- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03921684
Trial of Nivolumab With FOLFOX After Chemoradiation in Rectal Cancer Patients
Phase II Trial to Evaluate the Addition of Nivolumab to Neoadjuvant Chemoradiation With FOLFOX for Locally Advanced Rectal Cancer
This is a phase II, prospective, open label, one-center study for evaluation of the addition of nivolumab to the chemotherapy phase of the neoadjuvant treatment for locally advanced rectal cancer patients. Subjects must have received no prior treatment for rectal cancer (chemotherapy, radiotherapy or surgery) and no prior treatment with checkpoint inhibitors.
Eligible subjects will receive chemoradiation for a period of 5 weeks, 6 cycles of chemo-immunotherapy (mFOLFOX6 + nivolumab) for a period of 12 weeks, once every 2 weeks, and will undergo surgery after 4 weeks.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
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-
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Petach Tikva, Israel
- Recruiting
- Rabin Medical Center, Beilinson Hospital
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Principal Investigator:
- Baruch Brenner, Prof
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Signed written IRB approved informed consent
- Age ≥ 18 years
- ECOG PS 0-1
- Subjects with histologically confirmed primary (non-recurrent) locally advanced rectal adenocarcinoma
- Stage T3-4 N0 or TX N+ according to baseline rectal EUS and PET-CT
- Patients who are planned for neoadjuvant chemoradiation and are surgical candidates
- No prior chemotherapy, radiotherapy or surgery for rectal cancer
- No prior radiotherapy to the pelvis, for any reason
- Presence of adequate contraception in fertile patients
- Women of childbearing potential must have a negative serum or urine pregnancy test within 24 hours prior to the start of study drug
- Women must not be breastfeeding
- Ability to swallow tablets
- No previous (within the last 5 years) or concurrent malignancies, with the exception of adequately treated cone-biopsied in situ carcinoma of the cervix or basal cell carcinoma of the skin
Exclusion Criteria:
- Active autoimmune disease. [Subjects with type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll]
- Prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways
- Known history of positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS)
- Pregnancy or breastfeeding
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Neoadjuvant Treatment
All subjects will receive chemoradiation followed by chemotherapy and nivolumab as neoadjuvant treatment
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Capecitabine 825 mg/m2 orally twice-daily, 5 days a week for a total of 28 days, given with radiation therapy
Other Names:
1.8 Gy/day, 5 days a week for a total of 28 days, given with Capecitabine
oxaliplatin 85 mg/m2, leucovorin 400 mg/m2 and fluorouracil 400 mg/m2 IV, fluorouracil 2400 mg/m2 IV (a 46 hrs CI), day 1 of each treatment cycle, every 2 weeks, given with nivolumab
Nivolumab 240mg IV, day 1 of each treatment cycle, every two weeks, given with mFOLFOX6
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
pathological complete response (pCR) rate
Time Frame: Time from start of neoadjuvant treatment until surgical resection, assessed up to 24 months
|
pCR is defined when no tumor is found on pathology review of the surgical specimen (TRG -0)
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Time from start of neoadjuvant treatment until surgical resection, assessed up to 24 months
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Incidence of Treatment-Emergent Adverse Events (Safety)
Time Frame: Time from screening until the end of study drug administration, assessed up to 24 months
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Treatment-emergent AEs will be graded according to NCI CTCAE v4.0, vital signs and clinical laboratory
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Time from screening until the end of study drug administration, assessed up to 24 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Disease Free Survival (DFS)
Time Frame: Time from the first day of treatment to the first event of: loco-regional failure, metastatic recurrence, the appearance of a secondary colorectal cancer or death from any cause, assessed up to 42 months
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DFS will be censored for patients who are alive and free of progression at the time of last follow-up.
DFS rate will be estimated using the Kaplan-Meier method
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Time from the first day of treatment to the first event of: loco-regional failure, metastatic recurrence, the appearance of a secondary colorectal cancer or death from any cause, assessed up to 42 months
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Overall Survival (OS)
Time Frame: The time interval between the first day of treatment and the date of death of any cause, assessed up to 66 months
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Patients who are still alive when last traced will be censored at the date of last follow-up.
OS rate will be estimated using the Kaplan-Meier method
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The time interval between the first day of treatment and the date of death of any cause, assessed up to 66 months
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Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms
- Neoplasms by Site
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Intestinal Diseases
- Intestinal Neoplasms
- Rectal Diseases
- Colorectal Neoplasms
- Rectal Neoplasms
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Immune Checkpoint Inhibitors
- Capecitabine
- Nivolumab
Other Study ID Numbers
- CA209-8M4
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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