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Locally Advanced Rectal CancerPhase 2NCT05245474

Neoadjuvant Long-course Chemoradiation Plus PD-1 Blockade for Mid-low Locally Advanced Rectal Cancer

A Phase 2 study testing Long-course chemoradiation, with or without Tislelizumab (PD-1 inhibitor) in people with Locally Advanced Rectal Cancer, run by Beijing Friendship Hospital at 8 sites in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This is a phase II/III, multi-center, open-label, 3-arm, randomized controlled trial assessing the efficacy and safety of neoadjuvant long-course chemoradiation combined with Tislelizumab (PD-1 inhibitor) and subsequent TME surgery, by comparing assorted endpoints between two experiment groups (Experiment group 1… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Locally Advanced Rectal Cancer
What is being tested?
Long-course chemoradiation, with or without Tislelizumab (PD-1 inhibitor)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
186 participants
Where
8 sitesChina
Study dates
1 Apr 2022to 1 Sep 2029
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • aged 18~75
  • ECOG score 0~2
  • biopsy diagnosed rectal adenocarcinoma, distal margin within 10cm to anal verge
  • no distant metastasis, staged II/III (T4b excluded) by MRI
  • maximum diameter of rectal cancer lesion≥10mm according to baseline CT or MRI (i.e. a "measurable lesion" as per RECIST 1.1 criteria)
  • willing and able to comply with study protocol
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  • consent to the use of blood and tissue specimens for study
  • no history of previous anti-tumor treatment (e.g. radiation, chemo, immuno, bio, herbal, etc.)
  • no disorders/diseases of immune system (e.g. systemic lupus erythematosus, rheumatoid arthritis, systemic vasculitis, scleroderma, pemphigus, dermatomyositis, mixed connective tissue disease, autoimmune hemolytic anemia, hyperthyroidism/hypothyroidism, ulcerative colitis, autoimmune hemolytic anemia, HIV infection, etc.)
  • no significant dysfunction of major viscera (e.g. heart, lung, liver, kidney, etc.)
  • no jaundice or gastrointestinal obstruction
  • no acute/ongoing infection
  • no significant irregularities in blood routine test and biochemical test results, particular requirements include: neutrophils≥1.5×109/L, HGB≥80g/L, platelet≥100×109/L, serum creatinine≤1.5×ULN, total bilirubin≤1.5×ULN, ALT、AST≤2.5×ULN
  • no social or mental disorder
  • for women of child-bearing age, a negative result of serological pregnancy test is required, and effective contraception measures from inclusion till 60 days after the last dose of study drug is required

Who cannot join

  • multiple cancers, or with concomitant malignant tumors besides rectal cancer
  • having received any anti-cancer treatment (surgery, drugs, etc.) in the past 5 years
  • history of recent major surgery
  • with condition that affects the absorption of capecitabine via gastrointestinal tract (e.g. inability to swallow, nausea, vomiting, chronic diarrhea, etc.)
  • with uncontrolled, severe, concomitant diseases of any sort
  • allergic to any of the ingredients under study
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  • estimated survival ≤ 5 years due to any reason
  • preparing for or having previously received organ or bone marrow transplant
  • having received immunosuppressive or systemic hormone therapy for immunosuppressive purposes within 1 month prior to inclusion
  • for patients with history of disorder of central nervous system, investigator discretion is required as to whether the clinical severity prevents the signing of informed consent or affects the patient's oral medication compliance
  • with other conditions/issues that may affect the study results or cause the study treatment to be terminated halfway (e.g. alcoholism, drug abuse, etc.)
  • pregnant or lactating women, or women intending on conception during treatment period

Trial locations and contacts

8 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Zhongtao Zhang, M.D. contact

+8613801060364

zhangzht@ccmu.edu.cn

8 sites in 1 country

China8 sites, 4 recruiting
  • Beijing Friendship Hospital, Capital Medical University

    Beijing, Beijing Municipality, 100050

    Kai Pang, M.D., 86 18811792819, pk2wys@foxmail.com

    Zhongtao Zhang, M.D.

    Recruiting
  • Beijing Cancer Hospital

    Beijing, Beijing Municipality

    Completed
  • Beijing Chaoyang Hospital, Capital Medical University

    Beijing, Beijing Municipality

    Completed
  • Beijing Hospital

    Beijing, Beijing Municipality

    Completed
  • Peking Union Medical College Hospital

    Beijing, Beijing Municipality

    Danyang Zhu, M.D., 86 13466711222, 17710202092@163.com

    Yi Xiao, M.D.

    Recruiting
  • Peking University First Hospital

    Beijing, Beijing Municipality

    Yingchao Wu, M.D., 86 13693214551, wuyingchao112@163.com

    Xin Wang, M.D.

    Recruiting
  • Peking University People's Hospital

    Beijing, Beijing Municipality

    Shuang Cao, M.D., 1610301226@pku.edu.cn

    Yingjiang Ye, M.D.

