中西医结合治疗难治性晚期结直肠癌的多中心临床研究

注册号:

Registration number:

ITMCTR2200006741

最近更新日期:

Date of Last Refreshed on:

2022-11-04

注册时间:

Date of Registration:

2022-11-04

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

中西医结合治疗难治性晚期结直肠癌的多中心临床研究

Public title:

Refractory advanced colorectal cancer in the treatment with integrated traditional Chinese and western medicine: a multi-center clinical study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

中西医结合治疗难治性晚期结直肠癌的多中心临床研究

Scientific title:

Refractory advanced colorectal cancer in the treatment with integrated traditional Chinese and western medicine: a multi-center clinical study

研究课题的正式科学名称简写:

Scientific title acronym:

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

ChiCTR2200065434 ; ChiMCTR2200006741

申请注册联系人:

徐汉辰

研究负责人:

季光

Applicant:

Xu Hanchen

Study leader:

Ji Guang

申请注册联系人电话:

Applicant telephone:

13564103399

研究负责人电话:

Study leader's telephone:

13564103399

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

hanson0702@126.com

研究负责人电子邮件:

Study leader's E-mail:

jiliver@vip.sina.com

申请单位网址(自愿提供):

Study leader's website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website
(voluntary supply):

申请注册联系人通讯地址:

上海市徐汇区宛平南路725号

研究负责人通讯地址:

上海市徐汇区宛平南路725号

Applicant address:

No.725 Wanping South Road, Xuhui District, Shanghai

Study leader's address:

No.725 Wanping South Road, Xuhui District, Shanghai

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

上海中医药大学附属龙华医院

Applicant's institution:

Longhua Hospital, Shanghai University of Traditional Chinese Medicine

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

2022LCSY082

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件

批准本研究的伦理委员会名称:

上海中医药大学附属龙华医院医学伦理委员会

Name of the ethic committee:

The Medical Ethics Committee, Longhua Hospital, Shanghai University of Traditional Chinese Medicine

伦理委员会批准日期:

Date of approved by ethic committee:

2022/9/29 0:00:00

伦理委员会联系人:

Contact Name of the ethic committee:

伦理委员会联系地址:

Contact Address of the ethic committee:

伦理委员会联系人电话:

Contact phone of the ethic committee:

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

上海中医药大学附属龙华医院

Primary sponsor:

Longhua Hospital, Shanghai University of Traditional Chinese Medicine

研究实施负责(组长)单位地址:

上海市徐汇区宛平南路725号

Primary sponsor's address:

No.725 Wanping South Road, Xuhui District, Shanghai

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海交通大学医学院附属瑞金医院

具体地址:

上海市黄浦区瑞金二路197号

Institution
hospital:

Ruijin Hospital, Shanghai Jiaotong University School Of Medicine

Address:

No.197 Ruijin 2nd Road, Huangpu District, Shanghai

国家:

中国

省(直辖市):

上海

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海中医药大学附属上海市中西医结合医院

具体地址:

上海市保定路230号

Institution
hospital:

Shanghai Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine

Address:

No.230 Baoding Road, Shanghai

国家:

中国

省(直辖市):

上海

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

复旦大学附属闵行医院

具体地址:

上海市闵行区万源路399号

Institution
hospital:

Minhang Hospital affiliated to Fudan University

Address:

No.399 Wanyuan Road, Minhang District, Shanghai

国家:

中国

省(直辖市):

上海

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海中医药大学附属岳阳中西医结合医院

具体地址:

上海市虹口区甘河路110号

Institution
hospital:

Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine

Address:

No.110 Ganhe Road, Hongkou District, Shanghai

经费或物资来源:

上海市科学技术委员会科研计划项目可行性方案 (22Y31920100)

Source(s) of funding:

Feasible programme for scientific research in Science and Technology Commission of Shanghai Municipality(22Y31920100)

研究疾病:

结直肠癌

研究疾病代码:

Target disease:

colorectal cancer

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

随机平行对照

randomized controlled trial(parallel group design)

