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Rectal AdenocarcinomaPhase 3CRITⅡNCT07549399

SCRT + Chemo Targeted Immuno-neoadjuvant Therapy for High-risk pMMR/MSS RC

A Phase 3 study testing Short-Course Radiotherapy, PD-1 monoclonal antibody and mFOLFOX6 regimen in people with Rectal Adenocarcinoma and High-Risk Cancer, run by Sixth Affiliated Hospital, Sun Yat-sen University at 1 site 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

To explore the efficacy and safety of an intensified treatment regimen consisting of short-course radiotherapy followed by mFOLFOX6 chemotherapy combined with precise targeted therapy (based on RAS/BRAF status: cetuximab for wild-type, bevacizumab for mutant) and a PD-1 monoclonal antibody, compared with short-course… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Rectal Adenocarcinoma, High-Risk Cancer, MSS
What is being tested?
Short-Course Radiotherapy, PD-1 monoclonal antibody and mFOLFOX6 regimen
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
204 participants
Where
1 siteChina
Study dates
20 May 2026to 30 Apr 2029
Phase
Phase 3
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

  • Before conducting procedures related to the research protocol but not part of routine care, written informed consent, voluntarily signed and dated by the subject, must be obtained in accordance with regulations and institutional guidelines.
  • Age 18-75 years.
  • Histologically or cytologically confirmed pMMR/MSS rectal adenocarcinoma; all other histological types are excluded.
  • Distance from the lower margin of the rectal tumor to the anal verge ≤10 cm.
  • Clinical staging with high-risk factors, including cT3Nx, EMVI(+), or cT4, ±MRF(+), ±EMVI(+).
  • No evidence of distant metastasis before treatment.
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  • No prior anti-cancer treatment (radiotherapy, chemotherapy, targeted therapy, or immunotherapy).
  • ECOG performance status of 0-1.
  • Peripheral blood counts and liver and kidney function within the following allowable ranges (tested within 15 days before the start of treatment):
  • White blood cells (WBC) ≥3.0×10^9/L or absolute neutrophil count (ANC) ≥1.5×10^9/L;
  • Hemoglobin (HGB) ≥80 g/L; ③Platelets (PLT) ≥100×10^9/L; ④Liver transaminases (AST/ALT) <3.0 times the upper limit of the normal range; ⑤Total bilirubin (TBIL) <1.5 times the upper limit of the normal range; ⑥Creatinine (CREAT) <1.5 times the upper limit of the normal range.
  • No history of other malignancies; not pregnant or breastfeeding, and effective contraception must be used during the study period and for 6 months after the last dose.

Who cannot join

  • Patients with a history of severe drug allergies (including allergies to platinum agents, 5-FU, LV, and 5-HT3 receptor antagonists);
  • Patients who have participated in or are currently participating in other clinical trials within 4 weeks prior to enrollment;
  • A history of having received anti-PD-1, PD-L1, PD-L2, CTLA-4, or any other specific T-cell costimulatory or checkpoint pathway-targeted therapy;
  • Severe electrolyte abnormalities;
  • Presence of gastrointestinal diseases, such as active ulcers in the stomach or duodenum, ulcerative colitis, or tumors with active bleeding that have not been resected; or other conditions that may lead to gastrointestinal bleeding or perforation; or gastrointestinal perforation that has not healed after surgical treatment;
  • History of arterial thrombosis or deep vein thrombosis within 6 months; history of bleeding or evidence of bleeding tendency within 2 months; or patients receiving high-dose anticoagulation therapy;
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  • Pregnant or breastfeeding women, or women of childbearing potential with a positive pregnancy test before the first dose; or female participants and their partners who are unwilling to strictly practice contraception during the study period;
  • Presence of other active malignancies (except for malignancies that have been treated with curative intent and have been disease-free for more than 3 years, or in situ cancers that can be cured with adequate treatment);
  • Presence of severe ECG abnormalities or active coronary artery disease, severe/unstable angina, newly diagnosed angina or myocardial infarction within 12 months prior to study entry, or New York Heart Association (NYHA) Class II or higher congestive heart failure;
  • Patients with active infections (infections causing fever above 38°C);
  • Patients with uncontrolled hypercalcemia, hypertension, or diabetes;
  • Patients with severe pulmonary diseases (interstitial pneumonia, pulmonary fibrosis, severe emphysema, etc.);
  • Patients with psychiatric disorders that may affect clinical treatment or a history of central nervous system diseases;
  • Patients with severe complications (bowel obstruction, renal insufficiency, hepatic insufficiency, cerebrovascular disorders, etc.);
  • Presence of any CTCAE Grade 2 or higher toxicity caused by previous treatments that has not resolved (excluding anemia, alopecia, and skin pigmentation);
  • Any unstable medical condition that may affect patient safety and compliance with the study;
  • Patients deemed by the investigator as unsuitable for participation in this clinical trial.

