Resectable Mucosal Melanoma
Conditions
Brief summary
The primary objective of this study is to evaluate the pathological response rate of neoadjuvant therapy with paclitaxel polymersomes for injection combined with carboplatin and adebrelimab in patients with resectable mucosal melanoma.Subjects will receive the combination therapy of paclitaxel polymersomes for injection, carboplatin and adebrelimab prior to surgery, with a treatment cycle of 3 weeks and a total of 3 cycles.After completing 3 cycles of treatment, subjects will undergo curative surgery. Pathologists will evaluate the surgically resected specimens to determine the status of pathological response, and immunohistochemical assays will be performed to assess the intensity of immune activation within the tumor microenvironment.
Interventions
DRUGPaclitaxel Polymersomes Combined with Carboplatin and Adebelimab
Chemotherapeutic agents are administered on Day 1 of each cycle: paclitaxel polymersomes for injection is given first, followed by carboplatin.Adebelimab injection is administered on Day 2 of each cycle.Patients will receive a maximum of 3 cycles of neoadjuvant chemotherapy combined with immunotherapy before surgery.Patients who are evaluated as resectable 3 weeks after the last cycle of chemotherapy will undergo radical surgery.
PROCEDURERadical Surgery
Chemotherapeutic agents are administered on Day 1 of each cycle: paclitaxel polymersomes for injection is given first, followed by carboplatin.Adebelimab injection is administered on Day 2 of each cycle.Patients will receive a maximum of 3 cycles of neoadjuvant chemotherapy combined with immunotherapy before surgery.Patients who are evaluated as resectable 3 weeks after the last cycle of chemotherapy will undergo radical surgery.
Sponsors
Sun Yat-sen University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age ≥ 18 years old. 2. Histopathologically confirmed resectable mucosal melanoma. 3. Subjects must provide 5 formalin-fixed paraffin-embedded (FFPE) tissue sections collected before treatment, or be willing to undergo needle biopsy for pathological tissue acquisition to facilitate pathological assessment. 4. ECOG (Performance Status, PS) score of 0-1. 5. No prior treatment with immune checkpoint inhibitors such as anti-CTLA-4, anti-PD-1, or anti-PD-L1 monoclonal antibodies. 6. No prior treatment with taxane-based drugs. 7. Presence of measurable lesions (per RECIST 1.1 criteria). 8. No history of immunosuppressant use within 6 months prior to enrollment. 9. Hematological and biochemical test results meeting the following criteria: i. Neutrophil count ≥ 1,500 × 10⁹/L; ii. Platelet count ≥ 100 × 10⁹/L; iii. Hemoglobin \> 9.0 g/dL; iv. Serum creatinine ≤ 1.5 × upper limit of normal (ULN) or creatinine clearance (CrCl) ≥ 40 mL/min; v. Aspartate aminotransferase (AST)/Alanine aminotransferase (ALT) ≤ 3 × ULN; vi. Total bilirubin ≤ 1.5 × ULN. 10. Women of childbearing potential must have a negative serum or urine pregnancy test and agree to use an appropriate contraceptive method (barrier contraception or oral contraceptives).
Exclusion criteria
1. Presence of distant metastatic lesions. 2. Active autoimmune disease. Note: Patients with vitiligo, type 1 diabetes mellitus, or Hashimoto's thyroiditis with hypothyroidism who only require hormone replacement therapy may be enrolled if there is no evidence of significant disease recurrence. 3. Need for systemic corticosteroid therapy (\> 10 mg prednisolone \[or equivalent\]/daily) or other immunosuppressant use within 14 days after enrollment. Note: Inhaled or topical corticosteroids, or adrenal hormone replacement therapy (\> 10 mg prednisolone \[or equivalent\]/daily) are acceptable for patients without obvious autoimmune diseases. 4. Concurrent diagnosis of other malignant tumors requiring anti-tumor treatment. Note: Patients may be considered for enrollment if the other malignant tumor has achieved complete remission for 2 years or more and no additional anti-tumor treatment is required during the study period. 5. Patients who are medically, psychologically, or physically unable to complete the study or understand the information provided in the patient brochure, as assessed by the investigator. 6. Prior treatment with anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4, or other drugs targeting T-cell costimulatory or immune regulatory pathways. 7. Prior chemotherapy with taxane-based drugs. 8. Positive HIV test result or confirmed diagnosis of acquired immunodeficiency syndrome (AIDS). 9. Known hypersensitivity to the study drugs. 10. Pregnant or lactating women.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pathologic response rate | 8 weeks | The proportion of patients with less than 50% residual tumor cells in the surgically resected pathological specimens, including those who achieved pathological complete response (pCR), major pathological response (MPCR) and partial pathological response (pPR). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| overall response rate | 8 weeks | The proportion of patients who achieve complete response (CR) or partial response (PR) evaluated according to the RECIST 1.1 criteria based on imaging examinations. |
| Surgical Resection Rate | 8 weeks | calculated as the number of patients who underwent scheduled surgical resection divided by the number of enrolled patients. |
| Acute and Chronic Toxicities and Adverse Reactions | 8 weeks | — |
| relapse-free survival | 8 weeks | — |
| Assessment of Immune Activation Intensity in the Tumor Microenvironment | 8 weeks | defined as the magnitude of changes in the proportions of CXCL13, CD4, CD8, CD19, and FOXP3-positive cells and the structural alterations of tertiary lymphoid organs (TLOs) in the tumor microenvironment before and after treatment. |
Countries
China
Contacts
Primary Contactxizhiwen wen
Outcome results
None listed