研究所处阶段:

Study phase:

其它

Others

研究目的:

以四君子汤为基础方,以无进展生存期(PFS)为主要结局终点,评价中西医协同治疗晚期结直肠癌的有效性及安全性,以期获得高级别的循证医学证据,形成可推广的的规范化治疗方案。

Objectives of Study:

To explore the efficacy and safety of integrated traditional Chinese and western medicine in the treatment of advanced colorectal cancer with Sijunzi Decoction as the basic formula and progression-free survival (PFS) as the primary outcome. We hope to obtain high-level evidence-based medical evidence and form a popularized standardized treatment scheme in the treatment of advanced colorectal cancer.

药物成份或治疗方案详述:

Description for medicine or protocol of treatment in detail:

纳入标准:

1. IV期结直肠癌患者,且病理学明确诊断为腺癌; 2. 按RECIST 1.1标准,至少有一个明确的可测量肿瘤病灶; 3. 年龄≥18岁; 4. 分子病理学检测结果显示RAS(包括KRAS、NRAS和HRAS)突变型; 5. 器官功能水平必须符合下列要求:(a) 血常规:白细胞计数≥3×109/L,中性粒细胞计数≥1.5×109/L,血红蛋白≥90g/L,血小板计数≥75×109/L。(b) 肝功能:总胆红素≤1.5×ULN,ALT、AST≤2.5×ULN(肝转移者≤5×ULN)。(c) 肾功能:肌酐≤1.5×ULN,肌酐清除率>50 mL/min。(d) 凝血功能:凝血酶原时间≤1.5×ULN,活化部分凝血活酶时间≤1.5×ULN,国际标准化比值≤1.5×ULN。(e) 电解质:血镁、血钾≥LLN,允许在筛选期间纠正电解质; 6. 拟接受一线治疗或既往由于不耐受药物毒性或影像学证实疾病进展而退出一线治疗(不论采用何种分子靶向药物),或在末次辅助化疗结束后6个月内复发的患者; 7. 入组治疗前评估为脾虚证的患者; 8. 体力状况ECOG评分为0-1分; 9. 预计生存期≥3月; 10. 患者知情同意,并能够配合长期随访。

Inclusion criteria

1.Stage IV disease and histologically confirmed adenocarcinoma of the colon or rectum; 2.Measurable index lesion according to RECIST1.1 criteria; 3.Age ≥18 years old; 4.RAS mutation (including KRAS, NRAS and HRAS) 5.Organ function must meet the following requirements: (a) Blood routine: white blood cell count ≥3×109/L, neutrophil count ≥1.5×109/L, hemoglobin ≥90g/L, platelet count ≥ 75× 109/L. (b) Liver function: total bilirubin ≤1.5×ULN, ALT and AST≤2.5×ULN (liver metastasis ≤5×ULN). (c) Renal function: creatinine ≤1.5×ULN, creatinine clearance rate > 50 mL/min. (d) Coagulation function: prothrombin time ≤1.5×ULN, activated partial thromboplastin time ≤1.5×ULN, international standardized ratio ≤1.5×ULN. (e) Electrolyte: serum magnesium and serum potassium ≥LLN, allowing electrolyte correction during screening; 6.Patients who intend to receive first-line treatment or withdrawal from first-line chemotherapy (regardless of containing molecular-targeted drugs) for metastatic colorectal cancer due to intolerable toxicity or progressive disease, or relapse within 180 days after the last dose of adjuvant chemotherapy; 7.Patients who are assessed as spleen deficiency syndrome; 8.Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; 9.Estimated life expectancy >3 months; 10. Patients have informed consent and can cooperate with long-term follow-up.

