive (copies ≥1×104/ml); known hepatitis C virus infection with HCV RNA positive (copies ≥1×103/m)
- Women who are pregnant or lactating
- Urinary protein ≥ ++, and the 24-hour urine protein quantification is greater than 1.0 g
- Have any other disease, metabolic disorder, physical examination anomaly, abnormal laboratory result, or any other conditions which, according to judgement of the investigator, renders the patient inappropriate for using of the investigational product or may affect interpretation of study results
- Patients considered unsuitable for inclusion in this study by the investigator.
Sites / Locations
- Henan Tumor HospitalRecruiting
- Henan Tumor Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Experimental
Arm Description
fruquintinib + sintilimab + SOX (S-1 + oxaliplatin)
Outcomes
Primary Outcome Measures
Surgical complete resection rate (R0)
This is a complete macroscopic resection of the gross tumor with negative surgical margins
Secondary Outcome Measures
Rate of downstaging
To determine the rate of downstaging of locally advanced cT3-4 and/or N+ gastric carcinomas after preoperative therapy
Pathological complete response (pCR) rate
pCR is defined as the absence of residual tumor based on evaluation of the resected esophagogastric specimen according to Becker remission criteria
Major pathological response (MPR)
MPR is defined as less than 10% residual tumor after neoadjuvant therapy
Objective Response Rate (ORR)
ORR was defined as the percentage of the participants in the analysis population who had a confirmed CR or PR according to RECIST 1.1 based on investigator assessment.
Progression-free survival (PFS)
Progression-free survival (PFS) [time frame: from the initial date of neoadjuvant therapy to the date of first documentation of disease progression or death due to any cause, whichever occurs first. Patients without an event prior to the time of analysis will be censored at the last assessment that is stable disease (SD) or better]. Progression is defined according to RECIST v1.1. Estimated using Kaplan-Meier method.
Overall survival (OS)
Overall survival (OS) [time frame: from the initial date of neoadjuvant therapy to the date of death due to any cause. Patients without documentation of death at the time of analysis will be censored at the last follow-up date]. Estimated using Kaplan-Meier method.
adverse event (AEs)
An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An adverse event (AE) can therefore be any unfavourable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.
Full Information
NCT ID
NCT05177068
First Posted
December 15, 2021
Last Updated
August 17, 2022
Sponsor
Henan Cancer Hospital
1. Study Identification
Unique Protocol Identification Number
NCT05177068
Brief Title
Conversion Therapy of Fruquintinib in Combination With Sintilimab and SOX in Unresectable Gastric Cancer
Official Title
A Phase II Clinical Study of Fruquintinib Combined With Sintilimab and SOX as Conversion Therapy of Potentially Resectable Stage IV Gastric Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 6, 2022 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
January 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Henan Cancer Hospital
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
This is a phase II study to evaluate the efficacy and safety of combination of fruquintinib (VEGFR 1/2/3 inhibitor), sintilimab (PD-1 inhibitor) and SOX conversion therapy in unresectable advanced gastric cancer patients.
Detailed Description
Eligible patients will be given 3 or 6 cycles of combined therapy of fruquintinib + sintilimab + SOX. Then the patients evaluated resectable will be given one additional cycle of combined treatment with sintilimab + SOX, followed by R0 resection. If evaluated unresectable after 6 cycles of combination therapy, the patient will be given palliative first-line treatment. Adjuvant treatment with SOX regimen will be started 4 weeks after R0 resection for a total of 8 cycles in the perioperative period.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
42 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Experimental
Arm Type
Experimental
Arm Description
fruquintinib + sintilimab + SOX (S-1 + oxaliplatin)
Intervention Type
Drug
Intervention Name(s)
fruquintinib + sintilimab + SOX
Intervention Description
fruquintinib: 4mg/d, qd po, d1-14, q3w; sintilimab: 200 mg/d, IV d1, q3w; S-1: BSA<1.25 m2, 40mg twice/day; BSA1.25-1.5m2, 50mg twice/day; BSA≥1.5 m2, 60mg twice/day, po, d1-14, q3w; oxaliplatin: 130mg/m2, ivgtt 2-6h, d1, q3w
Primary Outcome Measure Information:
Title
Surgical complete resection rate (R0)
Description
This is a complete macroscopic resection of the gross tumor with negative surgical margins
Time Frame
about 3 years
Secondary Outcome Measure Information:
Title
Rate of downstaging
Description
To determine the rate of downstaging of locally advanced cT3-4 and/or N+ gastric carcinomas after preoperative therapy
Time Frame
about 3 years
Title
Pathological complete response (pCR) rate
Description
pCR is defined as the absence of residual tumor based on evaluation of the resected esophagogastric specimen according to Becker remission criteria
Time Frame
about 3 years
Title
Major pathological response (MPR)
Description
MPR is defined as less than 10% residual tumor after neoadjuvant therapy
Time Frame
about 3 years
Title
Objective Response Rate (ORR)
Description
ORR was defined as the percentage of the participants in the analysis population who had a confirmed CR or PR according to RECIST 1.1 based on investigator assessment.
