- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT04751370
Testování nivolumabu a ipilimumabu krátkodobou radiací u lokálně pokročilého karcinomu rekta
Studie fáze II neoadjuvantního nivolumabu plus ipilimumabu a krátkodobého ozáření u MSI-H/dMMR lokálně pokročilého rektálního adenokarcinomu
This phase II trial investigates the effect of nivolumab and ipilimumab when given together with short-course radiation therapy in treating patients with rectal cancer that has spread to nearby tissue or lymph nodes (locally advanced). Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Giving nivolumab, ipilimumab, and radiation therapy may kill more cancer cells.
Přehled studie
Postavení
Podmínky
Detailní popis
PRIMARY OBJECTIVE:
I. To demonstrate that neoadjuvant nivolumab and ipilimumab in combination with short-course radiation will improve the pathologic complete response rate (pCR) in microsatellite instability-high (MSI-H)/mismatch repair deficiency (dMMR) locally advanced rectal adenocarcinoma at total mesorectal excision (TME).
SECONDARY OBJECTIVES:
I. To demonstrate that neoadjuvant nivolumab and ipilimumab in combination with short-course radiation will improve the rate of sphincter preservation in low-lying tumors.
II. To demonstrate that neoadjuvant nivolumab and ipilimumab in combination with short-course radiation will improve 5-year disease-free survival (DFS).
III. To demonstrate that neoadjuvant nivolumab and ipilimumab in combination with short-course radiation will improve overall survival (OS).
IV. To demonstrate that neoadjuvant nivolumab and ipilimumab in combination with short-course radiation will have acceptable safety/toxicity.
OUTLINE:
Patients receive nivolumab intravenously (IV) over 30 minutes and ipilimumab IV over 90 minutes on day 1. Treatment repeats every 28 days for 2 cycles. Starting at least 2 weeks but no longer than 6 weeks after completion of cycle 2 of nivolumab and ipilimumab, patients undergo short-course radiation therapy of 5 fractions daily for 1 week. Patients then continue to receive nivolumab IV over 30 minutes and ipilimumab IV over 90 minutes on day 1. Treatment repeats every 28 days for 2 cycles in the absence of disease progression or unacceptable toxicity. 8-12 weeks after completion of 4th cycle of nivolumab and ipilimumab, patients undergo TME. Patients also undergo magnetic resonance imaging (MRI) and computed tomography (CT) prior to TME and during follow up, and undergo sigmoidoscopy prior to TME.
After completion of study treatment, patients are followed up for 5 years.
Typ studie
Zápis (Odhadovaný)
Fáze
- Fáze 2
Kontakty a umístění
Studijní místa
-
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Alabama
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Mobile, Alabama, Spojené státy, 36607
- Mobile Infirmary Medical Center
-
-
Alaska
-
Anchorage, Alaska, Spojené státy, 98508
- Anchorage Associates in Radiation Medicine
-
Anchorage, Alaska, Spojené státy, 99508
- Alaska Breast Care and Surgery LLC
-
Anchorage, Alaska, Spojené státy, 99508
- Alaska Oncology and Hematology LLC
-
Anchorage, Alaska, Spojené státy, 99508
- Alaska Women's Cancer Care
-
Anchorage, Alaska, Spojené státy, 99508
- Anchorage Oncology Centre
-
Anchorage, Alaska, Spojené státy, 99508
- Katmai Oncology Group
-
Anchorage, Alaska, Spojené státy, 99508
- Providence Alaska Medical Center
-
-
Arizona
-
Phoenix, Arizona, Spojené státy, 85004
- Cancer Center at Saint Joseph's
-
-
Arkansas
-
Fort Smith, Arkansas, Spojené státy, 72903
- Mercy Hospital Fort Smith
-
Hot Springs, Arkansas, Spojené státy, 71913
- CHI Saint Vincent Cancer Center Hot Springs
-
-
California
-
Arroyo Grande, California, Spojené státy, 93420
- PCR Oncology
-
Burbank, California, Spojené státy, 91505
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
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Los Angeles, California, Spojené státy, 90033
