- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT04751370
Testen von Nivolumab und Ipilimumab mit Kurzzeitbestrahlung bei lokal fortgeschrittenem Rektumkarzinom
Eine Phase-II-Studie mit neoadjuvantem Nivolumab plus Ipilimumab und Kurzzeitbestrahlung bei lokal fortgeschrittenem rektalem Adenokarzinom mit MSI-H/dMMR
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.
Studienübersicht
Status
Bedingungen
Detaillierte Beschreibung
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.
Studientyp
Einschreibung (Geschätzt)
Phase
- Phase 2
Kontakte und Standorte
Studienorte
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Alabama
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Mobile, Alabama, Vereinigte Staaten, 36607
- Mobile Infirmary Medical Center
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Alaska
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Anchorage, Alaska, Vereinigte Staaten, 98508
- Anchorage Associates in Radiation Medicine
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Anchorage, Alaska, Vereinigte Staaten, 99508
- Alaska Breast Care and Surgery LLC
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Anchorage, Alaska, Vereinigte Staaten, 99508
- Alaska Oncology and Hematology LLC
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Anchorage, Alaska, Vereinigte Staaten, 99508
- Alaska Women's Cancer Care
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Anchorage, Alaska, Vereinigte Staaten, 99508
- Anchorage Oncology Centre
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Anchorage, Alaska, Vereinigte Staaten, 99508
- Katmai Oncology Group
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Anchorage, Alaska, Vereinigte Staaten, 99508
- Providence Alaska Medical Center
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Arizona
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Phoenix, Arizona, Vereinigte Staaten, 85004
- Cancer Center at Saint Joseph's
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Arkansas
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Fort Smith, Arkansas, Vereinigte Staaten, 72903
- Mercy Hospital Fort Smith
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Hot Springs, Arkansas, Vereinigte Staaten, 71913
- CHI Saint Vincent Cancer Center Hot Springs
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California
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Arroyo Grande, California, Vereinigte Staaten, 93420
- PCR Oncology
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Burbank, California, Vereinigte Staaten, 91505
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
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Los Angeles, California, Vereinigte Staaten, 90033
- USC / Norris Comprehensive Cancer Center
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Orange, California, Vereinigte Staaten, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
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San Luis Obispo, California, Vereinigte Staaten, 93401
- Pacific Central Coast Health Center-San Luis Obispo
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Santa Maria, California, Vereinigte Staaten, 93444
- Mission Hope Medical Oncology - Santa Maria
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Colorado
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Colorado Springs, Colorado, Vereinigte Staaten, 80907
- Penrose-Saint Francis Healthcare
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Colorado Springs, Colorado, Vereinigte Staaten, 80907
- Rocky Mountain Cancer Centers-Penrose
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Denver, Colorado, Vereinigte Staaten, 80210
- AdventHealth Porter
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Lakewood, Colorado, Vereinigte Staaten, 80228
- CommonSpirit Saint Anthony Hospital Cancer Center
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Littleton, Colorado, Vereinigte Staaten, 80122
- AdventHealth Littleton
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Longmont, Colorado, Vereinigte Staaten, 80501
- Longmont United Hospital
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Parker, Colorado, Vereinigte Staaten, 80138
- AdventHealth Parker
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Pueblo, Colorado, Vereinigte Staaten, 81004
- Saint Mary Corwin Medical Center
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Delaware
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Millville, Delaware, Vereinigte Staaten, 19967
- Beebe South Coastal Health Campus
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Newark, Delaware, Vereinigte Staaten, 19713
- Helen F Graham Cancer Center
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Newark, Delaware, Vereinigte Staaten, 19713
- Medical Oncology Hematology Consultants PA
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Rehoboth Beach, Delaware, Vereinigte Staaten, 19971
- Beebe Health Campus