Time Frame
about 3 years
Title
Progression-free survival (PFS)
Description
Progression-free survival (PFS) [time frame: from the initial date of neoadjuvant therapy to the date of first documentation of disease progression or death due to any cause, whichever occurs first. Patients without an event prior to the time of analysis will be censored at the last assessment that is stable disease (SD) or better]. Progression is defined according to RECIST v1.1. Estimated using Kaplan-Meier method.
Time Frame
about 3 years
Title
Overall survival (OS)
Description
Overall survival (OS) [time frame: from the initial date of neoadjuvant therapy to the date of death due to any cause. Patients without documentation of death at the time of analysis will be censored at the last follow-up date]. Estimated using Kaplan-Meier method.
Time Frame
about 3 years
Title
adverse event (AEs)
Description
An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An adverse event (AE) can therefore be any unfavourable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.
Time Frame
about 3 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:
Signed the Informed Consent Form
Ages: 18-75 Years (concluding 18 and 75 Years)
Pathologically confirmed gastric/gastroesophageal junction adenocarcinoma, and meets one of the following conditions: invasion of adjacent organs such as colon, tail of pancreas and spleen; localized peritoneal metastasis; positive exfoliative cytology of ascites; class I, class II, part of class III and very few class IV stage IV gastric adenocarcinoma according to biological behavior; N3; extensive or fused lymph node metastasis; Krukenberg tumor; Liver metastasis limited to one lobe, less than 5cm in diameter, isolated abdominal aortic metastasis, etc;
Untreated(e.g. radiotherapy, chemotherapy, target therapy and immunotherapy)
Life expectancy greater than 3 months
ECOG(Eastern Cooperative Oncology Group) :0~1
Sufficient organ and bone marrow functions as follows:
Absolute Neutrophil Count (ANC) ≥1.5×109/L, White Blood Cell≥3.5×109/L;
Platelet Count of ≥100×109/L;
Hemoglobin≥90g/L;
Total Bilirubin (TBIL) ≤1.5 x ULN;
ALT and AST<2.5 x ULN, GPT≤1.5×ULN; If there is liver metastasis, then ALT and AST<5.0 x ULN, GPT≤3.0×ULN;
Serum Creatinine (SCr) ≤1.0×ULN;
Endogenous creatinine clearance rate > 60ml / min (Cockcroft Gault formula);
No severe dysfunction of heart, lung and liver; No jaundice and gastrointestinal obstruction; No acute infection
Not participating in other clinical trials 4 weeks before and during the treatment
Exclusion Criteria:
Known HER-2 positive
Distal metastasis to lung, brain, and bone
Have received operation on the stomach
A history of other malignancies within 5 years prior to inclusion, except for cervical carcinoma in situ, basal or squamous cell skin cancer
Patients with any active autoimmune disease or a documented history of autoimmune disease within 4 weeks prior to enrollment
Previously received allogeneic bone marrow transplantation or organ transplantation
Known hypersensitivity to any of the study drugs or excipients
Hypertension that is not controlled by the drug, and is defined as: SBP ≥150 mmHg and/or DBP ≥90 mmHg
International normalized ratio (INR) > 1.5 or partially activated prothrombin time (APTT) > 1.5 × ULN
Poorly controlled diabetes before enrollment
Clinically significant electrolyte abnormalities judged by researchers
With any diseases or conditions that affected drug absorption, or the patient could not take drugs orally
Patients with obvious evidence of bleeding tendency or medical history within 3 months before enrollment, hemoptysis or thromboembolism within 12 months
Cardiovascular diseases with significant clinical significance, including but not limited to acute myocardial infarction, severe / unstable angina pectoris or coronary artery bypass grafting within 6 months before enrollment; Congestive heart failure, New York Heart Association (NYHA) grade > 2; ventricular arrhythmia requiring drug treatment; LVEF (left ventricular ejection fraction) < 50%
Active infection or serious infection that is not controlled by drug (≥CTCAE v5.0 Grade 2)
History of clinically significant hepatic disease, including, but not limited to, known hepatitis B virus (HBV) infection with HBV DNA positive (copies ≥1×104/ml); known hepatitis C virus infection with HCV RNA positive (copies ≥1×103/m)
Women who are pregnant or lactating
Urinary protein ≥ ++, and the 24-hour urine protein quantification is greater than 1.0 g
Have any other disease, metabolic disorder, physical examination anomaly, abnormal laboratory result, or any other conditions which, according to judgement of the investigator, renders the patient inappropriate for using of the investigational product or may affect interpretation of study results
Patients considered unsuitable for inclusion in this study by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Suxia Luo, M.D.
Phone
0086-371-65587009
Email
zlyyluosuxia0361@zzu.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Fei Ma, M.D.
Phone
0086-13703923592
Email
mafeizzu@outlook.com
Facility Information:
Facility Name
Henan Tumor Hospital
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450000
Country
China
Individual Site Status
Recruiting
Facility Name
Henan Tumor Hospital
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450000
Country
China
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
FEI MA
Phone
0086-13703923592
Email
mafeizzu@outlook.com
12. IPD Sharing Statement
Learn more about this trial
Conversion Therapy of Fruquintinib in Combination With Sintilimab and SOX in Unresectable Gastric Cancer
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