- USC / Norris Comprehensive Cancer Center
-
Orange, California, Spojené státy, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
-
San Luis Obispo, California, Spojené státy, 93401
- Pacific Central Coast Health Center-San Luis Obispo
-
Santa Maria, California, Spojené státy, 93444
- Mission Hope Medical Oncology - Santa Maria
-
-
Colorado
-
Colorado Springs, Colorado, Spojené státy, 80907
- Penrose-Saint Francis Healthcare
-
Colorado Springs, Colorado, Spojené státy, 80907
- Rocky Mountain Cancer Centers-Penrose
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Denver, Colorado, Spojené státy, 80210
- AdventHealth Porter
-
Lakewood, Colorado, Spojené státy, 80228
- CommonSpirit Saint Anthony Hospital Cancer Center
-
Littleton, Colorado, Spojené státy, 80122
- AdventHealth Littleton
-
Longmont, Colorado, Spojené státy, 80501
- Longmont United Hospital
-
Parker, Colorado, Spojené státy, 80138
- AdventHealth Parker
-
Pueblo, Colorado, Spojené státy, 81004
- Saint Mary Corwin Medical Center
-
-
Delaware
-
Millville, Delaware, Spojené státy, 19967
- Beebe South Coastal Health Campus
-
Newark, Delaware, Spojené státy, 19713
- Helen F Graham Cancer Center
-
Newark, Delaware, Spojené státy, 19713
- Medical Oncology Hematology Consultants PA
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Rehoboth Beach, Delaware, Spojené státy, 19971
- Beebe Health Campus
-
-
Florida
-
Altamonte Springs, Florida, Spojené státy, 32701
- AdventHealth Altamonte
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Orlando, Florida, Spojené státy, 32803
- AdventHealth Orlando
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-
Idaho
-
Boise, Idaho, Spojené státy, 83706
- Saint Alphonsus Cancer Care Center-Boise
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Boise, Idaho, Spojené státy, 83712
- Saint Luke's Cancer Institute - Boise
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Caldwell, Idaho, Spojené státy, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
-
Coeur d'Alene, Idaho, Spojené státy, 83814
- Kootenai Health - Coeur d'Alene
-
Fruitland, Idaho, Spojené státy, 83619
- Saint Luke's Cancer Institute - Fruitland
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Meridian, Idaho, Spojené státy, 83642
- Idaho Urologic Institute-Meridian
-
Meridian, Idaho, Spojené státy, 83642
- Saint Luke's Cancer Institute - Meridian
-
Nampa, Idaho, Spojené státy, 83687
- Saint Alphonsus Cancer Care Center-Nampa
-
Nampa, Idaho, Spojené státy, 83687
- Saint Luke's Cancer Institute - Nampa
-
Post Falls, Idaho, Spojené státy, 83854
- Kootenai Clinic Cancer Services - Post Falls
-
Twin Falls, Idaho, Spojené státy, 83301
- Saint Luke's Cancer Institute - Twin Falls
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Illinois
-
Bloomington, Illinois, Spojené státy, 61704
- Illinois CancerCare-Bloomington
-
Canton, Illinois, Spojené státy, 61520
- Illinois CancerCare-Canton
-
Carbondale, Illinois, Spojené státy, 62902
- Memorial Hospital of Carbondale
-
Carterville, Illinois, Spojené státy, 62918
- SIH Cancer Institute
-
Carthage, Illinois, Spojené státy, 62321
- Illinois CancerCare-Carthage
-
Centralia, Illinois, Spojené státy, 62801
- Centralia Oncology Clinic
-
Chicago, Illinois, Spojené státy, 60612
- University of Illinois
-
Danville, Illinois, Spojené státy, 61832
- Carle at The Riverfront
-
Decatur, Illinois, Spojené státy, 62526
- Decatur Memorial Hospital
-
Decatur, Illinois, Spojené státy, 62526
- Cancer Care Specialists of Illinois - Decatur
-
Dixon, Illinois, Spojené státy, 61021
- Illinois CancerCare-Dixon
-
Effingham, Illinois, Spojené státy, 62401
- Crossroads Cancer Center
-
Effingham, Illinois, Spojené státy, 62401
- Carle Physician Group-Effingham
-
Eureka, Illinois, Spojené státy, 61530
- Illinois CancerCare-Eureka
-
Galesburg, Illinois, Spojené státy, 61401
- Western Illinois Cancer Treatment Center
-
Galesburg, Illinois, Spojené státy, 61401
- Illinois CancerCare-Galesburg
