Adjuvant Therapy for High-Risk Intrahepatic Cholangiocarcinoma: A Real-World Study
A Real-World Study on Postoperative Adjuvant Therapy for Intrahepatic Cholangiocarcinoma Patients With High-Risk Recurrence Factors
This multicenter real-world study assesses the efficacy and safety of adjuvant therapies in postoperative intrahepatic cholangiocarcinoma (ICC) patients with high-risk recurrence factors.
90 eligible patients will be assigned to: Cohort 1: GP (gemcitabine/cisplatin) + adebrelimab Cohort 2: Apatinib + adebrelimab Cohort 3: S-1 (tegafur/gimeracil/oteracil) + adebrelimab Outcomes will be compared against historical real-world controls receiving standard chemotherapy.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Baoluhe Zhang
- Telefonnummer: 010-69152831
- E-Mail: dushd@pumch.cn
Studienorte
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Beijing, China
- Rekrutierung
- Peking Union Medical College Hospital (PUMCH)
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Kontakt:
- Baoluhe Zhang
- Telefonnummer: 010-69152831
- E-Mail: dushd@pumch.cn
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Probenahmeverfahren
Studienpopulation
Beschreibung
Inclusion Criteria:
- Histologically confirmed ICC within 12 weeks after curative resection
- Any T stage; N0/N+; M0.
- At least one high-risk factor:
Preoperative tumor penetration of the liver capsule or extrahepatic direct invasion; Preoperative imaging showing multifocal lesions or a single lesion >5 cm; Vascular invasion (preoperative or postoperative pathology); Regional lymph node metastasis.
- No prior systemic therapy for ICC.
- ECOG performance status 0-2.
- Expected survival ≥3 months.
- Adequate organ function.
- Agreement to use effective contraception (or surgical sterilization) during the study and for 120 days after the last dose.
- Signed informed consent and anticipated good compliance with the study protocol.
Exclusion Criteria:
- Immunosuppressive therapy within 28 days prior to enrollment (excluding topical/inhaled corticosteroids or physiologic steroid doses ≤10 mg/day prednisone equivalent).
- Systemic anticancer herbs/immunomodulators (e.g., thymosin, interferons) within 4 weeks, except for pleural effusion control.
- Uncontrolled cardiovascular disease:
Unstable angina/myocardial infarction Arrhythmias with QTc ≥450 ms (men) or ≥470 ms (women) NYHA Class III-IV heart failure or LVEF <50%
- Active infections (IV antibiotics/antivirals required) or fever >38.5°C within 4 weeks; or major surgery within 3 weeks.
- Active autoimmune/immunodeficiency diseases (e.g., hepatitis, pneumonitis, rheumatoid arthritis), except:
Hypothyroidism on stable hormone replacement Type 1 diabetes with controlled glucose Uncontrolled asthma requiring systemic bronchodilators (resolved childhood asthma allowed).
- Active infections: HIV/AIDS
HBV (DNA ≥500 IU/mL) or HCV (RNA-positive) unless:
HBV DNA <500 IU/mL + antiviral therapy ≥14 days
- Prior/proposed organ transplantation (excluding corneal grafts).
- Concurrent interventional trials or investigational drugs within 4 weeks without recovery to Grade ≤1 toxicity.
- Hypersensitivity to study drug components.
- Allogeneic transplant history/plans.
- Uncontrolled psychiatric/substance abuse disorders.
- Refractory hypertension (≥140/90 mmHg despite treatment).
- Clinically significant bleeding/thromboembolism:
GI bleeding within 3 months Thrombotic events within 6 months (stroke, DVT/PE)
- Coagulopathy (INR >1.5, PT >ULN+4s, aPTT >1.5×ULN) or anticoagulant use.
- Proteinuria ≥++ on dipstick or 24-h urine protein ≥1 g.
- Other high-risk conditions per investigator judgment.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
Anzahl der Gruppen / Kohorten
Kohorten und Interventionen
Gruppe / KohorteGruppe / Kohorte |
Intervention / BehandlungIntervention / Behandlung |
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Cohort 1: GP + adebrelimab
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Adebrelimab administered intravenously at [1200mg] on day 1 of each 21-day cycle, for up to 17 cycles, common to all three cohorts.
Gemcitabine administered intravenously at [1000 mg/m^2] on days 1 and 8 of each [21]-day cycle, for up to 8 cycles, in combination with cisplatin and adebrelimab,
Cisplatin administered intravenously at [25 mg/m^2] on days 1 and 8 of each [21]-day cycle, for up to 8 cycles, in combination with gemcitabine and adebrelimab.
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Cohort 2: Apatinib + adebrelimab
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Adebrelimab administered intravenously at [1200mg] on day 1 of each 21-day cycle, for up to 17 cycles, common to all three cohorts.
Apatinib administered orally at [250mg] once daily continuously, for up to 17 cycles, in combination with adebrelimab.
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Cohort 3: S-1 + adebrelimab
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Adebrelimab administered intravenously at [1200mg] on day 1 of each 21-day cycle, for up to 17 cycles, common to all three cohorts.
S-1 (tegafur/gimeracil/oteracil) administered orally twice daily on days 1-14 of each 21-day cycle, dosed according to body surface area, for up to 8 cycles, in combination with adebrelimab.
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
|---|---|
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Recurrence-Free Survival (RFS)
Zeitfenster: Through study completion, an average of 4 years
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Through study completion, an average of 4 years
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
|---|---|
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Overall Survival (OS)
Zeitfenster: Through study completion, an average of 4 years
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Through study completion, an average of 4 years
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Shunda Du, Peking Union Medical College Hospital (PUMCH)
- Hauptermittler: Mei Guan, Peking Union Medical College Hospital (PUMCH)
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Neubildungen
- Neubildungen nach histologischem Typ
- Neubildungen, Drüsen und Epithelien
- Adenokarzinom
- Karzinom
- Cholangiokarzinom
- Zirrhose, familiär, mit pulmonaler Hypertonie
- Heterocyclische Verbindungen, 1-Ring
- Heterocyclische Verbindungen
- Anorganische Chemikalien
- Chlorverbindungen
- Stickstoffverbindungen
- Desoxycytidin
- Cytidin
- Pyrimidin -Nucleoside
- Pyrimidine
- Platinverbindungen
- Gemcitabin
- Cisplatin
- Apatinib
- S 1 (Kombination)
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- I-25PJ1046
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