研究疾病:
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转移性结肠癌
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研究疾病代码:
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Target disease:
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Metastatic colon carcinoma
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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探索性研究/预试验
Pilot clinical trial
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研究目的:
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评价“和中方”联合化疗及靶向疗法治疗晚期结直肠癌的无进展生存期,评价“和中方”联合化疗及靶向疗法治疗晚期结直肠癌的总生存期、客观缓解率、化疗后恶心-呕吐-食欲减退复合症状群改善情况、恶液质情况、;评价“和中方”化疗及靶向疗法治疗晚期结直肠癌的不良事件发生率和严重不良事件发生率。
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Objectives of Study:
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To evaluate progression-free survival in combination with chemotherapy and targeted therapy for advanced colorectal cancer; To evaluate the chemotherapy-induced peripheral neurotoxicity, total survival time, objective remission rate, bad fluid quality, nausea, vomiting and anorexia after chemotherapy in combination with chemotherapy and targeted therapy for advanced colorectal cancer; and to evaluate the incidence of adverse events and serious adverse events in advanced colorectal cancer treated with "and Chinese side" chemotherapy and targeted therapy.
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药物成份或治疗方案详述:
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Description for medicine or protocol of treatment in detail:
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纳入标准:
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1.自愿签署知情同意书;
2.经组织学确认的结肠或直肠腺癌,参考NCCN结肠癌临床实践指南2019.1版,评价为ⅢB-Ⅳ期的不能手术治疗的局部晚期、复发性或转移性受试者;
3.距离首次研究用药28天内,经影像学证实,存在RECIST 1.1标准定义的可测量病灶;
4.受试者在过去4周内未接受任何系统的抗肿瘤治疗,如化疗、放疗、免疫治疗、生物或激素治疗,且未接受任何VEGFR抑制剂治疗;
5.随机分配后4周内无手术或大活检;
6.年龄≥18岁且≤75岁,体重≥40Kg,性别不限;
7.受试者无心、肝、肾和造血系统功能障碍;定义如下:绝对中性粒细胞计数(ANC)>1.5×10^9/L,;血小板>100×10^9/L;血红蛋白≥90g/L;总胆红素≤1.5×正常上限(ULN);AST(SGOT)或ALT(SGPT)≤2.5×正常上限,如果明确归因于肝转移,则<5倍正常上限;UPCR<1.0;
8.身体状况评分ECOG评分≤2分,KPS≥50分;
9.预计生存期≥12周;
10.女性必须满足以下条件之一:
①已行手术绝育;
②已绝经者,停经至少1年以上;
③具有生育能力,需满足下列条件:
入组本试验前血清/尿妊娠检查结果阴性;整个研究期间至末次用药后6个月,同意采取一种被认可的方法避孕。
男性必须满足以下条件之一:
①已行手术绝育;
②须在整个研究期间至末次用药后6个月采用一种被认可的避孕方法。
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Inclusion criteria
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1. Sign the informed consent form voluntarily;
2. For colon or rectal adenocarcinoma confirmed by histology, refer to the 2019.1 edition of NCCN Colon Cancer Clinical Practice Guidelines, and evaluate as inoperable locally advanced, recurrent or metastatic subjects of stage IIIB-IV;
3. Within 28 days of the first study medication, it is confirmed by imaging that there are measurable lesions defined by the RECIST 1.1 standard;
4. The subject has not received any systemic anti-tumor therapy, such as chemotherapy, radiotherapy, immunotherapy, biological or hormone therapy, and has not received any VEGFR inhibitor treatment in the past 4 weeks;
5. No surgery or major biopsy within 4 weeks after random assignment;
6. Aged >= 18 years old and <= 75 years old, weight >= 40Kg, no gender limit;
7. Subjects have no heart, liver, kidney and hematopoietic system dysfunction; the definition is as follows: absolute neutrophil count (ANC) > 1.5 x 10^9/L; platelets > 100 x 10^9/L; hemoglobin >= 90g/L; Total bilirubin <= 1.5 x upper limit of normal (ULN); AST(SGOT) or ALT(SGPT) <= 2.5 x upper limit of normal, if it is clearly attributed to liver metastasis, < 5 times the upper limit of normal; UPCR < 1.0;
8. Physical condition score ECOG score <= 2 points, KPS >= 50 points;
9. Estimated survival time >= 12 weeks;
10. Women must meet one of the following conditions:
(1) Surgical sterilization has been performed;
(2) Patients who have been menopausal, menopause for at least 1 year
(3) With fertility, the following conditions must be met:
Serum/urinary pregnancy test results were negative before enrollment; during the entire study period to 6 months after the last medication, they agreed to adopt an approved method of contraception.
