Clinical trial NCT07025239: QL1706 Injection Plus Bevacizumab and XELOX vs Placebo Plus Bevacizumab and XELOX as First-Line Treatment of Unresectable Metastatic Colorectal Cancer
Official title: A Randomized, Double-blind, Multicenter Phase 3 Study of QL1706 Injection in Combination With Bevacizumab and XELOX Versus Placebo in Combination With Bevacizumab and XELOX as First-line Therapy for the Treatment of Patients With Unresectable Metastatic Colorectal Cancer (mCRC)
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: PHASE3
Conditions: Metastatic Colorectal Cancer
Lead sponsor: Qilu Pharmaceutical Co., Ltd.
Sponsor class: INDUSTRY
First posted: 2025-06-17
Enrollment: 430
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to evaluate the efficacy and safety of QL1706 Injection in combination with bevacizumab and XELOX compared with placebo in combination with bevacizumab and XELOX for first-line treatment in patients with unresectable mCRC.


Eligibility criteria: Inclusion Criteria:

* Patients who voluntarily sign the informed consent form (ICF) and can understand and comply with the study requirements;
* Males and females aged 18 to 75 years old (including boundary value) on the date of signing ICF;
* Unresectable metastatic colorectal adenocarcinoma confirmed by histopathology examination;
* No previous systemic anti-tumor drug therapy for metastatic colorectal adenocarcinoma;
* At least one target lesion as judged by the investigator per RECIST v1.1 (lesions previously treated with topical treatment such as radiotherapy should not be considered as target lesions, unless it is confirmed that there has been definite progression of lesions located in the previous radiotherapy region);
* Be able to provide sufficient previously archived tumor tissue samples or agree to collect tumor tissue samples (≥ 5 unstained pathological tissue sections) by biopsy for biomarker testing. If sufficient tissue samples cannot be provided, it should be determined with the sponsor;
* ECOG PS score of 0 or 1 within 7 days before the first dose;
* Adequate liver, bone marrow, and renal organ function.

Exclusion Criteria:

* Patients had other active malignant tumors within 5 years prior to the first dose. Patients with localized tumors that have been cured, such as basal cell carcinoma of the skin, squamous cell carcinoma of skin, superficial bladder carcinoma, carcinoma in situ of prostate, cervical carcinoma in situ, and breast carcinoma in situ, can be enrolled.
* Previous treatment with radiotherapy at any site within 4 weeks prior to the first dose.
* Previous treatment with postoperative adjuvant therapy with targeted drugs targeting epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF) or its receptor (VEGFR), including but not limited to Bevacizumab, Cetuximab, Panitumumab, Aflibercept, Regorafenib or Anlotinib;
* Previous treatment with any T cell costimulation or immune checkpoint inhibitors, including but not limited to anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4, anti-OX-40 or anti-CD137 monoclonal antibodies;
* Participation in a clinical study and treatment with study drug or device within 4 weeks prior to the first dose, or traditional Chinese medicine treatment \< 2 weeks from the first dose;
* Patients who have a history of severe (≥ Grade 3) gastrointestinal ulcers, gastrointestinal perforation, fistula formation, intra-abdominal inflammation/abscess, intra-abdominal pneumatosis not due to puncture or surgery, macroscopic digestive tract hemorrhage/melena (excluding hemorrhoidal hemorrhage), and hemoptysis (about 3 mL or more) within 6 months prior to the first dose;
* Uncontrollable pleural effusion, pericardial effusion or ascites requiring drainage;
* Presence of dysphagia and unable to swallow the investigational product;

Primary outcomes:
measure: Progression Free Survival (PFS) Assessed by the Independent Radiology Review Committee (IRRC)
timeFrame: Up to approximately 2 years
Secondary outcomes:
measure: Overall Survival (OS)
timeFrame: Approximately 66 months
measure: Progression Free Survival (PFS) Assessed by Investigator
timeFrame: Up to approximately 2 years
measure: Objective Response Rate (ORR)
timeFrame: Approximately 36 months
measure: Duration Of Response (DOR)
timeFrame: Approximately 36 months
measure: Incidence of AEs, SAEs and treatment-emergent adverse events (TEAEs).
timeFrame: From the subject signs the ICF to 30 days after the last dose of study drug is administered
Other outcomes:
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Study officials:
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