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Colorectal CancerPhase 1/2XS-03-II201NCT06936527

XS-03 in Combination With FOLFOX or FOLFIRI and Bevacizumab for Treatment of Metastatic Colorectal Cancer Patients With RAS Mutation

A Phase 1/2 study testing Drug: XS-03, Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI, Drug: XS-03 and Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI in people with Colorectal Cancer and Metastatic Colorectal Cancer With RAS Mutation, run by Shanghai Fosun Pharmaceutical Industrial Development Co. Ltd. at 1 site in China.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
Search all trials

Trial summary

XS-03 in combination with FOLFOX or FOLFIRI and Bevacizumab for treatment of metastatic colorectal cancer patients with RAS mutation Read more about this study

Who is it for?
Ages 18 to 75 years
What is being tested?
Drug: XS-03, Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI, Drug: XS-03 and Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI
Could I receive a placebo?
No, everyone receives an active treatment
How many people
102 participants
Where
1 siteChina
Study dates
23 May 2025to 30 Jul 2028
Phase
Phase 1/2
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

  • Voluntarily participate in the clinical trial and sign the informed consent form.
  • Age ≥18 and ≤ 75 years. No gender restrictions.
  • Patients with histologically and/or cytologically confirmed metastatic colorectal cancer who are not suitable for surgical treatment.
  • Advanced or metastatic colorectal cancer: Stage Ib patients must have received at least one prior systemic therapy; Stage II patients have no prior systemic therapy. For patients with previously neoadjuvant/adjuvant therapy, disease progression must occur no less than 6 months after the end of therapy to be eligible for inclusion.
  • Documentation of RAS mutation. The previously gene test report issued by qualified testing institution is acceptable. BRAF status is not restricted.
  • Consent to provide tumor tissue samples and peripheral blood for biomarker analysis.
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  • Has measurable extracranial lesion according to RECIST v1.1 criteria, defined as at least one lesion that has not received radiotherapy. For previously radiotherapy lesion, there must be imaging evidence of progression after radiotherapy.
  • Eastern Cooperative Oncology Group (ECOG) performance status score 0-1.
  • Expected life expectancy ≥ 6 months.
  • The patient has adequate hepatic, renal and bone marrow function.
  • For a woman of child-bearing potential must have a negative serum pregnancy test within 7 days prior to enrollment. Woman of child-bearing potential and fertile men must agree to use adequate contraception for the duration of study participation and for 6 months after the last dose.

Who cannot join

  • Patients with known high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR) primary or metastatic colorectal cancer and suitable for immune checkpoint inhibitor treatment assessed by investigators.
  • Previously received bevacizumab and its biosimilar therapy. (Only for phase II)
  • Central nervous system metastases which are symptomatic or require therapy.
  • Imaging shows major blood vessel invasion (such as the aorta, pulmonary artery, pulmonary vein, vena cava, etc.).
  • Adverse events and/or complications that caused by previous antitumor therapy have not recovered to baseline level or ≤ CTCAE grade 1.
  • Baseline level or ≤ Grade 1. However, any grade of alopecia, pigmentation, or ≤ Grade 2 peripheral sensory neuropathy, or other conditions assessed by the investigator as having become chronic and not affecting the safety of the study medication are allowed for inclusion.
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  • With a history of other malignancies within 5 years or with other malignancies currently prior to screening, except colorectal cancer. Exception: curatively treated early-stage malignancies (in situ carcinoma or stage I tumors), such as adequately treated basal cell or squamous cell skin cancer or in situ cancer of the cervix.
  • Patients have a significant risk of bleeding.
  • Patients have a significant risk of thrombus.
  • Patients have severe cardiovascular disease, including but not limited to: Ischemic heart disease within the past 6 months prior to screening; coronary artery disease post-surgery or stent implantation within 6 months; New York Heart Association (NYHA) functional classification ≥ Class II within 6 months prior to screening; or known left ventricular insufficiency (LVEF <50%);transient ischemic attack or cerebrovascular accident within 6 months prior to screening; uncontrolled hypertension (systolic blood pressure >150 mmHg or diastolic blood pressure >100 mmHg) despite standard treatment, or history of hypertensive crisis or hypertensive encephalopathy;severe arrhythmia requiring clinical intervention; any other cardiovascular disease that researchers regard the patient unsuitable for participation in the study.
  • Patients with a significantly increased risk of QTc prolongation.
  • Patients unable to swallow drugs or have severe diseases that significantly affect drug absorption.
  • Patients have one of the following viral active infections: active hepatitis B or C; human immunodeficiency virus (HIV) infection; active syphilis
  • During screening, the presence of interstitial lung disease, interstitial pneumonia, pulmonary interstitial fibrosis requiring therapy, or a history of pneumonia caused by tyrosine kinase inhibitors.
  • Patients received radiotherapy within the past 4 weeks prior to the first first dose of study drug.
  • Patients received therapeutic surgeries (excluding diagnosis, biopsy, or drainage procedures) within the past 4 weeks prior to the first dose of study drug, including local treatments such as radiofrequency ablation for liver metastases, or are expected to have major surgeries during the study period.
  • Severity infection need intravenous infusion of antibiotics, antiviral drugs, or hospitalisation within the past 2 weeks prior to the first dose of study drug.
  • Patients must use strong CYP3A4 inducers or inhibitors within the past 2 weeks prior to the first administration, or during the anticipated study period,
  • History of severe allergy, or known allergy to any active or inactive components of the study drug product.
  • Pregnancy or lactation.
  • Patients with severe diseases of any organs or systems, any clinical or laboratory test abnormalities, or other reasons that investigator assess them unsuitable to participate in this clinical study.

Trial locations and contacts

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

China1 site
  • Beijing Cancer Hospital

    Beijing

Other trials in China

About this study

Official title: An Open-label, Multicenter Phase Ib/II Clinical Study: Aim to Valuate the Efficacy and Safety of XS-03 Comination With FOLFOX or FOLFIRI and Bevacizumab in Metastatic Colorectal Cancer Patients With RAS Mutation

XS-03 in combination with FOLFOX or FOLFIRI and Bevacizumab for treatment of metastatic colorectal cancer patients with RAS mutation

Being tested
Drug: XS-03, Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI, Drug: XS-03, Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI
Medical subject headings
Colorectal Neoplasms

What participants receive

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

  • Drug: XS-03, Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRIBiological

    XS-03 orally Bevacizumab intravenously FOLFOX intravenously FOLFIRI intravenously

  • Drug: XS-03Biological

    XS-03 orally

  • Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRIBiological

    Bevacizumab intravenously FOLFOX intravenously FOLFIRI intravenously

Study groups in NCT06936527
Study groupRoleWhat they receive
Experimental arm 1: XS-03 + FOLFOX/FOLFIRI + BevacizumabExperimentalPhase 1b: XS-03 escalating orally Day 1 through Day 5 and Day 15 through Day 19 of each 28-day cycle in combination with FOLFOX or FOLFIRI and bevacizumab. FOLFOX (85 mg/m^2 oxaliplatin, 400 mg/m^2 leucovorin, 400 mg/m^2 bolus 5-fluorouracil (5-FU), and 2400 mg/m^2 continuous intravenous infusion 5-FU) , 5 mg/kg bevacizumab FOLFIRI (180 mg/m^2 irinotecan, 400 mg/m^2 leucovorin, 400 mg/m^2 bolus 5-fluorouracil (5-FU), and 2400 mg/m^2 continuous intravenous infusion 5-FU), 5 mg/kg bevacizumab
Receives: Biological: Drug: XS-03, Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI
Experimental arm 2: XS-03 + FOLFOX/FOLFIRI + BevacizumabExperimentalPhase 2: XS-03 Recommended Phase 2 Dose (RP2D) and selected one more dosage orally Day 1 through Day 5 and Day 15 through Day 19 of each 28-day cycle in combinationwith FOLFOX or FOLFIRI and bevacizumab. FOLFOX (85 mg/m^2 oxaliplatin, 400 mg/m^2 leucovorin, 400 mg/m^2 bolus 5-fluorouracil (5-FU), and 2400 mg/m^2 continuous intravenous infusion 5-FU) , 5 mg/kg bevacizumab FOLFIRI (180 mg/m^2 irinotecan, 400 mg/m^2 leucovorin, 400 mg/m^2 bolus 5-fluorouracil (5-FU), and 2400 mg/m^2 continuous intravenous infusion 5-FU), 5 mg/kg bevacizumab
Receives: Biological: Drug: XS-03
Comparator: FOLFOX/FOLFIRI + BevacizumabActive comparatorPhase 2: Comparator arm treat with FOLFOX or FOLFIRI + bevacizumab intravenously. FOLFOX (85 mg/m^2 oxaliplatin, 400 mg/m^2 leucovorin, 400 mg/m^2 bolus 5-fluorouracil (5-FU), and 2400 mg/m^2 continuous intravenous infusion 5-FU) , 5 mg/kg bevacizumab FOLFIRI (180 mg/m^2 irinotecan, 400 mg/m^2 leucovorin, 400 mg/m^2 bolus 5-fluorouracil (5-FU), and 2400 mg/m^2 continuous intravenous infusion 5-FU), 5 mg/kg bevacizumab
Receives: Biological: Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI

What is being measured

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

  1. Phase 1b: Number of participants with Dose-limiting Toxicities (DLTs) in experimental arm of XS-03 in combination with FOLFOX or FOLFIRI and Bevacizumab