-
Kewanee, Illinois, Spojené státy, 61443
- Illinois CancerCare-Kewanee Clinic
-
Macomb, Illinois, Spojené státy, 61455
- Illinois CancerCare-Macomb
-
Mattoon, Illinois, Spojené státy, 61938
- Carle Physician Group-Mattoon/Charleston
-
Mount Vernon, Illinois, Spojené státy, 62864
- SSM Health Good Samaritan
-
O'Fallon, Illinois, Spojené státy, 62269
- Cancer Care Center of O'Fallon
-
Ottawa, Illinois, Spojené státy, 61350
- Illinois CancerCare-Ottawa Clinic
-
Pekin, Illinois, Spojené státy, 61554
- Illinois CancerCare-Pekin
-
Pekin, Illinois, Spojené státy, 61554
- OSF Saint Francis Radiation Oncology at Pekin
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Peoria, Illinois, Spojené státy, 61636
- Methodist Medical Center of Illinois
-
Peoria, Illinois, Spojené státy, 61637
- OSF Saint Francis Medical Center
-
Peoria, Illinois, Spojené státy, 61615
- Illinois CancerCare-Peoria
-
Peoria, Illinois, Spojené státy, 61615
- OSF Saint Francis Radiation Oncology at Peoria Cancer Center
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Peru, Illinois, Spojené státy, 61354
- Illinois CancerCare-Peru
-
Peru, Illinois, Spojené státy, 61354
- Valley Radiation Oncology
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Princeton, Illinois, Spojené státy, 61356
- Illinois CancerCare-Princeton
-
Springfield, Illinois, Spojené státy, 62702
- Southern Illinois University School of Medicine
-
Springfield, Illinois, Spojené státy, 62702
- Springfield Clinic
-
Springfield, Illinois, Spojené státy, 62781
- Springfield Memorial Hospital
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Urbana, Illinois, Spojené státy, 61801
- Carle Cancer Center
-
Washington, Illinois, Spojené státy, 61571
- Illinois CancerCare - Washington
-
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Iowa
-
Ames, Iowa, Spojené státy, 50010
- Mary Greeley Medical Center
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Ames, Iowa, Spojené státy, 50010
- McFarland Clinic - Ames
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Carroll, Iowa, Spojené státy, 51401
- Saint Anthony Regional Hospital
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Clive, Iowa, Spojené státy, 50325
- Mercy Cancer Center-West Lakes
-
Clive, Iowa, Spojené státy, 50325
- UI Health Care Mission Cancer and Blood - West Des Moines Clinic
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Creston, Iowa, Spojené státy, 50801
- Greater Regional Medical Center
-
Des Moines, Iowa, Spojené státy, 50309
- Iowa Methodist Medical Center
-
Des Moines, Iowa, Spojené státy, 50314
- Mercy Medical Center - Des Moines
-
Des Moines, Iowa, Spojené státy, 50314
- Broadlawns Medical Center
-
Des Moines, Iowa, Spojené státy, 50316
- Iowa Lutheran Hospital
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Des Moines, Iowa, Spojené státy, 50309
- UI Health Care Mission Cancer and Blood - Des Moines Clinic
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Des Moines, Iowa, Spojené státy, 50314
- UI Health Care Mission Cancer and Blood - Laurel Clinic
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West Des Moines, Iowa, Spojené státy, 50266-7700
- Methodist West Hospital
-
West Des Moines, Iowa, Spojené státy, 50266
- Mercy Medical Center-West Lakes
-
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Kansas
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Garden City, Kansas, Spojené státy, 67846
- Central Care Cancer Center - Garden City
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Great Bend, Kansas, Spojené státy, 67530
- Central Care Cancer Center - Great Bend
-
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Kentucky
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Lexington, Kentucky, Spojené státy, 40504
- Saint Joseph Radiation Oncology Resource Center
-
Lexington, Kentucky, Spojené státy, 40509
- CommonSpirit Saint Joseph Medical Center - East Lexington
