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Fruquintinib Combined With Tislelizumab and HAIC in Patients With Advanced Colorectal Liver Metastases Cancer Who Failed Standard Therapy

Primary Purpose

Colorectal Cancer

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
HAIC
Fruquintinib
Tislelizumab
Raltitrexed
Oxaliplatin
Irinotecan
Sponsored by
Fudan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Informed consent has been signed
  2. Histologically or cytologically confirmed unresectable advanced colorectal liver metastases cancer
  3. Age ≥ 18 years, ≤75 years
  4. ECOG PS:0-1
  5. Expected overall survival ≥12 months
  6. Patients must have at least one measurable liver metastases (RECIST 1.1)
  7. Patients who have previously failed standard treatment, or who cannot tolerate standard treatment
  8. Patients must have adequate organ and bone marrow function
  9. Women of childbearing age must have a negative pregnancy test within the first day of the study, and contraceptive methods should be taken during the study until 6 months after the last administration

Exclusion Criteria:

  1. Patients who are allergic or suspected to be allergic to the study drug or similar drugs
  2. Patients had other malignant tumors in the past 5 years or at the same time (except for the cured skin basal cell carcinoma and cervical carcinoma in situ);
  3. Participating in other clinical trials and received at least one treatment within 4 weeks before enrollment
  4. Patients with autoimmune disease or history of autoimmune disease within 4 weeks before enrollment
  5. patients currently have central nervous system (CNS) metastasis or previous brain metastasis and the symptom control time is less than 2 months
  6. Patients cannot take fruquintinib orally
  7. Patients who have received organ transplantation and bone marrow transplantation in the past
  8. Have taken other strong inducers or inhibitors of CYP3A4, P-gp substrates and BCRP substrates within 2 weeks before the First medication
  9. Received any operation (except biopsy) or invasive treatment or operation (except venous catheterization, puncture and drainage, etc.) within 4 weeks before enrollment
  10. Pleural effusion or ascites causing relevant clinical symptoms, including respiratory syndrome (dyspnea≥CTC AE grade 2)
  11. Clinically significant electrolyte abnormality;
  12. Systolic blood pressure > 140mmHg or diastolic blood pressure > 90mmHg regardless of any antihypertensive drugs; Or patients need more than two antihypertensive drugs
  13. Proteinuria ≥ 2+ (1.0g/24hr);
  14. Active gastric and duodenal ulcer, ulcerative colitis or uncontrolled hemorrhage in GI, or other conditions that may cause GI bleeding and perforation as determined by the investigator;
  15. Have evidence or history of bleeding tendency within 3 months or thromboembolic events within 12 months before enrollment
  16. Clinically significant cardiovascular disease, including but not limited to acute myocardial infarction, severe/unstable angina pectoris or coronary artery bypass grafting within 6 months before enrollment; NYHA classification > 2 Grade; ventricular arrhythmia requiring medical therapy; ECG showing QTc interval ≥ 480 ms
  17. Active or uncontrolled serious infection (≥CTCAE grade 2 infection)
  18. Pregnant or lactating women
  19. Any other disease, with clinically significant metabolic abnormalities, physical examination abnormalities or laboratory abnormalities, according to the judgment of investigator that the patient is not suitable for the the study drug (such as having epileptic seizures and require treatment), or would affect the interpretation of study results, or put patients at high risk
  20. Clinical uncontrolled active infections, including human immunodeficiency virus (HIV) infection, active hepatitis B / C (HBV DNA Positive[1×104 copies/mL or >2000 IU/ml], HCV RNA positive[>1×103 copies/mL]);
  21. Patients have other factors that may affect the results of the study or cause the study to be terminated halfway, such as alcoholism, drug abuse, other serious diseases (including mental diseases) that require concomitant treatment, and serious laboratory abnormalities. Accompanied by family or social factors, which will affect the safety of patients.

Sites / Locations

  • Fudan University Shanghai Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

combination therapy

Arm Description

Combination: Fruquintinib plus Tislelizumab and HAIC (TOMOX/TOMIRI) Maintenance: Fruquintinib plus Tislelizumab

Outcomes

Primary Outcome Measures

objective response rate (ORR)
Defined as percentage of participants achieving assessed complete response (CR) and partial response (PR) by the investigator according to the RECIST 1.1.