Males must meet one of the following conditions:
(1) Surgical sterilization has been performed;
(2) A recognized method of contraception must be used during the entire study period to 6 months after the last medication.
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排除标准:
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1.组织学证实以鳞状细胞为主要成分的混合性腺鳞癌(鳞癌细胞占比≥10%);
2.5年内出现过或当前同时患有其它恶性肿瘤,治愈的子宫颈原位癌、非黑色素瘤的皮肤癌和表浅的膀胱肿瘤除外;
3.筛选期证实HCV阳性、HIV阳性、梅毒检测阳性、或HBsAg阳性且外周血乙肝病毒脱氧核糖核酸(HBV DNA)滴度检测≥103copies/mL或≥2000IU/mL的受试者;
4.既往有高血压危象、高血压脑病病史,或未控制的高血压(服用降压药后,收缩压>150mmHg,或舒张压>100mmHg);
5.具有临床意义的心血管疾病,包括但不限于短暂性脑缺血发作(筛选前6个月内)、心肌梗死(筛选前6个月内)、不稳定型心绞痛、纽约心脏病协会分类≥Ⅱ级充血性心力衰竭、药物无法控制的严重心律失常;
6.已知对研究药物过敏者;
7.距离首次研究用药前2周内对胸部以外的骨病灶进行过姑息性放疗;
8.有已知中枢神经系统转移和/或脊髓压迫、癌性脑膜炎、软脑膜疾病的受试者;
9.在过去4周或正在参与其他临床试验中;
10.预期生存期<12周者;
11.患有不易控制的精神病史者;
12.未从先前的抗癌疗法(NCICTCAE1级,包括奥沙利铂引起的脱发和神经毒性≤2级)的毒性中恢复,未从先前的手术中完全恢复,或先前的抗癌疗法或手术的时间少于4周;
13.临床未控制的活动性感染,如急性肺炎等;
14.吞咽困难、非化疗相关性呕吐或药物吸收不良;
15.凝血功能障碍,出血倾向或接受抗凝治疗明显的出血史;
16.首次治疗前12个月内发生动脉/静脉血栓栓塞事件,如脑血管意外(包括短暂性脑缺血发作)等;
17.骨折或伤口长期未治愈。
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Exclusion criteria:
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1.Histologically confirmed mixed adenosquamous carcinoma with squamous cells as the main component (squamous cell carcinoma accounted for >= 10%);
2.Other malignant tumors that have occurred or are currently suffering from within 5 years, except for cured cervical carcinoma in situ, non-melanoma skin cancer and superficial bladder tumors.
3.Subjects who confirmed HCV-positive, HIV-positive, syphilis test-positive, or HBsAg-positive and peripheral blood hepatitis B virus deoxyribonucleic acid (HBV DNA) titer test >= 10^3 copies/mL or >= 2000IU/mL during the screening period;
4.Past hypertensive crisis, history of hypertensive encephalopathy, or uncontrolled hypertension (after taking antihypertensive drugs, systolic blood pressure > 150mmHg, or diastolic blood pressure > 100mmHg);
5.Cardiovascular diseases of clinical significance, including but not limited to transient ischemic attack (within 6 months before screening), myocardial infarction (within 6 months before screening), unstable angina, and New York Heart Association classification >= Grade II congestive heart failure, severe arrhythmia that cannot be controlled by drugs;
6.Those who are known to be allergic to the study drug;
7.Palliative radiotherapy was performed on bone lesions other than the chest within 2 weeks before the first study medication;
8.Subjects with known central nervous system metastasis and/or spinal cord compression, cancerous meningitis, or leptomeningeal disease;
9.In the past 4 weeks or are participating in other clinical trials;
10.The expected survival period is less than 12 weeks;
11.People with a history of mental illness that is difficult to control;
12.Did not recover from the toxicity of previous anti-cancer therapy (NCICTCAE level 1, including oxaliplatin-induced alopecia and neurotoxicity <= level 2), did not fully recover from previous surgery, or previous anti-cancer therapy or surgery Less than 4 weeks;
13.Active infections that are not clinically controlled, such as acute pneumonia;
14.Dysphagia, non-chemotherapy-related vomiting or drug malabsorption;
15.Coagulation dysfunction, bleeding tendency or obvious bleeding history after receiving anticoagulant therapy;
16.Arterial/venous thromboembolic events such as cerebrovascular accidents (including transient ischemic attacks) occurred within 12 months before the first treatment.
17. The fracture or wound has not been cured for a long time.
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研究实施时间:
Study execute time:
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从From
2020-12-17
至To
2023-11-30
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征募观察对象时间:
Recruiting time:
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从From
2021-01-04
至To
2022-11-01
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