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, 1 recruiting
  • Sixth Affiliated Hospital, Sun Yat-sen University

    Guangzhou, Guangdong, 510065

    Jun Hu, +86-020-38379764, zslyllb@mail.sysu.edu.cn

    Recruiting

Other trials in China

About this study

Official title: Short-Course Radiotherapy Combined With mFOLFOX6, PD-1 Antibody and Cetuximab (for RAS/BRAF Wild-Type)/Bevacizumab (for RAS/BRAF Mutant) in High-Risk pMMR/MSS Rectal Adenocarcinoma: a Phase III Randomized Controlled Trial

To explore the efficacy and safety of an intensified treatment regimen consisting of short-course radiotherapy followed by mFOLFOX6 chemotherapy combined with precise targeted therapy (based on RAS/BRAF status: cetuximab for wild-type, bevacizumab for mutant) and a PD-1 monoclonal antibody, compared with short-course radiotherapy followed by mFOLFOX6 chemotherapy alone, in high-risk locally advanced pMMR/MSS rectal adenocarcinoma through a prospective, randomized controlled phase III clinical study, providing high-level evidence-based medical evidence to establish a superior neoadjuvant treatment strategy for this population.

Read the detailed description

Patients with locally advanced rectal cancer (LARC) who have high-risk factors, such as low rectal cancer, clinical stage T4b, positive mesorectal fascia (MRF), and positive extramural vascular invasion (EMVI), are at extremely high risk of distant metastasis. For these LARC patients with high-risk factors, the pathological complete response (PCR) rate with neoadjuvant chemotherapy alone is relatively low, ranging from 4.3% to 13.3%. Therefore, the use of a more potent comprehensive neoadjuvant treatment regimen, including concurrent chemoradiotherapy combined with targeted therapy and immunotherapy, may offer greater benefits to these patients. For patients with high-risk LARC, this study aims to explore whether the combination of short-course radiotherapy, mFOLFOX6, PD-1 monoclonal antibody and cetuximab (for RAS/BRAF Wild-Type)/bevacizumab (for RAS/BRAF Mutant) can improve the pathological responce rate, and achieve better long-term survival benefits. The study will investigate the efficacy and safety of short-course radiotherapy, mFOLFOX6, PD-1 monoclonal antibody and cetuximab (for RAS/BRAF Wild-Type)/bevacizumab (for RAS/BRAF Mutant) for high-risk LARC.

Based on the above theoretical and clinical needs, we conducted a preliminary phase II exploratory study (the CRIT study). This study preliminarily validated the safety and excellent preliminary efficacy of the strategy of "short-course radiotherapy (SCRT) followed by mFOLFOX6 chemotherapy combined with RAS-guided targeted therapy and a PD-1 monoclonal antibody," achieving a pathological complete response (pCR) rate of 62.1% (66.7% in the RAS/BRAF wild-type subgroup and 57.1% in the RAS/BRAF mutant subgroup), which is much higher than historical controls, suggesting that this regimen has great clinical application value. Therefore, a phase III randomized controlled trial is being conducted.

Enrolled patients will be randomized into 2 groups with different treatment regimen. The control group will receive neoadjuvant treatment phase includes short-course radiotherapy (SCRT) combined with four cycles of the mFOLFOX6 regimen. The experimental group will receive neoadjuvant treatment phase includes short-course radiotherapy (SCRT) combined with four cycles of the mFOLFOX6 regimen, PD-1 monoclonal antibody, and molecularly targeted drugs (selected based on RAS status; patients with RAS/BRAF wild-type receive cetuximab, while those with RAS/BRAF mutations receive bevacizumab). After completing the first cycle of mFOLFOX6 chemotherapy (combined with targeted and immune therapy in the experimental group), patients undergo SCRT at a dose of 5Gy × 5 fractions. At least 7 days after the completion of radiotherapy, patients continue with three additional cycles of mFOLFOX6 chemotherapy (combined with PD-1 monoclonal antibody and targeted drugs in the experimental group). Bevacizumab is not used in the last cycle with RAS/BRAF mutations. Surgery is performed 8-10 weeks after the completion of SCRT. If pelvic MRI indicates clinical complete response (CCR) and N0, or T1N0M0, local excision (LE) will be performed. Otherwise, total mesorectal excision (TME) will be performed. The decision regarding adjuvant chemotherapy after surgery will be made by the attending physician.