排除标准:

1.除腺癌之外的其它结直肠癌组织学类型; 2.分子病理学检测结果显示 RAS(包括KRAS、HRAS和NRAS)野生型; 3.研究开始前存在肠梗阻(通过造瘘或置入支架解除梗阻的患者除外)、活动性炎性肠病(目前需医疗干预或有症状的患者); 4.孕妇、哺乳期妇女以及在研究期间不愿采取避孕措施而有生育能力的患者; 5.存在精神异常无法配合治疗和随访的患者; 6.研究开始治疗前6个月内,出现活动性心血管疾病,如脑血管意外、心肌梗死及不稳定心绞痛、纽约心脏协会(NYHA)II级及以上的充血性心力衰竭、需要药物治疗的严重心律失常; 7.无法控制的高血压; 8.长期服用大剂量阿司匹林(>325 mg/d); 9.有出血倾向或严重的凝血功能障碍; 10.不能口服药物、上胃肠道缺乏物理完整性、吸收不良综合征等其他被治疗医生认为可能干扰胃肠运动或吸收的疾病; 11.存在严重的蛋白尿(肾病综合征); 12.活动性肺结核(结核杆菌)感染病史或需接受全身治疗的活动性或慢性感染; 13.合并严重、不可愈合的伤口、溃疡或骨折; 14.合并脑转移或出现脊髓压迫或原发性脑肿瘤; 15.合并中枢神经系统疾病病史(如癫痫或中风)且标准药物治疗无法良好控制病情; 16.在研究治疗开始前28天内进行重大手术、开放性活检或经历重大创伤的患者; 17.研究开始前5年内诊断出其他恶性肿瘤疾病(已充分治疗的皮肤基底细胞癌或宫颈原位癌除外); 18.正在接受其他临床试验者; 19.研究者认为不适合纳入的其他情况。

Exclusion criteria:

1.Other histological types of colorectal cancer except adenocarcinoma; 2.RAS wild type status (including KRAS, HRAS and NRAS); 3.Intestinal obstruction (except for patients who were relieved by fistulation or implantation stent) and active inflammatory bowel disease (patients who need medical intervention or have symptoms currently) before the study; 4.Pregnant or breast feeding women; man or woman of child-bearing potential not consenting to use adequate contraceptive methods or abstinence during the course of the study; 5.Patients with mental disorders who cannot cooperate with treatment and follow-up; 6.Clinically significant cardiovascular diseases, such as cerebrovascular accident, myocardial infarction and unstable angina pectoris, New York Heart Association (NYHA) grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication (within 6 months before the study); 7.Uncontrollable hypertension; 8.High-dose aspirin (> 325mg/d) in a long term; 9.Bleeding tendency or severe coagulation dysfunction; 10.Inability to take drugs orally, lack of physical integrity of the upper gastrointestinal tract, malabsorption syndrome and other diseases that the doctor thinks may interfere with gastrointestinal movement or absorption; 11.Severe proteinuria (nephrotic syndrome); 12.History of active tuberculosis (Bacillus tuberculosis [TB]) infection or active or chronic infection requiring systemic treatment; 13.Serious and unhealed wounds, ulcers or fractures; 14.Known history of brain metastasis, spinal cord compression or primary brain tumor; 15.History of central nervous system diseases (such as epilepsy or stroke) and the standard medication can't control the disease well; 16.Patients who have undergone major surgery, open biopsy or experienced serious trauma within 28 days before the study; 17.Other malignant tumor diseases were diagnosed within 5 years before the start of the study (except basal and squamous cell carcinoma or cervical cancer in situ which has been fully treated); 18.Those who are participating in other clinical trials; 19.Other situations that the researcher thinks are not suitable for inclusion.