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Louisville, Kentucky, Spojené státy, 40202
- Jewish Hospital
-
Louisville, Kentucky, Spojené státy, 40245
- UofL Health Medical Center Northeast
-
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Massachusetts
-
Springfield, Massachusetts, Spojené státy, 01199
- Baystate Medical Center
-
Worcester, Massachusetts, Spojené státy, 01655
- UMass Memorial Medical Center - University Campus
-
-
Minnesota
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Burnsville, Minnesota, Spojené státy, 55337
- Fairview Ridges Hospital
-
Burnsville, Minnesota, Spojené státy, 55337
- Minnesota Oncology - Burnsville
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Coon Rapids, Minnesota, Spojené státy, 55433
- Mercy Hospital
-
Edina, Minnesota, Spojené státy, 55435
- Fairview Southdale Hospital
-
Fridley, Minnesota, Spojené státy, 55432
- Unity Hospital
-
Maple Grove, Minnesota, Spojené státy, 55369
- Fairview Clinics and Surgery Center Maple Grove
-
Maplewood, Minnesota, Spojené státy, 55109
- Saint John's Hospital - Healtheast
-
Maplewood, Minnesota, Spojené státy, 55109
- Minnesota Oncology Hematology PA-Maplewood
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Minneapolis, Minnesota, Spojené státy, 55415
- Hennepin County Medical Center
-
Minneapolis, Minnesota, Spojené státy, 55407
- Abbott-Northwestern Hospital
-
Monticello, Minnesota, Spojené státy, 55362
- Monticello Cancer Center
-
Robbinsdale, Minnesota, Spojené státy, 55422
- North Memorial Medical Health Center
-
Rochester, Minnesota, Spojené státy, 55905
- Mayo Clinic in Rochester
-
Saint Louis Park, Minnesota, Spojené státy, 55416
- Park Nicollet Clinic - Saint Louis Park
-
Saint Paul, Minnesota, Spojené státy, 55101
- Regions Hospital
-
Saint Paul, Minnesota, Spojené státy, 55102
- United Hospital
-
Shakopee, Minnesota, Spojené státy, 55379
- Saint Francis Regional Medical Center
-
Waconia, Minnesota, Spojené státy, 55387
- Ridgeview Medical Center
-
Willmar, Minnesota, Spojené státy, 56201
- Rice Memorial Hospital
-
Woodbury, Minnesota, Spojené státy, 55125
- Minnesota Oncology Hematology PA-Woodbury
-
-
Missouri
-
Ballwin, Missouri, Spojené státy, 63011
- Mercy Oncology and Hematology - Clayton-Clarkson
-
Bolivar, Missouri, Spojené státy, 65613
- Central Care Cancer Center - Bolivar
-
Cape Girardeau, Missouri, Spojené státy, 63703
- Saint Francis Medical Center
-
Cape Girardeau, Missouri, Spojené státy, 63703
- Mercy Cancer Center - Cape Girardeau
-
Farmington, Missouri, Spojené státy, 63640
- Parkland Health Center - Farmington
-
Jefferson City, Missouri, Spojené státy, 65109
- MU Health Care Goldschmidt Cancer Center
-
Joplin, Missouri, Spojené státy, 64804
- Freeman Health System
-
Joplin, Missouri, Spojené státy, 64804
- Mercy Hospital Joplin
-
Rolla, Missouri, Spojené státy, 65401
- Mercy Clinic-Rolla-Cancer and Hematology
-
Rolla, Missouri, Spojené státy, 65401
- Phelps Health Delbert Day Cancer Institute
-
Saint Joseph, Missouri, Spojené státy, 64506
- Heartland Regional Medical Center
-
Sainte Genevieve, Missouri, Spojené státy, 63670
- Sainte Genevieve County Memorial Hospital
-
Springfield, Missouri, Spojené státy, 65807
- CoxHealth South Hospital
-
Springfield, Missouri, Spojené státy, 65804
- Mercy Hospital Springfield
-
St Louis, Missouri, Spojené státy, 63131
- Missouri Baptist Medical Center
-
St Louis, Missouri, Spojené státy, 63141
- Mercy Hospital Saint Louis
-
St Louis, Missouri, Spojené státy, 63128
- Mercy Hospital South
-
Sullivan, Missouri, Spojené státy, 63080
- Missouri Baptist Sullivan Hospital
-
-
Montana
-
Billings, Montana, Spojené státy, 59101
- Billings Clinic Cancer Center
-
Bozeman, Montana, Spojené státy, 59715
- Bozeman Health Deaconess Hospital
-
Great Falls, Montana, Spojené státy, 59405
- Great Falls Clinic
-
Great Falls, Montana, Spojené státy, 59405
- Benefis Sletten Cancer Institute
-
Kalispell, Montana, Spojené státy, 59901