Being tested
Short-Course Radiotherapy, PD-1 monoclonal antibody, mFOLFOX6 regimen, Cetuximab, Bevacizumab
Keywords
Short-Course Radiotherapy, Targeting Therapy, Immunotherapy
Medical subject headings
Rectal Neoplasms

What participants receive

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

  • Short-Course RadiotherapyRadiation

    Also called SCRT

    Patients undergo SCRT at a dose of 5Gy × 5 fractions

  • PD-1 monoclonal antibodyDrug

    Also called PD-1

    Patients complete immune therapy with PD-1 monoclonal antibody for 4 cycles.

  • mFOLFOX6 regimenDrug

    Also called mFOLFOX6

    Patients complete chemotherapy with mFOLFOX6 regimen for 4 cycles.

  • CetuximabDrug

    Also called Cetuximab Antibody

    Patients with RAS/BRAF wild-type receive targeting therapy with Cetuximab for 4 cycles.

  • BevacizumabDrug

    Also called Bevacizumab Antibody

    Patients with RAS/BRAF mutations receive targeting therapy with Bevacizumab for 3 cycles. (Bevacizumab is not used in the last cycle of the bevacizumab group)

  • Surgical resectionProcedure or surgery

    Also called Surgery

    Surgery either local excition or total mesorectal excision is performed 8-10 weeks after the completion of short-course radiotherapy.

Study groups in NCT07549399
Study groupRoleWhat they receive
SCRT + mFOLFOX6 + PD-1 Antibody + Targeted TherapyExperimentalThe neoadjuvant treatment phase includes short-course radiotherapy (SCRT) combined with four cycles of the mFOLFOX6 regimen, PD-1 monoclonal antibody, and molecularly targeted drugs (selected based on RAS status; patients with RAS/BRAF wild-type receive cetuximab, while those with RAS/BRAF mutations receive bevacizumab). After completing the first cycle of mFOLFOX6 chemotherapy combined with targeted and immune therapy, patients undergo SCRT at a dose of 5Gy × 5 fractions. At least 7 days after the completion of radiotherapy, patients continue with three additional cycles of mFOLFOX6 chemotherapy combined with PD-1 monoclonal antibody and targeted drugs (bevacizumab is not used in the last cycle of the bevacizumab group). Surgery is performed 8-10 weeks after the completion of SCRT.
Receives: Radiation: Short-Course Radiotherapy; Drug: PD-1 monoclonal antibody; Drug: mFOLFOX6 regimen; Drug: Cetuximab; Drug: Bevacizumab; Procedure: Surgical resection
SCRT + mFOLFOX6Active comparatorThe neoadjuvant treatment phase includes short-course radiotherapy (SCRT) combined with four cycles of the mFOLFOX6 regimen. After completing the first cycle of mFOLFOX6 chemotherapy, patients undergo SCRT at a dose of 5Gy × 5 fractions. At least 7 days after the completion of radiotherapy, patients continue with three additional cycles of mFOLFOX6 chemotherapy. Surgery is performed 8-10 weeks after the completion of SCRT.
Receives: Radiation: Short-Course Radiotherapy; Drug: mFOLFOX6 regimen; Procedure: Surgical resection

What is being measured

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

  1. 3 years DFS Rate

    3 years Disease Free Survival Rate

    Measured: 3 years

Secondary outcomes (7)
  1. pCR rate

    pathological complete response rate

    Measured: 1 year

  2. 3 years OS rate

    3 years Overall Survival Rate

    Measured: 3 years

  3. 3 years DMFS Rate

    3 years Disease Metastasis Free Survival Rate

    Measured: 3 years

  4. 3 years RFS Rate

    3 years Recurrence Free Survival Rate

    Measured: 3 years

  5. R0 resection rate

    R0 resection rate in participants

    Measured: 1 year

  6. Toxicities Associated with Neoadjuvant Therapy

    incidence of adverse events related to neoadjuvant therapy as assessed by CTCAE v5.0

    Measured: 1 year

  7. CR rate

    Complete response rate in participants

    Measured: 1 year

Timeline

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

  1. First posted24 Apr 2026
  2. Study start20 May 2026
  3. Primary completion30 Apr 2029 (estimated)
  4. Study completion30 Apr 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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
204 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07549399
Sponsor's protocol ID
E2026073
Acronym
CRITⅡ
Status last verified
Jun 2026
First submitted
13 Apr 2026
Last updated
1 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Short-Course Radiotherapy, PD-1 monoclonal antibody and mFOLFOX6 regimen in people with Rectal Adenocarcinoma and High-Risk Cancer, run by Sixth Affiliated Hospital, Sun Yat-sen 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 12 inclusion and 17 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 1 Jul 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 phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 Jun Huang, PhD. (+8613926451242, huangj97@mail.sysu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

3 years DFS Rate (time frame: 3 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 1 Jul 2026; AzTrials last refreshed its copy on 4 Nov 2026.

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