- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05965531
Treating Locally Advanced Rectal Cancer With TAS-102 Chemotherapy Plus Neoadjuvant Radiotherapy (TASLARC)
October 29, 2023 updated by: Hui Chang, Sun Yat-sen University
A Single-arm, Phase II Clinical Trial to Treat Locally Advanced, pMMR Rectal Cancer With Single-agent Trifluridine/Tipiracil Chemotherapy Plus Neoadjuvant Intensity-modulated Radiotherapy
The goal of this Phase 2 trial is to evaluate a neoadjuvant treatment mode for locally advanced rectal cancer (LARC), consisting of radiotherapy and concurrent Trifluridine/Tipiracil (TAS-102).
The main questions it aims to answer are: (i) whether TAS-102 is effective in treating LARC, when combined with radiotherapy; (ii) whether TAS-102 is safe in combination with radiotherapy.
Participants will receive one cycle of TAS-102 chemotherapy and neoadjuvant radiotherapy based on intensity-modulated technique.
Then the ones with a possibility of R0 resection will receive radical surgery followed by 6 cycles of adjuvant XELOX (capecitabine plus oxaliplatin) chemotherapy.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Detailed Description
The standard management recommended by the National Comprehensive Cancer Network for locally advanced rectal cancer (LARC) is neoadjuvant chemo-radiotherapy followed by surgery plus adjuvant chemotherapy or not.
Currently, the regimens of neoadjuvant chemotherapy are based on fluorouracil or capecitabine.
The therapeutic effects of these regimens are satisfactory, with a pathological complete response (pCR) and 3-year disease-free survival (DFS) rate of 14% and 68%.
Addition of oxaliplatin has been proven to further improve the pCR and DFS rates, by the CAO/ARO/AIO-04, FOWARC and ADORE trials.
However, the acute toxicities of fluorouracil and capecitabine remain as a concern.
It was reported that the incidence of the grade 3/4 symptomatic toxicities brought by these two agents was nearly 15%.
When combined with oxaliplatin, the incidence could rise to 25%.
A special toxicity, hand-foot syndrome, was seen in 43-71% of the patients receiving capecitabine.
It included blister, ulceration, numbness, pain and paresthesia, and seriously influenced the daily work and life of the patients.
Trifluridine/Tipiracil (TAS-102) is a new generation of cytotoxic agent whose therapeutic effects in metastatic colorectal cancer have been confirmed by a series of large-scale, multicenter, randomized controlled trials.
And the latest TASCO1 trial reported that TAS-102 exhibited a trend to improve overall survival, compared to capecitabine.
Moreover, it could be well tolerated, with an incidence of grade 3/4 symptomatic toxicities of merely 1.5%.
Until now, there was few study focusing on combination of TAS-102 and radiotherapy.
This phase 2 trial intended to evaluate the therapeutic and adverse effects of TAS-102 concurrently with neoadjuvant radiotherapy, in a small patient cohort with LARC.
The results might provide an effective and low-toxic choice which improves patients' experience of chemo-radiotherapy.
Study Type
Interventional
Enrollment (Estimated)
65
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Hui Chang, MD
- Phone Number: +86-020-87343374
- Email: changhui@sysucc.org.cn
Study Contact Backup
- Name: Qiao-xuan Wang, MD
- Phone Number: +86-020-87343374
- Email: wangqx@sysucc.org.cn
Study Locations
-
-
Guangdong
-
Guangzhou, Guangdong, China, 510060
- Cancer Center, Sun Yat-sen University
-
Contact:
- Hui Chang, MD
- Phone Number: +86-020-87343374
- Email: changhui@sysucc.org.cn
-
Contact:
- Qiao-xuan Wang, MD
- Email: wangqx@sysucc.org.cn
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Pathologically diagnosed rectal adenocarcinoma via biopsy
- Pretreatment clinical TNM stage as T3-4N0M0 or T1-4N1-2M0 (UICC TNM staging classification, version 8)
- Tumor with proficient DNA mismatch repair confirmed by immunohistochemical analysis
- Age between 18 and 70 years old
- Karnofsky performance score ≥ 70
- Distance from tumor lower margin to anal verge < 12 cm
Exclusion Criteria:
- Inguinal lymph node metastasis
- Multiple primary colorectal cancer
- Complete obstruction or perforation
- Uncontrolled tuberculosis, AIDS or mental diseases
- Severe cardiac, renal, hepatic or hematopoietic dysfunctions unsuitable for chemotherapy or radiotherapy
- Prior history of other malignancies with 5 years, except cured cervical carcinoma in situ and skin basal cell carcinoma
- Prior history of rectal surgery, pelvic radiotherapy or chemotherapy
- Pregnant or lactating women
- Other situations for which the investigators consider a patient inappropriate to participate
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
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 |
---|---|
Experimental: Neoadjuvant chemo-radiotherapy with TAS-102
The patients in this group will all receive neoadjuvant treatment consisting of intensity-modulated radiotherapy and concurrent Trifluridine/Tipiracil (TAS-102).
Then the ones evaluated to have a possibility of R0 resection will receive radical surgery, followed by 6 cycles of adjuvant XELOX (capecitabine plus oxaliplatin) chemotherapy.
|
TAS-102 is given in a dose of 35 mg/m2, twice daily on the 1st to 5th and 8th to 12th days of the period of neoadjuvant radiotherapy.
Other Names:
intensity-modulated radiotherapy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Objective response rate
Time Frame: One week after surgery
|
The percentage of the patients complete R0 resection and attain a tumor regression grade of 1-4 (Mandard's 5-tier standard) in postsurgical pathologic examination
|
One week after surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pathological complete response rate
Time Frame: One week after surgery
|
The percentage of the patients complete R0 resection and attain a complete remission of both primary tumor and regional lymph nodes in postsurgical pathologic examination
|
One week after surgery
|
The incidence of grade 3/4 toxicities
Time Frame: Once a week during the period of neoadjuvant treatment
|
The percentage of the patients undergo any grade 3/4 toxicity during neoadjuvant treatment, based on the Common Terminology Criteria for Adverse Events
|
Once a week during the period of neoadjuvant treatment
|
The incidence of grade 3/4 complications
Time Frame: The period from the date of radical surgery to the 90th day after surgery
|
The percentage of the patients undergo any grade 3/4 surgery-related complication, based on the Clavien-Dindo classification.
|
The period from the date of radical surgery to the 90th day after surgery
|
Disease-free survival
Time Frame: When all the patients are followed-up for 1, 2 and 5 years
|
The percentage of the patients survive without local recurrence or distant metastasis after a time period, from pathological diagnosis
|
When all the patients are followed-up for 1, 2 and 5 years
|
Overall survival
Time Frame: When all the patients are followed-up for 1, 2 and 5 years
|
The percentage of the patients survive after a time period, from pathological diagnosis
|
When all the patients are followed-up for 1, 2 and 5 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Hui Chang, MD, Sun Yat-sen University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Estimated)
November 1, 2023
Primary Completion (Estimated)
December 31, 2028
Study Completion (Estimated)
December 31, 2028
Study Registration Dates
First Submitted
July 14, 2023
First Submitted That Met QC Criteria
July 27, 2023
First Posted (Actual)
July 28, 2023
Study Record Updates
Last Update Posted (Actual)
October 31, 2023
Last Update Submitted That Met QC Criteria
October 29, 2023
Last Verified
October 1, 2023
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
- Anti-Infective Agents
- Antiviral Agents
- Antimetabolites
- Trifluridine
Other Study ID Numbers
- 2023-FXY-087
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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