研究实施时间:

Study execute time:

From 2022-11-07

To      2026-06-30

征募观察对象时间:

Recruiting time:

From 2022-11-14

To      2024-12-31

干预措施:

Interventions:

组别:

西医标准治疗组

样本量:

160

Group:

control group

Sample size:

干预措施:

安慰剂与标准西医化疗方案和抗血管内皮生长因子靶向治疗

干预措施代码:

Intervention:

placebo and standard chemotherapy and bevacizumab

Intervention code:

组别:

中西医协同治疗组

样本量:

160

Group:

experimental group

Sample size:

干预措施:

四君子汤颗粒剂协同标准西医化疗方案和抗血管内皮生长因子靶向治疗

干预措施代码:

Intervention:

Sijunzi decotion with standard chemotherapy and bevacizumab

Intervention code:

样本总量 Total sample size : 320

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

上海

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海中医药大学附属上海市中西医结合医院

单位级别:

三级甲等医院

Institution/hospital:

Shanghai Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine

Level of the institution:

Third-grade class-A hospital

国家:

中国

省(直辖市):

上海

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海交通大学医学院附属瑞金医院

单位级别:

三级甲等医院

Institution/hospital:

Ruijin Hospital, Shanghai Jiaotong University School Of Medicine

Level of the institution:

Third-grade class-A hospital

国家:

中国

省(直辖市):

上海

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

复旦大学附属闵行医院

单位级别:

三级甲等医院

Institution/hospital:

Minhang Hospital affiliated to Fudan University

Level of the institution:

Third-grade class-A hospital

国家:

中国

省(直辖市):

上海

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海中医药大学附属岳阳中西医结合医院

单位级别:

三级甲等医院

Institution/hospital:

Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine

Level of the institution:

Third-grade class-A hospital

国家:

中国

省(直辖市):

上海

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海中医药大学附属龙华医院

单位级别:

三级甲等医院

Institution/hospital:

Longhua Hospital, Shanghai University of Traditional Chinese Medicine

Level of the institution:

Third-grade class-A hospital

测量指标:

Outcomes:

指标中文名:

疾病控制时间

指标类型:

次要指标

Outcome:

duration of disease control

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肾功能

指标类型:

副作用指标

Outcome:

renal function

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

心电图

指标类型:

副作用指标

Outcome:

electrocardiogram

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

治疗相关不良事件发生率

指标类型:

次要指标

Outcome:

incidence of treatment-related adverse events

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

尿常规

指标类型:

副作用指标

Outcome:

routine urine test

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

脾虚证候评分

指标类型:

次要指标

Outcome:

score of spleen deficiency

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

无进展生存期

指标类型:

主要指标

Outcome:

progression free survival

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

化疗完成率

指标类型:

次要指标

Outcome:

chemotherapy completion rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血常规

指标类型:

副作用指标

Outcome:

routine blood test

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肝功能

指标类型:

副作用指标

Outcome:

liver function

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

粪便常规

指标类型:

副作用指标

Outcome:

routine feces test

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肿瘤病人生存质量量表评分

指标类型:

次要指标

Outcome:

quality of life of patients with colorectal cancer

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

整体生存期

指标类型:

次要指标

Outcome:

overall survival

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

粪便

组织:

Sample Name:

feces

Tissue:

人体标本去向

使用后销毁

说明

Fate of sample 

Destruction after use

Note:

标本中文名:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后销毁

说明

Fate of sample 

Destruction after use

Note:

征募研究对象情况:

尚未开始

Not yet recruiting

年龄范围:

最小 18
Min age years
最大
Max age years

Recruiting status:

Participant age:

性别:

Gender:

男女均可

Both

随机方法(请说明由何人用什么方法产生随机序列):

本研究根据患者接受一线或者二线西医标准化疗方案进行分层。采用分层区组随机化方法,选取合适的区组长度,根据给定随机种子数,借助SAS统计软件产生随机数,320例按1:1比例随机分为试验组与安慰剂组,于5个研究中心收集病例共计320例。

Randomization Procedure (please state who generates the random number sequence and by what method):

In this study, patients will be stratified according to the standard chemotherapy regimen of first-line or second-line. The stratified block randomization method will be adopted, and the appropriate block length will be selected. According to the given number of random seeds, the SAS statistical software will be

盲法:

Blinding:

是否共享原始数据:

IPD sharing:

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

No

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表和网络电子数据库

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form and electronic data capture

数据管理委员会:

Data Managemen Committee:

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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