Clinical trial NCT06881537: CapeOX Combined With Bevacizumab Plus Anti-PD1 Antibody as Neoadjuvant Therapy for Locally Recurrent Colorectal Cancer
Official title: CapeOX Combined With Bevacizumab Plus Anti-PD1 Antibody as Neoadjuvant Therapy for Locally Recurrent Colorectal Cancer
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE2
Conditions: Locally Recurrent Colorectal Cancer
Lead sponsor: Shanghai Changzheng Hospital
Sponsor class: OTHER
First posted: 2025-03-18
Enrollment: 15
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This prospective, single-arm study aims to investigate the efficacy and safety of CapeOX combined with Bevacizumab plus Anti-PD1 Antibody as neoadjuvant therapy for locally recurrent colorectal cancer


Eligibility criteria: Inclusion Criteria:

* Primary colorectal cancer underwent radical surgery, histologically confirmed as adenocarcinoma and achieved R0 resection, and postoperative adjuvant chemotherapy with Xelox or other first-line standard regimens.
* Based on the imaging and histological examination results, the patient was clinically assessed and diagnosed with locally recurrent colorectal adenocarcinoma.
* The patients did not receive any treatment, including chemotherapy, targeted therapy, immunotherapy, or radiotherapy, within the past month.
* Measurable disease according to the Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 criteria.
* Eastern Cooperative Oncology Group (ECOG) 0-1.
* Absence of distant metastasis confirmed by CT, MRI or PET/CT.
* Adequate hematologic and organ function, defined by protocol-specified laboratory test results, obtained within 7 days before first dose. Absolute neutrophil count ≥1500/mm3, platelet ≥100,000/mm3, Hb ≥10g/dl, serum creatinine ≤1.5 times ULN, creatinine clearance rate ≥50mL/min, ALT and AST ≤2.5 times ULN, INR or aPTT ≤1.5 times ULN (INR ≤2 times ULN and aPTT in normal range for patients who are on prophylactic anticoagulant therapy within 14 days before study treatment), total bilirubin level ≤2 times ULN (within 7 days before study treatment).
* Women of childbearing age should confirm that serum pregnancy test is negative and agree to use effective contraceptive methods during study treatment and the following 60 days.
* Life expectancy\> 3 months
* Signed and written informed consent

Exclusion Criteria:

* Previously received anti-PD1 or anti-PDL1 or anti-PDL2 or anti-CTLA4.
* Intestinal obstruction or uncontrollable active bleeding caused by the tumor requiring urgent treatment.
* Contraindications of Oxaliplatin, Capecitabine, Bevacizumab, and Tislelizumab.
* Hypersensitivity to other monoclonal antibodies.
* Any active, known or suspected autoimmune disease.
* Uncontrolled pleural effusion, pericardial effusion, or ascites to a moderate or greater extent.
* History of one of the following diseases: idiopathic pulmonary fibrosis, organized pneumonia (eg. bronchiolitis obliterans), drug-induced pneumonia, idiopathic pneumonia and interstitial pneumonia, or evidence of active pneumonia through enhanced chest CT screening.
* Major surgery within 4 weeks before enrollment and haven't fully recovered from the previous surgery.
* Active bleeding or abnormal coagulation (aPTT \>43s or INR \>1.5 times ULN), or having a tendency to bleed or receiving thrombolytic or anticoagulant therapy.
* Previously received allogeneic stem cell or parenchymal organ transplantation.
* Any significant clinical or laboratory abnormality that the investigator considers to influence the safety assessment, eg. uncontrolled active infection, uncontrolled diabetes, hypertension that cannot be reduced to normal range with monotherapy, grade II or above peripheral neuropathy, congestive heart failure, heart disease (class II or higher) as defined by the New York College of Cardiology, myocardial infarction within 3 months prior to enrollment, unstable arrhythmias, unstable angina pectinis, chronic kidney disease, abnormal thyroid function and previous or co-existing malignancies.
* History of uncorrected serum electrolyte disturbances such as potassium, calcium and magnesium.
* HIV infection.
* Active hepatitis B or hepatitis C.
* Pregnancy or lactation period, or unwilling to use contraception during the trial.
* With other malignancy within 5 year, except cervical carcinoma in situ, basal or squamous skin cancer, local prostatic carcinoma and ductal carcinoma in situ.
* Use corticosteroids (dose of prednisone or similar drugs\> 10mg/day) or other immunosuppressive agents within 14 days before enrollment.
* Patients with active tuberculosis (TB) who are receiving anti-TB treatment or have received anti-TB treatment within 1 year.
* Active infection, or treatment with oral or intravenous antibiotics within the first 2 weeks prior to neoadjuvant therapy, except prophylactic administration.
* Anti-infective vaccine (eg. influenza vaccine, varicella vaccine, etc.) injection within 4 weeks before neoadjuvant therapy.
* Previous participation in other clinical trials within 4 weeks before neoadjuvant therapy.
* Any other disease, metabolic disorder, abnormal physical examination or abnormal laboratory results that may constrain the use of trial drug, or affect the reliability of study results, or lead to high risk of treatment complications, or affect patient compliance.

Primary outcomes:
measure: Objective response rate
timeFrame: 15 weeks
measure: R0 resection rate
timeFrame: 15 weeks
measure: Pathological complete response rate
timeFrame: 15 weeks
measure: Tumor regression grade (TRG)
timeFrame: 15 weeks
measure: Incidence of Treatment-Related Adverse Events
timeFrame: Until 30 days after the last treatment
Secondary outcomes:
measure: Surgical complications
timeFrame: Until 90 days after surgery
measure: Quality of life score (QoL score)
timeFrame: Until 30 days after the last treatment
measure: Event free survival
timeFrame: Up to 3 years
measure: Disease-free survival
timeFrame: Up to 3 years
measure: One-year or two-year disease-free survival rate
timeFrame: Up to 2 years
measure: One-year or two-year overall survival rate
timeFrame: Up to 2 years
Other outcomes:
Locations:
city: Shanghai
country: China
facility: Shanghai Changzheng Hospital
Study officials:
References: