AK112 Combination Therapy as First Line Treatment for Metastatic Digestive System Neuroendocrine Cancer

A Prospective, Parallel, Double-cohort, Multicenter Phase II Clinical Study of Ivonescimab (AK112) Combined With IP Chemotherapy ± TACE for First-line Treatment of Metastatic Digestive System Neuroendocrine Cancer

This study is a single prospective, parallel, double-cohort, multicenter phase II clinical trial, aiming to evaluate the efficacy and safety of ivonescimab (AK112) combined with IP chemotherapy ± TACE in the first-line treatment of metastatic digestive system neuroendocrine cancer.

Study Overview

Status

Not yet recruiting

Study Type

Interventional

Enrollment (Estimated)

56

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

Study Locations

      • Tianjin, China
        • Tianjin Medical University General Hospital
        • Contact:
      • Tianjin, China
        • Tianjin Third Central Hospital
        • Contact:
      • Tianjin, China
        • Tianjin Medical University Cancer Institute and Hospital
        • Contact:
      • Tianjin, China
        • Tianjin First Central Hospital
        • Contact:
      • Tianjin, China
        • Tianjin People's Hospital
        • Contact:
    • Inner Mongolia
      • Baotou, Inner Mongolia, China
        • Baotou Cancer Hospital
        • Contact:
      • Tongliao, Inner Mongolia, China
        • The First People's Hospital of Horqin District, Tongliao City
        • Contact:
    • Shanxi
      • Taiyuan, Shanxi, China
        • Shanxi Bethune Hospital
        • Contact:

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:

  1. Age: 18 - 75 years old;
  2. Metastatic digestive system neuroendocrine carcinoma (NEC) confirmed by tissue or cytological examination;
  3. For cohort 2 only: Liver metastasis, suitable for TACE;
  4. No previous systemic treatment; For patients who received adjuvant therapy, disease recurrence and metastasis more than 6 months after the last treatment can be regarded as first-line treatment;
  5. Clear measurable lesions meeting the requirements of RECIST (1.1); If the lesion that received previous local treatment (radiation, ablation, vascular intervention, etc.) is the only lesion, there must be clear imaging evidence of disease progression for this lesion;
  6. ECOG score of 0 or 1;
  7. Expected survival ≥ 12 weeks;
  8. Basic normal functions of major organs and bone marrow;
  9. Male or female patients with reproductive capacity voluntarily use effective contraceptive methods during the study period and within 6 months after the last study medication, such as double barrier contraceptive methods, condoms, oral or injectable contraceptives, intrauterine devices, etc. All female patients will be considered to have reproductive capacity, unless the female patient has naturally menopause, artificial menopause or sterilization (such as hysterectomy, bilateral ovary removal or radiotherapy of the ovaries, etc.).
  10. Have fully understood this study, voluntarily participated, and signed the informed consent form.

Exclusion Criteria:

