Clinical Study of Short-course Radiotherapy Followed by Fruquintinib Plus Sintilimab vs Bevacizumab Plus Capecitabine as First Line Treatment in Advanced mCRC

NCT ID: NCT06195670

Last Updated: 2024-01-08

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 220 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-01-31
• Study Completion Date: 2027-01-31

Brief Summary

The aim of this study is to evaluate the efficacy and safety of short course radiotherapy followed by fruquintinib combined with Sintilimab as the first-line treatment of advanced mCRC compared to bevacizumab combined with capecitabine in patients unfit for intensive therapy.

Detailed Description

Anti-angiogenic therapy combined with immune checkpoint inhibitors in advanced mCRC has shown promising efficacy with acceptable toxicities. Radiotherapy may reshape the tumor immune microenvironment, thereby improving the efficacy of subsequent anti angiogenic drugs combined with immunotherapy.

The study is a prospective, multi-centered, two-stage clinical study with 220 unresectable advanced mCRC patients unfit for oxaliplatin or irinotecan-based intensive chemotherapy enrolled. In phase 1b, 20 patients will be recruited and the efficacy and safety of SCRT followed by fruquintinib plus sintilimab will be explored. In phase 2, 200 patients will be randomized and the efficacy and safety will be compared between SCRT followed by fruquintinib plus sintilimab and capecitabine plus bevacizumab.

Conditions

CRC; Metastatic Colorectal Cancer; Metastatic Colorectal Adenocarcinoma

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

SCRT + fruquintinib + sintilimab

Group Type: EXPERIMENTAL

Experimental

Intervention Type: DRUG

SCRT: 5\*5Gy for 5 days, after a one-week rest, with fruquintinib plus sintilimab followed; Fruquintinib: qd po, 4mg/d, 2weeks on/1 week off, q3w; Sintilimab: intravenous infusion, 200mg, on day 1, q3w.

Bevacizumab + Capecitabine

Group Type: ACTIVE_COMPARATOR

Active Comparator

Intervention Type: DRUG

Capecitabine: bid po, 1000mg/m², on days 1-14, q3w; Bevacizumab: intravenous infusion, 7.5mg/kg, on day 1, q3w.

Interventions

Experimental

SCRT: 5\*5Gy for 5 days, after a one-week rest, with fruquintinib plus sintilimab followed; Fruquintinib: qd po, 4mg/d, 2weeks on/1 week off, q3w; Sintilimab: intravenous infusion, 200mg, on day 1, q3w.

Intervention Type: DRUG

Active Comparator

Capecitabine: bid po, 1000mg/m², on days 1-14, q3w; Bevacizumab: intravenous infusion, 7.5mg/kg, on day 1, q3w.

Intervention Type: DRUG

Other Intervention Names

SCRT + fruquintinib + sintilimab; Bevacizumab + Capecitabine

Eligibility Criteria

Inclusion Criteria

• Have signed an informed consent;
• 18 to 85 years old (including 18 and 85 years old);
• Histopathologically confirmed unresectable advanced metastatic colorectal adenocarcinoma;
• Have not received anti-tumor treatment for metastatic disease;
• Inability to tolerate intensive treatment regimens based on oxaliplatin or irinotecan as determined by researchers;
• At least one measurable lesion;
• Expected life expectancy ≥ 12 weeks;
• The function of important organs within the 14 days prior to enrollment meets the following requirements (no blood components or cell growth factors are allowed to be used within the 14 days prior to enrollment):
• Neutrophil absolute count ≥ 1.5 × 10^9/L;
• Platelets ≥ 80 × 10^9/L;
• Hemoglobin ≥ 8g/dL;
• Total bilirubin<1.5 times ULN;
• ALT and AST<2.5 times ULN (liver metastasis patients<5 times ULN);
• Serum creatinine ≤ 1.5 times ULN;
• Endogenous creatinine clearance rate>50ml/min;
• International standardized ratio (INR) of coagulation function ≤ 1.5 × ULN, prothrombin time (PT) and activated partial thromboplastin time (APTT) ≤ 1.5 × ULN
• Women of childbearing age or men whose partners have a desire to conceive should take effective contraceptive measures.

Exclusion Criteria

• Currently has a disease or condition that affects drug absorption, or the patient is unable to take oral drugs;
• Currently has digestive tract diseases such as active gastric and duodenal ulcers, ulcerative colitis, or active bleeding from unresectable tumors, or other conditions determined by the researcher that may cause gastrointestinal bleeding or perforation;
• History of serious cardiovascular and cerebrovascular diseases;
• Other malignant tumors within the past 5 years, excluding skin basal cell or squamous cell carcinoma after radical surgery, or cervical carcinoma in situ;
• Clinically uncontrolled active infection, such as acute pneumonia, active hepatitis B or hepatitis C (hepatitis B virus DNA ≥ 1 × 104 copies/mL or>2000 IU/ml);
• Currently has central nervous system (CNS) metastasis or has a history of unstable or clinically symptomatic brain metastasis;
• Pregnant (positive pregnancy test before medication) or breastfeeding women;
• Urine protein ≥ 2+, or 24-hour urine protein >1.0g;
• Histologically confirmed MSI-H/dMMR tumors;
• Patients deemed unsuitable by the researchers for inclusion in this study.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 85 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Zhejiang Cancer Hospital

OTHER

Sponsor Role: lead

Responsible Party

Ji Zhu

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Ji Zhu, M.D.

Role: PRINCIPAL_INVESTIGATOR

Zhejiang Cancer Hospital

Zhong Shi, M.D.

Role: PRINCIPAL_INVESTIGATOR

Zhejiang Cancer Hospital

Wangxia Lv, M.D.

Role: PRINCIPAL_INVESTIGATOR

Zhejiang Cancer Hospital

Locations

Ji Zhu

Hangzhou, Zhejiang, China

Countries

China

Central Contacts

Ji Zhu, M.D.

Role: CONTACT

leozhu@126.com

0571-88128142 ext +86

Other Identifiers

HMPL-013-FLAG-C124

Identifier Type: -

Identifier Source: org_study_id