    Dose-limiting toxicities were defined as events related to XS-03 that were considered an adverse reaction or suspected adverse reaction during the first cycle of treatment

    Measured: up to day 28

  2. Phase 1b: Determine the Maximum Tolerated Dose (MTD) in experimental arm of XS-03 in combination with FOLFOX or FOLFIRI and Bevacizumab

    MTD is defined as at most 1 patient out of 6 experiencing DLT

    Measured: up to day 28

  3. Phase 2: Objective Response Rate (ORR) of two experimental arms and comparator arm

    Defined as the percentage of participants that achieve a best overall response of complete response (CR) or partial response (PR) (per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria)

    Measured: up to 18 months after first dose of last patient

Secondary outcomes (15)
  1. Phase 1b: Objective Response Rate (ORR) of all treated participants

    Measured: up to 18 months after first dose of last patient

  2. Duration of response (DOR) of all treated participants

    Duration of response defined as time from when response was first documented until first documented disease progression or death, whichever occurs first.

    Measured: up to 18 months after first dose of last patient

  3. Progression-free survival (PFS) of treated participants

    as determined based on RECIST version 1.1 criteria

    Measured: up to 18 months after first dose of last patient

  4. Overall survival (OS) of treated participants

    Time in months from date of first dose for phase 1b and randomization for phase 2 to death due to any cause

    Measured: up to 18 months after first dose of last patient

  5. Number of Participants With Adverse Events (AEs) of treated participants

    The severity of each AE will be graded using the Common Terminology Criteria for Adverse Events (CTCAE).

    Measured: up to 28 days after last dose of study drug

  6. Number of Participants With Clinically Significant Change From Baseline in safety monitoring

    Measured: up to 28 days after last dose of study drug

  7. Number of Participants With dose adjustment

    AE associated with dose reduction, interruption and discontinuation

    Measured: up to 28 days after last dose of study drug

  8. Time to Reach Maximum Peak Plasma Concentration (Tmax)

    Pharmacokinetic parameter

    Measured: From pre-dose on day 1 of cycle 1 to day 5 of cycle 3 (28-day cycle length)

  9. Maximum Plasma Concentration(Cmax)

    Pharmacokinetic parameter

    Measured: From pre-dose on day 1 of cycle 1 to day 5 of cycle 3 (28-day cycle length)

  10. Area under the plasma concentration versus time curve from time zero to the last measurable concentration(AUC0-t)

    Pharmacokinetic parameter

    Measured: From pre-dose on day 1 of cycle 1 to day 5 of cycle 3 (28-day cycle length)

  11. Elimination Half-life (T1/2)

    Pharmacokinetic parameter

    Measured: From pre-dose on day 1 of cycle 1 to day 5 of cycle 3 (28-day cycle length)

  12. Systemic Clearance From Plasma Following Extravascular Administration (CL/F)

    Pharmacokinetic parameter

    Measured: From pre-dose on day 1 of cycle 1 to day 5 of cycle 3 (28-day cycle length)

  13. The volume of distribution(Vd/F)

    Pharmacokinetic parameter

    Measured: From pre-dose on day 1 of cycle 1 to day 5 of cycle 3 (28-day cycle length)

  14. Average concentration at steady state(Cavg,ss)

    Pharmacokinetic parameter

    Measured: From pre-dose on day 1 of cycle 1 to day 5 of cycle 3 (28-day cycle length)

  15. Minimum observed concentration at steady state(Cmin,ss)

    Pharmacokinetic parameter

    Measured: From pre-dose on day 1 of cycle 1 to day 5 of cycle 3 (28-day cycle length)

Timeline

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

  1. First posted20 Apr 2025
  2. Study start23 May 2025
  3. Primary completion30 Apr 2028 (estimated)
  4. Study completion30 Jul 2028 (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 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
102 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06936527
Sponsor's protocol ID
XS-03-II201
Acronym
XS-03-II201
Status last verified
Sep 2026
First submitted
2 Apr 2025
Last updated
25 Sep 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Drug: XS-03, Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI, Drug: XS-03 and Biological: Bevacizumab, Drug: FOLFOX, Drug: FOLFIRI in people with Colorectal Cancer and Metastatic Colorectal Cancer With RAS Mutation, run by Shanghai Fosun Pharmaceutical Industrial Development Co. Ltd. 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 11 inclusion and 21 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: enrolling by invitation, as of the sponsor's last update on 25 Sep 2026. 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 combined 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.

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?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase 1b: Number of participants with Dose-limiting Toxicities (DLTs) in experimental arm of XS-03 in combination with FOLFOX or FOLFIRI and Bevacizumab (time frame: up to day 28). The study lists 3 primary outcomes in all. 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 25 Sep 2026.

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