- Logan Health Medical Center
-
Missoula, Montana, Spojené státy, 59802
- Saint Patrick Hospital - Community Hospital
-
Missoula, Montana, Spojené státy, 59804
- Community Medical Center
-
-
Nebraska
-
Grand Island, Nebraska, Spojené státy, 68803
- Nebraska Cancer Specialists/Oncology Hematology West PC
-
Kearney, Nebraska, Spojené státy, 68847
- CHI Health Good Samaritan
-
Omaha, Nebraska, Spojené státy, 68124
- Alegent Health Bergan Mercy Medical Center
-
Omaha, Nebraska, Spojené státy, 68122
- Alegent Health Immanuel Medical Center
-
Omaha, Nebraska, Spojené státy, 68130
- Alegent Health Lakeside Hospital
-
-
Nevada
-
Henderson, Nevada, Spojené státy, 89052
- Comprehensive Cancer Centers of Nevada - Henderson
-
Henderson, Nevada, Spojené státy, 89074
- Oncology Las Vegas - Henderson
-
Las Vegas, Nevada, Spojené státy, 89102
- OptumCare Cancer Care at Charleston
-
Las Vegas, Nevada, Spojené státy, 89106
- Radiation Oncology Centers of Nevada Central
-
Las Vegas, Nevada, Spojené státy, 89119
- Radiation Oncology Centers of Nevada Southeast
-
Las Vegas, Nevada, Spojené státy, 89128
- Comprehensive Cancer Centers of Nevada - Northwest
-
Las Vegas, Nevada, Spojené státy, 89128
- OptumCare Cancer Care at MountainView
-
Las Vegas, Nevada, Spojené státy, 89135
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
-
Las Vegas, Nevada, Spojené státy, 89144
- Comprehensive Cancer Centers of Nevada - Town Center
-
Las Vegas, Nevada, Spojené státy, 89144
- Comprehensive Cancer Centers of Nevada-Summerlin
-
Las Vegas, Nevada, Spojené státy, 89148
- Comprehensive Cancer Centers of Nevada
-
Las Vegas, Nevada, Spojené státy, 89169
- Comprehensive Cancer Centers of Nevada - Central Valley
-
Las Vegas, Nevada, Spojené státy, 89183
- OptumCare Cancer Care at Fort Apache
-
Reno, Nevada, Spojené státy, 89502
- Renown Regional Medical Center
-
Reno, Nevada, Spojené státy, 89503
- Saint Mary's Regional Medical Center
-
Reno, Nevada, Spojené státy, 89509
- Radiation Oncology Associates
-
-
New Hampshire
-
Concord, New Hampshire, Spojené státy, 03301
- New Hampshire Oncology Hematology PA-Concord
-
Lebanon, New Hampshire, Spojené státy, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
Manchester, New Hampshire, Spojené státy, 03103
- Solinsky Center for Cancer Care
-
-
New York
-
Lake Success, New York, Spojené státy, 11042
- Northwell Health/Center for Advanced Medicine
-
Middletown, New York, Spojené státy, 10940
- Garnet Health Medical Center
-
Mount Kisco, New York, Spojené státy, 10549
- Northern Westchester Hospital
-
New York, New York, Spojené státy, 10075
- Lenox Hill Hospital
-
New York, New York, Spojené státy, 10065
- Manhattan Eye Ear and Throat Hospital
-
-
Ohio
-
Cincinnati, Ohio, Spojené státy, 45220
- Good Samaritan Hospital - Cincinnati
-
Cincinnati, Ohio, Spojené státy, 45242
- Bethesda North Hospital
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Spojené státy, 73104
- University of Oklahoma Health Sciences Center
-
Oklahoma City, Oklahoma, Spojené státy, 73120
- Mercy Hospital Oklahoma City
-
-
Oregon
-
Bend, Oregon, Spojené státy, 97701
- Saint Charles Health System
-
Clackamas, Oregon, Spojené státy, 97015
- Clackamas Radiation Oncology Center
-
Clackamas, Oregon, Spojené státy, 97015
- Providence Cancer Institute Clackamas Clinic
-
Coos Bay, Oregon, Spojené státy, 97420
- Bay Area Hospital
-
Newberg, Oregon, Spojené státy, 97132
- Providence Newberg Medical Center
-
Portland, Oregon, Spojené státy, 97213
- Providence Portland Medical Center
-
Portland, Oregon, Spojené státy, 97225
- Providence Saint Vincent Medical Center
-
-
Pennsylvania
-
Chadds Ford, Pennsylvania, Spojené státy, 19317
- Christiana Care Health System-Concord Health Center
-
-
South Dakota
-
Rapid City, South Dakota, Spojené státy, 57701
- Rapid City Regional Hospital
-
Sioux Falls, South Dakota, Spojené státy, 57105
- Avera Cancer Institute
-
-
Tennessee
-
Nashville, Tennessee, Spojené státy, 37232
- Vanderbilt University/Ingram Cancer Center
-
Nashville, Tennessee, Spojené státy, 37204
- Vanderbilt Breast Center at One Hundred Oaks
-
-
Texas
-
Bryan, Texas, Spojené státy, 77802
- Saint Joseph Regional Cancer Center
-
-
Vermont
-
Saint Johnsbury, Vermont, Spojené státy, 05819
- Dartmouth Cancer Center - North
-
-
Washington
-
Aberdeen, Washington, Spojené státy, 98520
- Providence Regional Cancer System-Aberdeen
-
Bellevue, Washington, Spojené státy, 98004
- Overlake Medical Center
-
Bellingham, Washington, Spojené státy, 98225
- PeaceHealth Saint Joseph Medical Center
-
Burien, Washington, Spojené státy, 98166
- Saint Anne Hospital
-
Centralia, Washington, Spojené státy, 98531
- Providence Regional Cancer System-Centralia
-
Edmonds, Washington, Spojené státy, 98026
- Swedish Cancer Institute-Edmonds
-
Everett, Washington, Spojené státy, 98201
- Providence Regional Cancer Partnership
-
Issaquah, Washington, Spojené státy, 98029
- Swedish Cancer Institute-Issaquah
-
Lacey, Washington, Spojené státy, 98503
- Providence Regional Cancer System-Lacey
-
Longview, Washington, Spojené státy, 98632
- PeaceHealth Saint John Medical Center
-
Renton, Washington, Spojené státy, 98055
- Valley Medical Center
-
Seattle, Washington, Spojené státy, 98107
- Swedish Medical Center-Ballard Campus
-
Seattle, Washington, Spojené státy, 98122
- Swedish Medical Center-First Hill
-
Sedro-Woolley, Washington, Spojené státy, 98284
- PeaceHealth United General Medical Center
-
Silverdale, Washington, Spojené státy, 98383
- Saint Joseph Medical Center Hematology and Oncology - Silverdale
-
Vancouver, Washington, Spojené státy, 98664
- PeaceHealth Southwest Medical Center
-
Walla Walla, Washington, Spojené státy, 99362
- Providence Saint Mary Regional Cancer Center
-
Yakima, Washington, Spojené státy, 98902
- North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
-
-
Wisconsin
-
Appleton, Wisconsin, Spojené státy, 54911
- ThedaCare Regional Cancer Center
-
New Richmond, Wisconsin, Spojené státy, 54017
- Cancer Center of Western Wisconsin
-
-
Wyoming
-
Sheridan, Wyoming, Spojené státy, 82801
- Welch Cancer Center
-
-
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- Patient must be >= 18 years of age
- Patient must have histologically confirmed adenocarcinoma of the rectum with the inferior margin within 15 cm from the anal verge based on colonoscopy and/or flexible sigmoidoscopy
- Patient must have T3-4Nx or TxN+ disease (stage II or III) based on magnetic resonance imaging of the pelvis and computed tomography of the chest and abdomen. These baseline scans must be done within 28 days prior to registration
- Patient must have MSI-H (microsatellite instability-high) or dMMR (deficient mismatch repair) tumors based on immunohistochemistry or PCR (polymerase chain reaction)
- Patient must have Eastern Cooperative Oncology Group (ECOG) Performance status 0-2
- Patient must not have previously received chemotherapy or immunotherapy for rectal cancer
- Patient must not have previously received radiotherapy to the pelvis
- Patient must have the ability to understand and the willingness to sign a written informed consent document. Patients with impaired decision-making capacity (IDMC) who have a legally authorized representative (LAR) or caregiver and/or family member available will also be considered eligible
- Patient must not have had major surgery performed within 28 days prior to registration
- Patient must not have a history of interstitial lung disease (e.g., pneumonitis or pulmonary fibrosis) or evidence of interstitial lung disease on baseline chest CT scan
- Patient must not have a serious active infection requiring IV antibiotics at time of registration
- Patient must agree to not receive live vaccines while on this study
