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Oligometastatic Gastrointestinal CancerPhase 1NCT04625894

The Combination of Immunotherapy and Stereotactic Ablative Radiotherapy in Oligometastatic Gastrointestinal Cancer

A Phase 1 study testing Stereotactic Ablative Radiotherapy (SABR) and Camrelizumab for injection (200 mg, iv), D1, Q2W, 14-day cycle in people with Oligometastatic Gastrointestinal Cancer, run by Fudan University at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a single-center, open-label, single-arm phase I clinical study to exploratory observe and evaluate the efficacy and safety of anti-PD-1 antibody (Camrelizumab for Injection) combined with multisite stereotactic ablative radiotherapy (SABR) in patients with oligometastatic gastrointestinal cancer. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Oligometastatic Gastrointestinal Cancer
What is being tested?
Stereotactic Ablative Radiotherapy (SABR) and Camrelizumab for injection (200 mg, iv), D1, Q2W, 14-day cycle
Could I receive a placebo?
No, everyone receives an active treatment
How many people
21 participants
Where
1 siteChina
Study dates
Dec 2020to Jun 2023
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged 18-70 years old, regardless of gender;
  • Fully informed and willing to provide written informed consent for the trial;
  • ECOG performance status 0-1;
  • Expected survival time ≥ 6 months;
  • Has gastric carcinoma /colorectal carcinoma / hepatocellular carcinoma, confirmed by histopathology (or pathology consultation in our hospital) and measurable oligometastatic lesions on imaging (RECIST version 1.1); pathological diagnosis confirmation of oligometastatic lesions using biopsy tissue samples (e.g. obtained by hollow core needle, biopsy, excision, etc.) is recommended but not required;
  • Has undergone curative treatment on the primary lesion at least three months ago, without local progression;
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  • Has received standard treatment prior to enrolment, except for any type of immunotherapy;
  • Has no more than three metastatic lesions detected on imaging in single organ (e.g. lung, liver, brain, bone, etc.), and the total number of metastases is no more than five;
  • Multiple sites of lesions can be safely treated by SABR; and the maximum diameter of each lesion for irradiation is no more than 5cm.
  • Contraindicated for surgery or the participant refuses to receive surgery.
  • Has adequate organ function to tolerate the regimen:
  • Bone marrow function: neutrophils ≥ 1.5 × 109/L, platelets ≥ 100 × 109/L, hemoglobin ≥ 90 g/L;
  • Liver and kidney function: serum creatinine ≤ 1.5 times the upper limit of normal; AST and ALT ≤ 2.5 times the upper limit of normal or the presence of liver metastasis ≤ 5 times the upper limit of normal; total bilirubin ≤ 1.5 times the upper limit of normal, or patients with Gilbert's syndrome ≤ 2.5 times the upper limit of normal;
  • Subject is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up
  • Non-lactating patients.

Who cannot join

  • Pregnant or lactating women
  • Serious medical comorbidities precluding radiotherapy
  • Prior radiotherapy to a site requiring treatment
  • Malignant pleural effusion
  • Inability to treat all sites of active disease
  • Has clinical or radiologic evidence of spinal cord compression or tumor within 3mm of spinal cord on MRI.
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  • Dominant brain metastasis requiring surgical decompression
  • Has prior treatment with cancer immunotherapy including, but not limited to immune checkpoint inhibitors.
  • Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy at a dose of >10 mg Prednisone daily or equivalent at time of trial treatment.
  • Has a known history of active Bacillus Tuberculosis
  • Has active autoimmune disease that has required systemic treatment in the past 2 years
  • Hypersensitivity to PD-1 inhibitor or any of its excipients.
  • Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study day 1 or who has not recovered from adverse events due to a previously administered agent.

Trial locations and contacts

1 site in 1 country.

Zhen Zhang, MD, PhD contact

18801735029

zhen_zhang@fudan.edu.cn

China1 site
  • Fudan University Shanghai Cancer Center

    Shanghai, Shanghai Municipality, 200032

Other trials in China

About this study

Official title: Phase I Clinical Trial of Multisite Stereotactic Ablative Radiotherapy (SABR) Combined With Camrelizumab in Patients With Oligometastatic Gastrointestinal Cancer

This is a single-center, open-label, single-arm phase I clinical study to exploratory observe and evaluate the efficacy and safety of anti-PD-1 antibody (Camrelizumab for Injection) combined with multisite stereotactic ablative radiotherapy (SABR) in patients with oligometastatic gastrointestinal cancer.