  1. Within the past 5 years, have been diagnosed with other malignant tumors (excluding carcinoma in situ, basal cell carcinoma, etc.);
  2. Known to be allergic to any component of any study drug; have a history of severe hypersensitivity reaction to other monoclonal antibodies;
  3. Within 4 weeks before enrollment, have received approved or investigational systemic anti-tumor treatment, including: photodynamic therapy, chemotherapy, radical radiotherapy, ablation, local radiotherapy (allowing for palliative radiotherapy for bone metastases at least 2 weeks before the study drug treatment), biological immunotherapy, targeted therapy, etc.;
  4. Within 4 weeks before enrollment, have participated in other domestic clinical trials of drugs that have not been approved or are not yet on the market and have received corresponding trial drug treatment;
  5. Within 4 weeks before enrollment, have received any surgery or invasive treatment or operation (except for intravenous catheterization, puncture drainage, etc.);
  6. The patient currently has active ulcers in the stomach and duodenum, ulcerative colitis and other digestive tract diseases or active bleeding from the unresected tumor, or conditions that the investigator deems may cause gastrointestinal bleeding or perforation;
  7. Within 3 months before enrollment, have obvious evidence or history of bleeding (more than 30 mL of bleeding within 3 months, hematemesis, black stool, bloody stool), hemoptysis (more than 5 mL of fresh blood within 4 weeks), or have had a thromboembolic event within 12 months (including stroke events and/or transient ischemic attacks);
  8. Have significant clinical cardiovascular diseases, including but not limited to acute myocardial infarction within 6 months before enrollment, severe/unstable angina pectoris or coronary artery bypass surgery; New York Heart Association (NYHA) class > 2 for congestive heart failure; Drug treatment for ventricular arrhythmias; Electrocardiogram (ECG) showing QTc interval ≥ 480 milliseconds;
  9. Unstable brain parenchymal metastases, spinal cord metastases or compression, cancerous meningitis or meningitis metastasis;
  10. Have third space fluid that cannot be controlled by drainage methods (such as large amounts of ascites, pleural effusion, pericardial effusion, etc.), and the subjects need to control the third space fluid through drainage within 14 days before administration;
  11. Active or uncontrolled severe infection (≥ CTCAE grade 2 infection);
  12. Known human immunodeficiency virus (HIV) infection; Known significant liver disease history, including viral hepatitis [must exclude active HBV infection if the HBV DNA is positive (> 1×10^4 copies/mL or > 2000 IU/ml); known hepatitis C infection (HCV) and HCV RNA positive (> 1×10^3 copies/mL), or other hepatitis, liver cirrhosis];
  13. Known mental illness, drug abuse, alcoholism or drug addiction history.
  14. Pregnant or lactating women.
  15. Have any disease, treatment, laboratory test abnormalities in the past or currently, which may confuse the research results, affect the full participation of the subjects in the research, or the participation in the research may not be in the best interests of the subjects.
  16. Local or systemic diseases not caused by malignant tumors, or secondary diseases or symptoms of tumors, which may lead to higher medical risks and/or uncertainty in survival period evaluation, such as tumor leukemia reaction (white blood cell count > 20×109/L), cachexia manifestations (such as weight loss of more than 10% within 3 months before screening), etc.
  17. Patients judged by the investigator to be unsuitable to participate in this study.

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: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: NEC

Combination treatment period (4-6 cycles):

AK112: 20mg/kg, intravenous infusion, administered on day 1, repeated every 3 weeks

Maintenance treatment period:

AK112: 20mg/kg, intravenous infusion, administered on day 1, repeated every 3 weeks

Combination treatment period (4-6 cycles):

Irinotecan: 65 mg/m2, intravenous infusion, administered on days 1 and 8, repeated every 3 weeks

Combination treatment period (4-6 cycles):

Cisplatin: 30 mg/m2, intravenous infusion, administered on days 1 and 8, repeated every 3 weeks

Experimental: NEC with liver metastases

Combination treatment period (4-6 cycles):

AK112: 20mg/kg, intravenous infusion, administered on day 1, repeated every 3 weeks

Maintenance treatment period:

AK112: 20mg/kg, intravenous infusion, administered on day 1, repeated every 3 weeks

Combination treatment period (4-6 cycles):

Irinotecan: 65 mg/m2, intravenous infusion, administered on days 1 and 8, repeated every 3 weeks

Combination treatment period (4-6 cycles):

Cisplatin: 30 mg/m2, intravenous infusion, administered on days 1 and 8, repeated every 3 weeks

Combination treatment period:

TACE with epirubicin, 30-40 mg, every 3 weeks or every 6 weeks. The total treatment cycle is determined as needed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
progression-free survival (PFS)
Time Frame: Up to 2 years
PFS is defined as the time from date of treatment start to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1
Up to 2 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
objective response rate (ORR)
Time Frame: Up to 2 years
Proportion of participants with complete response (CR) or partial response (PR), as assessed by RECIST version 1.1
Up to 2 years
disease control rate (DCR)
Time Frame: Up to 2 years
Proportion of subjects with CR,PR, or SD based on RECIST Version 1.1.
Up to 2 years
duration of response (DOR)
Time Frame: Up to 2 years
Time from the first documentation of objective response to the first documented disease progression as assessed by RECIST version 1.1 or death due to any cause, whichever occurs first
Up to 2 years
overall survival (OS)
Time Frame: Up to 2 years
Time from the date of treatment start to death due to any cause
Up to 2 years
The number of subjects experiencing adverse events (AEs)
Time Frame: From the time of treatment start through 90 days following termination of treatment with investigational product
From the time of treatment start through 90 days following termination of treatment with investigational product

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

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)

August 1, 2026

Primary Completion (Estimated)

February 27, 2029

Study Completion (Estimated)

August 31, 2029

Study Registration Dates

First Submitted

July 14, 2026

First Submitted That Met QC Criteria

July 14, 2026

First Posted (Actual)

July 17, 2026

Study Record Updates

Last Update Posted (Actual)

July 17, 2026

Last Update Submitted That Met QC Criteria

July 14, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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