- Patient must not have active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including chronic prolonged systemic corticosteroids (defined as corticosteroid use of duration one month or greater). These include but are not limited to patients with a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis; systemic autoimmune disease such as systemic lupus erythematosus (SLE), connective tissue diseases, scleroderma, inflammatory bowel disease (IBD), Crohn's, ulcerative colitis, and patients with a history of toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, or anti-phospholipid syndrome. Patients with any of these are ineligible for this study because of the risk of recurrence or exacerbation of disease
- Patient must not have a condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days prior to registration. Inhaled or topical steroids and adrenal replacement doses < 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease. Patients are permitted to use topical, ocular, intra-articular, intranasal, and inhalational corticosteroids (with minimal systemic absorption). Physiologic replacement doses of systemic corticosteroids are permitted, even if < 10 mg/day prednisone equivalents. A brief course of corticosteroids for prophylaxis (e.g., contrast dye allergy) or for treatment of non-autoimmune conditions (e.g., delayed-type hypersensitivity reaction caused by contact allergen) is permitted
- Patient must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used. All patients of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy. A repeat pregnancy test must be done within 72 hours prior to first dose of treatment if the baseline test was done outside the 72 hour window. A patient of childbearing potential is defined as anyone, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
- Patients of childbearing potential and sexually active patients must not expect to conceive or father children by using accepted and effective method(s) of contraception or by abstaining from sexual intercourse for at least one month (female patients) or one week (male patients) prior to the start of study drug and continue for 5 months after the last dose of study drug (for female patients). Investigators must counsel patients on the importance of pregnancy prevention and the implications of an unexpected pregnancy
- Leukocytes >= 3,000/mcL (must be obtained =< 14 days prior to protocol registration)
- Absolute neutrophil count (ANC) >= 1,500/mcL (must be obtained =< 14 days prior to protocol registration)
- Platelets >= 100,000/mcL (must be obtained =< 14 days prior to protocol registration)
- Total bilirubin =< institutional upper limit of normal (ULN) (must be obtained =< 14 days prior to protocol registration)
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) =< 2.5 x institutional ULN (must be obtained =< 14 days prior to protocol registration)
- Creatinine =< 1.5 x institutional ULN (must be obtained =< 14 days prior to protocol registration)
- Patients should have urine dipstick with proteinuria < 1. If urine dipstick > 2, proteinuria must be less than 1 g in 24 hours urine collection
- Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months of registration are eligible for this trial
- For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
- Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
- Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
- Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better
- Patient must not have had live vaccines within 30 days prior to registration. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, chicken pox, yellow fever, rabies, Bacillus Calmette-Guerin (BCG), and typhoid (oral) vaccine. Patients are permitted to receive inactivated vaccines and any non-live vaccines including those for the seasonal influenza and COVID-19 (Note: intranasal influenza vaccines, such as Flu-Mist [registered trademark] are live attenuated vaccines and are not allowed). If possible, it is recommended to separate study drug administration from vaccine administration by about a week (primarily, in order to minimize an overlap of adverse events)