According to the origin site of metastases, this study will consist of three subgroups, including gastric carcinoma group, colorectal carcinoma group and hepatocellular carcinoma group. For each of the subgroup, seven eligible patients with oligometastatic cancer originating from stomach, colon and liver, respectively will be recruited. All patients will receive multisite SABR followed by immunotherapy of Camrelizumab within one week from completion. Camrelizumab will be administered at a fixed dose of 200 mg intravenously (iv) on D1 in a 14-day cycle. The treatment will continue for up to two years until disease progression, unacceptable toxicity or patient withdrawal.

Tumor tissue samples, sections, paraffin blocks or biopsy blocks, and biomarkers, including but not limited to PD-L1 expression level and the proportion of positive cells, TMB level and MMR status, will be collected from subjects.

Being tested
Stereotactic Ablative Radiotherapy (SABR), Camrelizumab for injection (200 mg, iv), D1, Q2W, 14-day cycle

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Stereotactic Ablative Radiotherapy (SABR)Radiation

    To irradiate as many metastatic lesions as possible, in the precondition that normal tissues can tolerate. Target dose will be adjusted depending on site of the lesion and organs at risk (BED > 100Gy). Sequence of irradiation for multiple metastases will be at the discretion of the investigators based on their experience.

  • Camrelizumab for injection (200 mg, iv), D1, Q2W, 14-day cycleDrug

    Administration of Carrelizumab will be started within one week upon SABR completion, and will be continued for up to two years until disease progression, unacceptable toxicity or patient withdrawal.

Study groups in NCT04625894
Study groupRoleWhat they receive
Treatment ArmExperimentalPatients with oligometastatic gastrointestinal cancer will receive multisite SABR, followed by Camrelizumab within one week from completion of radiation. Camrelizumab for injection at 200 mg, d1, q2w, 14-day cycle will continue for up to two years until disease progression, unacceptable toxicity or patient withdrawal.
Receives: Radiation: Stereotactic Ablative Radiotherapy (SABR); Drug: Camrelizumab for injection (200 mg, iv), D1, Q2W, 14-day cycle

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Dose-limiting toxicities (DLT)

    Defined as treatment-related Grade 3 or higher toxicities (excluding asymptomatic biochemical abnormalities) within 3 months, starting from the first day of radiotherapy. Toxicities will be assessed and graded according to NCI-CTCAE v5.0.

    Measured: Up to 2 years

Secondary outcomes (5)
  1. Adverse events (AEs)

    Assessed according to NCI-CTCAE v5.0., and summarized by type and severity in tabular format to examine their frequency, organ systems affected, severity, and relationship to study treatment.

    Measured: Up to 2 years

  2. Local control (LC)

    Defined as stable disease, partial response, or complete response based on serial imaging with CT scan. Recurrence will be defined as a suspicious mass at the site of SABR treated lesion, progressing in size on 2 consecutive computed tomography scans at a minimum interval of 1 month, combined with a positive FDG-PET defined by a SUV max ≥ 5, or a biopsy-proven confirmation.

    Measured: Up to 2 years

  3. Progression-free survival (PFS)

    Regional or distant disease progression according to RECIST v1.1 or death due to any cause

    Measured: Up to 2 years

  4. Overall survival (OS)

    A subject will be classified as either alive or dead due to any cause. The time to event will be calculated as the time from Day 1 until date of death. Day 1 is the date of 1st treatment with SABR.

    Measured: Up to 2 years

  5. Quality of life assessment

    Assessed with the Functional Assessment of Cancer Therapy: General (FACT-G)

    Measured: Up to 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Nov 2020
  2. Study startDec 2020 (estimated)
  3. Primary completionDec 2022 (estimated)
  4. Study completionJun 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
21 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04625894
Sponsor's protocol ID
MA-CRC-I-002
Status last verified
Nov 2020
First submitted
6 Nov 2020
Last updated
12 Nov 2020
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Stereotactic Ablative Radiotherapy (SABR) and Camrelizumab for injection (200 mg, iv), D1, Q2W, 14-day cycle in people with Oligometastatic Gastrointestinal Cancer, run by Fudan University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 12 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Zhen Zhang, MD, PhD (18801735029, zhen_zhang@fudan.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Dose-limiting toxicities (DLT) (time frame: Up to 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Nov 2020.

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