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Florida
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Altamonte Springs, Florida, Vereinigte Staaten, 32701
- AdventHealth Altamonte
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Orlando, Florida, Vereinigte Staaten, 32803
- AdventHealth Orlando
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Idaho
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Boise, Idaho, Vereinigte Staaten, 83706
- Saint Alphonsus Cancer Care Center-Boise
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Boise, Idaho, Vereinigte Staaten, 83712
- Saint Luke's Cancer Institute - Boise
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Caldwell, Idaho, Vereinigte Staaten, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
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Coeur d'Alene, Idaho, Vereinigte Staaten, 83814
- Kootenai Health - Coeur d'Alene
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Fruitland, Idaho, Vereinigte Staaten, 83619
- Saint Luke's Cancer Institute - Fruitland
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Meridian, Idaho, Vereinigte Staaten, 83642
- Idaho Urologic Institute-Meridian
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Meridian, Idaho, Vereinigte Staaten, 83642
- Saint Luke's Cancer Institute - Meridian
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Nampa, Idaho, Vereinigte Staaten, 83687
- Saint Alphonsus Cancer Care Center-Nampa
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Nampa, Idaho, Vereinigte Staaten, 83687
- Saint Luke's Cancer Institute - Nampa
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Post Falls, Idaho, Vereinigte Staaten, 83854
- Kootenai Clinic Cancer Services - Post Falls
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Twin Falls, Idaho, Vereinigte Staaten, 83301
- Saint Luke's Cancer Institute - Twin Falls
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Illinois
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Bloomington, Illinois, Vereinigte Staaten, 61704
- Illinois CancerCare-Bloomington
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Canton, Illinois, Vereinigte Staaten, 61520
- Illinois CancerCare-Canton
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Carbondale, Illinois, Vereinigte Staaten, 62902
- Memorial Hospital of Carbondale
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Carterville, Illinois, Vereinigte Staaten, 62918
- SIH Cancer Institute
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Carthage, Illinois, Vereinigte Staaten, 62321
- Illinois CancerCare-Carthage
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Centralia, Illinois, Vereinigte Staaten, 62801
- Centralia Oncology Clinic
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Chicago, Illinois, Vereinigte Staaten, 60612
- University of Illinois
-
Danville, Illinois, Vereinigte Staaten, 61832
- Carle at The Riverfront
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Decatur, Illinois, Vereinigte Staaten, 62526
- Decatur Memorial Hospital
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Decatur, Illinois, Vereinigte Staaten, 62526
- Cancer Care Specialists of Illinois - Decatur
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Dixon, Illinois, Vereinigte Staaten, 61021
- Illinois CancerCare-Dixon
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Effingham, Illinois, Vereinigte Staaten, 62401
- Crossroads Cancer Center
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Effingham, Illinois, Vereinigte Staaten, 62401
- Carle Physician Group-Effingham
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Eureka, Illinois, Vereinigte Staaten, 61530
- Illinois CancerCare-Eureka
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Galesburg, Illinois, Vereinigte Staaten, 61401
- Western Illinois Cancer Treatment Center
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Galesburg, Illinois, Vereinigte Staaten, 61401
- Illinois CancerCare-Galesburg
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Kewanee, Illinois, Vereinigte Staaten, 61443
- Illinois CancerCare-Kewanee Clinic
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Macomb, Illinois, Vereinigte Staaten, 61455
- Illinois CancerCare-Macomb
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Mattoon, Illinois, Vereinigte Staaten, 61938
- Carle Physician Group-Mattoon/Charleston
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Mount Vernon, Illinois, Vereinigte Staaten, 62864
- SSM Health Good Samaritan
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O'Fallon, Illinois, Vereinigte Staaten, 62269
- Cancer Care Center of O'Fallon
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Ottawa, Illinois, Vereinigte Staaten, 61350
- Illinois CancerCare-Ottawa Clinic
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Pekin, Illinois, Vereinigte Staaten, 61554
- Illinois CancerCare-Pekin
