Rectal Cancer, Radiotherapy, Immunotherapy, Chemotherapy
Conditions
Brief summary
This study is a prospective phase II clinical trial aimed at exploring the potential benefits of supplementing β-hydroxybutyrate with existing short course radiotherapy sequential immunotherapy and CAPEOX therapy.
Interventions
Eligible subjects will receive short-course radiotherapy (SCRT). One week after the end of treatment, subjects continued to receive neoadjuvant chemotherapy.
1000mg/m2, bid, po, d1-14,q3w
130mg/m2, ivgtt, d1,q3w
The surgery was performed 1 week after the end of neoadjuvant therapy.
Oral β-hydroxybutyrate supplement (5g/day, starting from the day of first radiotherapy, lasting for 2 weeks).
Sponsors
Study design
Eligibility
Inclusion criteria
1. Patients or their family members agree to participate in the study and sign the informed consent form; 2. Age 18-75 years, male or female; 3. Histologically confirmed Locally Advanced rectal adenocarcinoma; 4. inferior margin ≤ 10 cm from the anal verge; 5. ECOG performance status score is 0-1; 6. Untreated with anti-tumor therapy for rectal cancer, including radiotherapy, chemotherapy, surgery, etc; 7. There was no operative contraindication; 8. Laboratory tests were required to meet the following requirements: white blood cell (WBC) ≥ 4×109/L; Absolute neutrophil count (ANC) ≥ 1.5×109/L; Platelet count ≥ 100×109/L; Hemoglobin ≥90 g/L; Serum total bilirubin ≤ 1.5 × upper limit of normal (ULN); Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN; Serum creatinine ≤1.5 times the upper limit of normal value or creatinine clearance rate ≥50 mL/min; International normalized ratio (INR) ≤ 1.5 × ULN; Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN; 9. Urinary protein \< 2+ or 24-hour urinary protein excretion \< 1 g at baseline.
Exclusion criteria
1. Patients with non-pMMR LARC; 2. Subjects who have previously received any form of immunotherapy, including but not limited to immune checkpoint inhibitors, immune checkpoint agonists, immune cell therapy, or any other treatment targeting tumor immunomodulatory mechanisms; 3. Presence of any concurrent disease, condition (including laboratory abnormality), history of substance abuse, or current evidence thereof, which, in the judgment of the Investigator, may compromise subject safety, interfere with the process of obtaining informed consent, affect subject compliance, or confound the safety assessment of the investigational product(s).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| complete response (CR) rate | an expected average of 12 months | Defined as pathological complete response (pCR) + Clinical complete response (cCR) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 3-year disease-Free Survival | an expected average of 3 years | The time from the first day of disease free (operation date) to local or distant recurrence, or the death event caused by any reason, whichever occurs first |
| Overall Survival | an expected average of 5 years | The time from the date of randomization to the death caused by any cause |
| Adverse events (AEs) were graded according to the NCI CTCAE version 5·0 | an expected average of 1.5 years | Adverse events and surgical safety |
Countries
China