    Recruiting
  • Xuanwu Hospital, Capital Medical University

    Beijing, Beijing Municipality

    Completed

Other trials in China

About this study

Official title: Efficacy and Safety of Neoadjuvant Long-course Chemoradiation Plus Tislelizumab in Mid-low Locally Advanced Rectal Cancer: a Phase II, Multi-center, Open-label, Randomized Controlled Trial (POLARSTAR Trial)

This is a phase II/III, multi-center, open-label, 3-arm, randomized controlled trial assessing the efficacy and safety of neoadjuvant long-course chemoradiation combined with Tislelizumab (PD-1 inhibitor) and subsequent TME surgery, by comparing assorted endpoints between two experiment groups (Experiment group 1: chemoradiation+concurrent PD-1 inhibitor; Experiment group 2: chemoradiation+sequential PD-1 inhibitor) with a control group (chemoradiation only).

Read the detailed description

This phase II, multi-center, open-label, 3-arm, randomized trial aims to recruit patients aged 18-75 years, diagnosed histologically as rectal adenocarcinoma, without metastasis (by CT), staged II/III (by MRI, T4b excluded), with distal margin within 10cm to anal verge. All patients should have no history of immune diseases, nor history of immunotherapy or radiotherapy. Sample size was thoroughly calculated to be 186. Eligible participants will be randomly assigned to Experiment Arm 1 (50.4Gy radiation, capecitabine, and anti-PD1 starting at Day 8 of radiation), Experiment Arm 2 (50.4Gy radiation, capecitabine, and anti-PD1 starting 2 weeks after completion of radiation), and Control Arm (50.4Gy radiation, capecitabine) in a 1:1:1 ratio. Randomization is stratified by different centers, with a block size of 6. For both experiment arms, Tislelizumab (anti-PD1) is scheduled to be administered at 200mg each time for 3 times, with 3-week intervals. The primary endpoint is pCR rate, and secondary endpoints include sphincter-preserving rate, adverse event rates, and DFS and OS rate at 2, 3 and 5 years post-operation. Data will be analyzed with an intention-to-treat or modified intention-to-treat approach.

Being tested
Long-course chemoradiation, with or without Tislelizumab (PD-1 inhibitor)
Keywords
LARC, radiation, chemoradiation, PD-1, Tislelizumab, neoadjuvant, randomized, controlled

What participants receive

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

  • Long-course chemoradiation, with or without Tislelizumab (PD-1 inhibitor)Combination product

    Tislelizumab is added to long-course chemoradiation (CRT) of LARC patients, with CRT+concurrent Tislelizumab for Arm 1, CRT+sequential Tislelizumab for Arm 2, and CRT only for Arm 3

Study groups in NCT05245474
Study groupRoleWhat they receive
CRT+concurrent PD-1 inhibition (Experiment Arm 1)ExperimentalLong-course chemoradiation plus PD-1 inhibition (Tislelizumab 200mg, 3 times, 3-week interval) starting on Day 8 of radiation therapy. TME surgery is scheduled in 8~12 weeks after completion of radiation.
Receives: Combination Product: Long-course chemoradiation, with or without Tislelizumab (PD-1 inhibitor)
CRT+sequential PD-1 inhibition (Experiment Arm 2)ExperimentalLong-course chemoradiation plus PD-1 inhibition (Tislelizumab 200mg, 3 times, 3-week interval) starting on Day 15 after completion of radiation therapy. TME surgery is scheduled in 8~12 weeks after completion of radiation.
Receives: Combination Product: Long-course chemoradiation, with or without Tislelizumab (PD-1 inhibitor)
CRT without PD-1 inhibition (Control Arm)Active comparatorLong-course chemoradiation plus PD-1 inhibition with no PD-1 inhibition. TME surgery is scheduled in 6~12 weeks after completion of radiation.
Receives: Combination Product: Long-course chemoradiation, with or without Tislelizumab (PD-1 inhibitor)

What is being measured

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

  1. pCR rate

    pathological complete response rate

    Measured: within 10 days after surgery

Secondary outcomes (21)
  1. NAR score

    neoadjuvant rectal score

    Measured: within 10 days after surgery

  2. 2-y OS rate

    2-year overall survival rate

    Measured: 2 year

  3. 2-y DFS rate

    2-year disease free survival rate

    Measured: 2 year

  4. 3-y OS rate

    3-year overall survival rate

    Measured: 3 year

  5. 3-y DFS rate

    3-year disease free survival rate

    Measured: 3 year

  6. 5-y OS rate

    5-year overall survival rate

    Measured: 5 year

  7. 5-y DFS rate

    5-year disease free survival rate

    Measured: 5 year

  8. median OS time

    median length (in months) of overall survival period

    Measured: 0~60 months

  9. median DFS time

    median length (in months) of disease free survival period

    Measured: 0~60 months

  10. R0 resection rate

    rate of R0 resection

    Measured: within 10 days after surgery

  11. sphincter preserving rate

    proportion of patients with preserved anal sphincter

    Measured: instantly after surgery

  12. nearly pCR rate

    nearly pathological complete response rate

    Measured: within 10 days after surgery

  13. ORR

    objective response rate

    Measured: before surgery

  14. immune-related adverse event rate

    adverse event rate that is deemed to be associated with PD-1 inhibition

    Measured: from commencing of PD-1 inhibition to the 30th day after surgery

  15. Grade 3+ immune-related adverse event rate

    adverse event (above Grade 3) rate that is deemed to be associated with PD-1 inhibition

    Measured: from commencing of PD-1 inhibition to the 30th day after surgery

  16. treatment-related adverse event rate

    adverse event rate that is deemed to be associated with all treatments

    Measured: from commencing of treatment to the 30th day after surgery

  17. Grade 3+ treatment-related adverse event rate

    adverse event (above Grade 3) rate that is deemed to be associated with all treatments

    Measured: from commencing of treatment to the 30th day after surgery

  18. cCR rate

    clinical complete response rate

    Measured: before surgery

  19. incidence rate of surgical complications

    incidence rate of surgical complications within 30 days after surgery

    Measured: within 30 days after surgery

  20. incidence rate of Grade 3+ surgical complications

    incidence rate of Grade 3+ surgical complications within 30 days after surgery

    Measured: within 30 days after surgery

  21. quality of life score

    quality of life score during the 5 years after surgery, multiple timepoint assessment

    Measured: during the 5 years after surgery

Timeline

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

  1. First posted18 Feb 2022
  2. Study start1 Apr 2022
  3. Primary completion1 Mar 2024 (estimated)
  4. Study completion1 Sep 2029 (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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
186 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05245474
Sponsor's protocol ID
BFH-POLARSTAR
Status last verified
Jan 2024
First submitted
6 Feb 2022
Last updated
10 Jan 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Export of individual patient data is a sensitive issue according to current Chinese laws

Publications

  • Pang K, Yang Y, Zhao P, Wu G, Li J, Gao J, Yao H, Yang Y, Zhang Z. Adding immune checkpoint blockade to neoadjuvant chemoradiation in locally advanced rectal cancer. Br J Surg. 2022 Oct 14;109(11):1178-1179. doi: 10.1093/bjs/znac298. No abstract available.

    PubMed 36001602
  • Pang K, Sun P, Liu X, Yang D, Zhao P, Huang Y, Cao S, Gao Y, Chen G, Yu H, Duan L, Yang Y, Zhang Z. Development of the rationale of a personalized cancer vaccine based on the in situ vaccine effect of radiotherapy: a mechanistic study of the POLARSTAR trial. Cancer Immunol Immunother. 2025 Nov 12;74(12):369. doi: 10.1007/s00262-025-04229-3.

    PubMed 41222702
  • Yang Y, Pang K, Lin G, Liu X, Gao J, Zhou J, Xu L, Gao Z, Wu Y, Li A, Han J, Wu G, Wang X, Li F, Ye Y, Zhang J, Chen G, Wang H, Kong Y, Wu A, Xiao Y, Yao H, Zhang Z. Neoadjuvant chemoradiation with or without PD-1 blockade in locally advanced rectal cancer: a randomized phase 2 trial. Nat Med. 2025 Feb;31(2):449-456. doi: 10.1038/s41591-024-03360-5. Epub 2025 Jan 6.

    PubMed 39762418
  • Pang K, Yang Y, Tian D, Zeng N, Cao S, Ling S, Gao J, Zhao P, Wang H, Kong Y, Zhang J, Chen G, Deng W, Bai Z, Jin L, Wu G, Zhu D, Wang Y, Zhou J, Wu B, Lin G, Xiao Y, Gao Z, Ye Y, Wang X, Li A, Han J, Yao H, Yang Y, Zhang Z. Long-course chemoradiation plus concurrent/sequential PD-1 blockade as neoadjuvant treatment for MMR-status-unscreened locally advanced rectal cancer: protocol of a multicentre, phase 2, randomised controlled trial (the POLAR-STAR trial). BMJ Open. 2023 Sep 12;13(9):e069499. doi: 10.1136/bmjopen-2022-069499.

    PubMed 37699634

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Long-course chemoradiation, with or without Tislelizumab (PD-1 inhibitor) in people with Locally Advanced Rectal Cancer, run by Beijing Friendship Hospital at 8 sites 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 12 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: looking for participants now, as of the sponsor's last update on 10 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Zhongtao Zhang, M.D. (+8613801060364, zhangzht@ccmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

pCR rate (time frame: within 10 days after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05245474, which also lists 4 linked publications.

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 10 Jan 2024.

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