PTC in Personalizing Neoadjuvant Therapy for Patients With Advanced Gastrointestinal Tumor
Primary Purpose
Gastrointestinal Neoplasms
Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
PTC drug screening
Sponsored by
About this trial
This is an interventional screening trial for Gastrointestinal Neoplasms focused on measuring neoadjuvant, chemotherapy
Eligibility Criteria
Inclusion Criteria:
- diagnosed of gastrointestinal adenocarcinoma by biopsy
- existence of initially resectable lesions evaluated by investigators
- indications of neoadjuvant chemotherapy including: 1) locally advanced gastric cancer cT1-2N1-3M0 & cT3-4N0-3M0; 2) locally advanced colorectal cancer cT3-4 or N+; 3)colorectal carcinoma with synchronous liver metastases: CRS≤2; 4)other patients who are considered to be appropriate to receive neoadjuvant chemotherapy determined by MDT
- never receive any tumor related treatment including chemotherapy, radiotherapy, and immune therapy
- never diagnosed of other malignancies
- able to tolerate chemotherapy
- ECOG≤2
- life expectance >6 months
- at least 1 measurable lesions(according to RECIST 1.1)
- informed consent
Exclusion Criteria:
- pregnant or lactating women
- participating in other clinical trials within 6 months
- MSI-H or dMMR or EBER(+)
- lesion located within 10cm from anal margin
- severe liver dysfunction
- severe renal dysfunction
- cognitive disorder, mental disease or poor compliance
- allergic to known chemotherapeutic agents
- other conditions not suitable to participate in this trial determined by investigators
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
Neoadjuvant therapy based on PTC drug screening
Neoadjuvant therapy based on clinical experience
Arm Description
Patients will receive neoadjuvant therapy based on PTC drug screening. The regimen is complied with NCCN and CSCO guidelines. PD-1 inhibitor will be used if effective in drug screening.
Patients will receive neoadjuvant therapy based on clinical experience. The regimen is complied with NCCN and CSCO guidelines.
Outcomes
Primary Outcome Measures
pathological complete response rate(pCR)
having no invasive cancer left in the resected sample
Secondary Outcome Measures
pathological response rate
tumor regression grade 0-2
objective response rate(ORR)
CR+PR according to RECIST 1.1
disease control rate(DCR)
CR+PR+SD according to RECIST 1.1
R0 resection rate
microscopically margin-negative resection, in which no gross or microscopic tumor remains in the primary tumor bed
prediction accuracy of PTC
consistency between the effect of neoadjuvant chemotherapy and the result of PTC assay
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05280210
Brief Title
PTC in Personalizing Neoadjuvant Therapy for Patients With Advanced Gastrointestinal Tumor
Official Title
Patient-derived Tumor-like Cell Clusters (PTC) in Personalizing Neoadjuvant Therapy for Patients With Advanced Gastrointestinal Tumor: A Prospective, Open-label and Randomized Study
Study Type
Interventional
2. Study Status
Record Verification Date
March 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
April 1, 2022 (Anticipated)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking 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
To explore the value of PTC drug screening technique in selecting neoadjuvant therapy for advanced gastrointestinal cancer.
Detailed Description
In this study, patients diagnosed with advanced gastrointestinal cancer including locally advanced gastric cancer, locally advanced colorectal cancer and colorectal cancer with liver metastasis. Tumor sample will be collected by endoscopy biopsy, needle biopsy or surgery, which will used for PTC drug screening.
Patients will be randomized to two groups. Patients in experiment group will receive neoadjuvant therapy based on PTC drug screening, and patients in control group will receive neoadjuvant therapy based on clinical experience. 2-4 cycles of neoadjuvant therapy will be administered. Patients appropriate for surgery will receive radical surgery after neoadjuvant therapy. Pathological response will be compared primarily between these two groups.
This is a randomized controlled, open-label and sequential designed clinical trial. All neoadjuvant therapy used in this study or for PTC drug screening comply with NCCN (National comprehensive cancer network) or CSCO (Chinese Society of Clinical Oncology) guidelines.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastrointestinal Neoplasms
Keywords
neoadjuvant, chemotherapy
7. Study Design
Primary Purpose
Screening
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
420 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Neoadjuvant therapy based on PTC drug screening
Arm Type
Experimental
Arm Description
Patients will receive neoadjuvant therapy based on PTC drug screening. The regimen is complied with NCCN and CSCO guidelines. PD-1 inhibitor will be used if effective in drug screening.
Arm Title
Neoadjuvant therapy based on clinical experience
Arm Type
No Intervention
Arm Description
Patients will receive neoadjuvant therapy based on clinical experience. The regimen is complied with NCCN and CSCO guidelines.
Intervention Type
Other
Intervention Name(s)
PTC drug screening
Intervention Description
PTC is an in vitro tumor model, which serves as a structural and functional unit recapitulating the original tumors in genotype, phenotype, and drug response. PTC will be used in drug screening.
Primary Outcome Measure Information:
Title
pathological complete response rate(pCR)
Description
having no invasive cancer left in the resected sample
Time Frame
immediately evaluated after surgery
Secondary Outcome Measure Information:
Title
pathological response rate
Description
tumor regression grade 0-2
Time Frame
immediately evaluated after surgery
Title
objective response rate(ORR)
Description
CR+PR according to RECIST 1.1
Time Frame
evaluated by imaging before surgery
Title
disease control rate(DCR)
Description
CR+PR+SD according to RECIST 1.1
Time Frame
evaluated by imaging before surgery
Title
R0 resection rate
Description
microscopically margin-negative resection, in which no gross or microscopic tumor remains in the primary tumor bed
Time Frame
immediately evaluated after surgery
Title
prediction accuracy of PTC
Description
consistency between the effect of neoadjuvant chemotherapy and the result of PTC assay
Time Frame
immediately evaluated after surgery
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:
diagnosed of gastrointestinal adenocarcinoma by biopsy
existence of initially resectable lesions evaluated by investigators
indications of neoadjuvant chemotherapy including: 1) locally advanced gastric cancer cT1-2N1-3M0 & cT3-4N0-3M0; 2) locally advanced colorectal cancer cT3-4 or N+; 3)colorectal carcinoma with synchronous liver metastases: CRS≤2; 4)other patients who are considered to be appropriate to receive neoadjuvant chemotherapy determined by MDT
never receive any tumor related treatment including chemotherapy, radiotherapy, and immune therapy
never diagnosed of other malignancies
able to tolerate chemotherapy
ECOG≤2
life expectance >6 months
at least 1 measurable lesions(according to RECIST 1.1)
informed consent
Exclusion Criteria:
pregnant or lactating women
participating in other clinical trials within 6 months
MSI-H or dMMR or EBER(+)
lesion located within 10cm from anal margin
severe liver dysfunction
severe renal dysfunction
cognitive disorder, mental disease or poor compliance
allergic to known chemotherapeutic agents
other conditions not suitable to participate in this trial determined by investigators
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Aiwen Wu, M.D.
Phone
+8613911577190
Email
wuaw@sina.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aiwen Wu, M.D.
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Study Director
12. IPD Sharing Statement
Learn more about this trial
PTC in Personalizing Neoadjuvant Therapy for Patients With Advanced Gastrointestinal Tumor
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