Secondary Outcome Measures

disease control rate (DCR)
DCR was defined as the percentage of participants who have a confirmed complete response(CR) or partial response(PR) or stable disease(SD) per RECIST 1.1 as assessed by investigator
Progression-Free Survival (PFS)
PFS is defined as the time from enrollment to the first documented disease progression or death due to any cause, whichever occurs first. Responses are according to the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by investigator
Progression-Free Survival rate at 6 months
The proportion of patients who did not experience disease progression or death from treatment initiation to 6 months
overall survival (OS)
OS is the time from enrollment to death due to any cause.
Adverse events as assessed by NCI CTCAE v5.0
overall incidence of adverse events (AE); incidence of grade 3 or higher AE; incidence of severe adverse events (SAE); incidence of AEs leading to discontinuation of drug use; incidence of AEs leading to suspension of drug use

Full Information

First Posted
June 23, 2022
Last Updated
November 17, 2022
Sponsor
Fudan University
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1. Study Identification

Unique Protocol Identification Number
NCT05435313
Brief Title
Fruquintinib Combined With Tislelizumab and HAIC in Patients With Advanced Colorectal Liver Metastases Cancer Who Failed Standard Therapy
Official Title
A Single-center, Single-arm, Open-label Clinical Study of Fruquintinib Combined With Tislelizumab and HAIC in Patients With Advanced Colorectal Liver Metastases Cancer Who Failed Standard Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 12, 2022 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
June 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fudan University

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 single-center, single-arm, open-label clinical study, to explore the efficacy and safety of fruquintinib combined with tislelizumab and HAIC (hepatic arterial infusion chemotherapy) in patients with colorectal liver metastases cancer (CRLM) who failed standard therapy.
Detailed Description
Liver is the most common metastatic site in patients with colorectal cancer (CRC) and the leading cause of death in patients. Surgery is the best way to cure CRLM, but few patients can receive surgery, and patients prone to recurrence after surgery. It is an urgent topic to choose an effective treatment method with less side effects for CRLM patients. HAIC is a unique and effective treatment option for CRLM patients. Fruquintinib is a small molecule angiogenesis inhibitor, and has been recommended for third-line treatment of metastatic colorectal cancer (mCRC). Tislelizumab is a humanized IgG4 anti-PD-1 monoclonal antibody, meanwhile, tislelizumab shows significant and durable antitumor activity in patients with CRC, and is well tolerated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal 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
39 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
combination therapy
Arm Type
Experimental
Arm Description
Combination: Fruquintinib plus Tislelizumab and HAIC (TOMOX/TOMIRI) Maintenance: Fruquintinib plus Tislelizumab
Intervention Type
Procedure
Intervention Name(s)
HAIC
Intervention Description
After successful percutaneous hepatic artery cannulation, superior mesenteric arteriogram and hepatic arteriogram were performed, and after confirming that the subjects were eligible for enrollment according to the results, the hepatic artery was cannulated to the predetermined position. The catheter was connected to a syringe pump in the ward for continuous pumping of drugs.
Intervention Type
Drug
Intervention Name(s)
Fruquintinib
Intervention Description
3mg, qd, po, 21 days for a cycle, Suspend medication on the day of HAIC
Intervention Type
Drug
Intervention Name(s)
Tislelizumab
Intervention Description
200mg, ivgtt, d1, 21 days for a cycle
Intervention Type
Drug
Intervention Name(s)
Raltitrexed
Intervention Description
2 mg/m2, hepatic artery infusion for 15 min, d1, 4-6 Cycles
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin
Intervention Description
85 mg/m2, hepatic artery infusion for 2 h, d1, 4-6 Cycles
Intervention Type
Drug
Intervention Name(s)
Irinotecan
Intervention Description
120mg/m2, hepatic artery perfusion for 30-90min, d1, 4-6 Cycles
Primary Outcome Measure Information:
Title
objective response rate (ORR)
Description
Defined as percentage of participants achieving assessed complete response (CR) and partial response (PR) by the investigator according to the RECIST 1.1.
Time Frame
24 months
Secondary Outcome Measure Information:
Title
disease control rate (DCR)
Description
DCR was defined as the percentage of participants who have a confirmed complete response(CR) or partial response(PR) or stable disease(SD) per RECIST 1.1 as assessed by investigator
Time Frame
24 months
Title
Progression-Free Survival (PFS)
Description
PFS is defined as the time from enrollment to the first documented disease progression or death due to any cause, whichever occurs first. Responses are according to the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by investigator
Time Frame
24 months
Title
Progression-Free Survival rate at 6 months
Description
The proportion of patients who did not experience disease progression or death from treatment initiation to 6 months
Time Frame
6 months
Title
overall survival (OS)
Description
OS is the time from enrollment to death due to any cause.
Time Frame
24 months
Title
Adverse events as assessed by NCI CTCAE v5.0
Description
overall incidence of adverse events (AE); incidence of grade 3 or higher AE; incidence of severe adverse events (SAE); incidence of AEs leading to discontinuation of drug use; incidence of AEs leading to suspension of drug use
Time Frame
24 months