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: N/A
- Intervenční model: Přiřazení jedné skupiny
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
|
Experimentální: Treatment (nivolumab, ipilimumab, radiation therapy, TME)
Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 90 minutes on day 1. Treatment repeats every 28 days for 2 cycles. Starting at least 2 weeks but no longer than 6 weeks after completion of cycle 2 of nivolumab and ipilimumab, patients undergo short-course radiation therapy of 5 fractions daily for 1 week. Patients then continue to receive nivolumab IV over 30 minutes and ipilimumab IV over 90 minutes on day 1. Treatment repeats every 28 days for 2 cycles in the absence of disease progression or unacceptable toxicity. 8-12 weeks after completion of 4th cycle of nivolumab and ipilimumab, patients undergo TME. Patients also undergo MRI and CT prior to TME and during follow up, and undergo sigmoidoscopy prior to TME. |
Given IV
Ostatní jména:
Undergo CT
Ostatní jména:
Undergo MRI
Ostatní jména:
Given IV
Ostatní jména:
Undergo sigmoidoscopy
Ostatní jména:
Undergo short-course radiation therapy
Ostatní jména:
Undergo TME
Ostatní jména:
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Časové okno |
|---|---|
|
Patologická kompletní odpověď
Časové okno: V době totální mezorektální excize
|
V době totální mezorektální excize
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Rate of sphincter preservation in low-lying tumors
Časové okno: Up to 5 years
|
95% confidence interval will be estimated. |
Up to 5 years
|
|
Disease free survival
Časové okno: Up to 5 years
|
Kaplan-Meier method will be used. |
Up to 5 years
|
|
Overall survival
Časové okno: Up to 5 years
|
Kaplan-Meier method will be used. |
Up to 5 years
|
|
Incidence of adverse events
Časové okno: Up to 5 years
|
Will be assessed by Common Terminology Criteria for Adverse Events 5.0. Toxicities will be tabulated by grade and treatment relation. |
Up to 5 years
|
Spolupracovníci a vyšetřovatelé
Sponzor
Vyšetřovatelé
- Vrchní vyšetřovatel: Kristen K Ciombor, ECOG-ACRIN Cancer Research Group
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
- Novotvary podle místa
- Novotvary
- Střevní nemoci
- Gastrointestinální novotvary
- Novotvary trávicího systému
- Nemoci trávicího systému
- Gastrointestinální onemocnění
- Kolorektální novotvary
- Střevní novotvary
- Rektální onemocnění
- Rektální novotvary
- Aminokyseliny, peptidy a proteiny
- Proteiny
- Vyšetřovací techniky
- Terapeutika
- Diagnostické techniky a postupy
- Diagnóza
- Chirurgické postupy, operativní
- Minimálně invazivní chirurgické zákroky
- Biologické faktory
- Fyzické jevy
- Protilátky, monoklonální, humanizované
- Protilátky, monoklonální
- Protilátky
- Imunoglobuliny
- Imunoproteiny
- Krevní proteiny
- Sérové globuliny
- Globuliny
- Diagnostické techniky, chirurgické
- Endoskopie, gastrointestinální
- Endoskopie, trávicí systém
- Diagnostické techniky, trávicí systém
- Endoskopie
- Chirurgické zákroky na trávicí systém
- Techniky chemie, analytické
- Analýza spektra
- Receptory, buněčný povrch
- Membránové proteiny
- Antigeny
- Kolonoskopie
- Antigeny, povrch
- Biomarkery
- Receptory, imunologické
- Antigeny, diferenciace, t-lymfocyt
- Antigeny, diferenciace
- Proteiny imunitního kontrolního bodu
- Kostimulační a inhibiční receptory T-buněk
- Nivolumab
- Ipilimumab
- Radioterapie
- Záření
- Magnetická rezonanční spektroskopie
- Sigmoidoskopie
- Antigen CTLA-4
Další identifikační čísla studie
- NCI-2021-00912
- U10CA180820 (Grant/smlouva NIH USA)
- NCI-2021-00912 (Identifikátor registru: CTRP (Clinical Trial Reporting Program))
- EA2201 (Jiný identifikátor: CTEP)
- EA2201 (Jiný identifikátor: ECOG-ACRIN Cancer Research Group)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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