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: Informed consent has been signed Histologically or cytologically confirmed unresectable advanced colorectal liver metastases cancer Age ≥ 18 years, ≤75 years ECOG PS:0-1 Expected overall survival ≥12 months Patients must have at least one measurable liver metastases (RECIST 1.1) Patients who have previously failed standard treatment, or who cannot tolerate standard treatment Patients must have adequate organ and bone marrow function Women of childbearing age must have a negative pregnancy test within the first day of the study, and contraceptive methods should be taken during the study until 6 months after the last administration Exclusion Criteria: Patients who are allergic or suspected to be allergic to the study drug or similar drugs Patients had other malignant tumors in the past 5 years or at the same time (except for the cured skin basal cell carcinoma and cervical carcinoma in situ); Participating in other clinical trials and received at least one treatment within 4 weeks before enrollment Patients with autoimmune disease or history of autoimmune disease within 4 weeks before enrollment patients currently have central nervous system (CNS) metastasis or previous brain metastasis and the symptom control time is less than 2 months Patients cannot take fruquintinib orally Patients who have received organ transplantation and bone marrow transplantation in the past Have taken other strong inducers or inhibitors of CYP3A4, P-gp substrates and BCRP substrates within 2 weeks before the First medication Received any operation (except biopsy) or invasive treatment or operation (except venous catheterization, puncture and drainage, etc.) within 4 weeks before enrollment Pleural effusion or ascites causing relevant clinical symptoms, including respiratory syndrome (dyspnea≥CTC AE grade 2) Clinically significant electrolyte abnormality; Systolic blood pressure > 140mmHg or diastolic blood pressure > 90mmHg regardless of any antihypertensive drugs; Or patients need more than two antihypertensive drugs Proteinuria ≥ 2+ (1.0g/24hr); Active gastric and duodenal ulcer, ulcerative colitis or uncontrolled hemorrhage in GI, or other conditions that may cause GI bleeding and perforation as determined by the investigator; Have evidence or history of bleeding tendency within 3 months or thromboembolic events within 12 months before enrollment Clinically significant cardiovascular disease, including but not limited to acute myocardial infarction, severe/unstable angina pectoris or coronary artery bypass grafting within 6 months before enrollment; NYHA classification > 2 Grade; ventricular arrhythmia requiring medical therapy; ECG showing QTc interval ≥ 480 ms Active or uncontrolled serious infection (≥CTCAE grade 2 infection) Pregnant or lactating women Any other disease, with clinically significant metabolic abnormalities, physical examination abnormalities or laboratory abnormalities, according to the judgment of investigator that the patient is not suitable for the the study drug (such as having epileptic seizures and require treatment), or would affect the interpretation of study results, or put patients at high risk Clinical uncontrolled active infections, including human immunodeficiency virus (HIV) infection, active hepatitis B / C (HBV DNA Positive[1×104 copies/mL or >2000 IU/ml], HCV RNA positive[>1×103 copies/mL]); Patients have other factors that may affect the results of the study or cause the study to be terminated halfway, such as alcoholism, drug abuse, other serious diseases (including mental diseases) that require concomitant treatment, and serious laboratory abnormalities. Accompanied by family or social factors, which will affect the safety of patients.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Li Tan
Phone
158 0068 0751
Email
121176421@qq.com
Facility Information:
Facility Name
Fudan University Shanghai Cancer Center
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200062
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lu Wang, M.D.
Phone
+86-18121299357
Email
w.lr@hotmail.com
First Name & Middle Initial & Last Name & Degree
Ti Zhang, PhD

12. IPD Sharing Statement

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Fruquintinib Combined With Tislelizumab and HAIC in Patients With Advanced Colorectal Liver Metastases Cancer Who Failed Standard Therapy

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