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Pekin, Illinois, Vereinigte Staaten, 61554
- OSF Saint Francis Radiation Oncology at Pekin
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Peoria, Illinois, Vereinigte Staaten, 61636
- Methodist Medical Center of Illinois
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Peoria, Illinois, Vereinigte Staaten, 61637
- OSF Saint Francis Medical Center
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Peoria, Illinois, Vereinigte Staaten, 61615
- Illinois CancerCare-Peoria
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Peoria, Illinois, Vereinigte Staaten, 61615
- OSF Saint Francis Radiation Oncology at Peoria Cancer Center
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Peru, Illinois, Vereinigte Staaten, 61354
- Illinois CancerCare-Peru
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Peru, Illinois, Vereinigte Staaten, 61354
- Valley Radiation Oncology
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Princeton, Illinois, Vereinigte Staaten, 61356
- Illinois CancerCare-Princeton
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Springfield, Illinois, Vereinigte Staaten, 62702
- Southern Illinois University School of Medicine
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Springfield, Illinois, Vereinigte Staaten, 62702
- Springfield Clinic
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Springfield, Illinois, Vereinigte Staaten, 62781
- Springfield Memorial Hospital
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Urbana, Illinois, Vereinigte Staaten, 61801
- Carle Cancer Center
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Washington, Illinois, Vereinigte Staaten, 61571
- Illinois CancerCare - Washington
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Iowa
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Ames, Iowa, Vereinigte Staaten, 50010
- Mary Greeley Medical Center
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Ames, Iowa, Vereinigte Staaten, 50010
- McFarland Clinic - Ames
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Carroll, Iowa, Vereinigte Staaten, 51401
- Saint Anthony Regional Hospital
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Clive, Iowa, Vereinigte Staaten, 50325
- Mercy Cancer Center-West Lakes
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Clive, Iowa, Vereinigte Staaten, 50325
- UI Health Care Mission Cancer and Blood - West Des Moines Clinic
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Creston, Iowa, Vereinigte Staaten, 50801
- Greater Regional Medical Center
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Des Moines, Iowa, Vereinigte Staaten, 50309
- Iowa Methodist Medical Center
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Des Moines, Iowa, Vereinigte Staaten, 50314
- Mercy Medical Center - Des Moines
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Des Moines, Iowa, Vereinigte Staaten, 50314
- Broadlawns Medical Center
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Des Moines, Iowa, Vereinigte Staaten, 50316
- Iowa Lutheran Hospital
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Des Moines, Iowa, Vereinigte Staaten, 50309
- UI Health Care Mission Cancer and Blood - Des Moines Clinic
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Des Moines, Iowa, Vereinigte Staaten, 50314
- UI Health Care Mission Cancer and Blood - Laurel Clinic
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West Des Moines, Iowa, Vereinigte Staaten, 50266-7700
- Methodist West Hospital
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West Des Moines, Iowa, Vereinigte Staaten, 50266
- Mercy Medical Center-West Lakes
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Kansas
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Garden City, Kansas, Vereinigte Staaten, 67846
- Central Care Cancer Center - Garden City
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Great Bend, Kansas, Vereinigte Staaten, 67530
- Central Care Cancer Center - Great Bend
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Kentucky
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Lexington, Kentucky, Vereinigte Staaten, 40504
- Saint Joseph Radiation Oncology Resource Center
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Lexington, Kentucky, Vereinigte Staaten, 40509
- CommonSpirit Saint Joseph Medical Center - East Lexington
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Louisville, Kentucky, Vereinigte Staaten, 40202
- Jewish Hospital
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Louisville, Kentucky, Vereinigte Staaten, 40245
- UofL Health Medical Center Northeast
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Massachusetts
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Springfield, Massachusetts, Vereinigte Staaten, 01199
- Baystate Medical Center
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Worcester, Massachusetts, Vereinigte Staaten, 01655
- UMass Memorial Medical Center - University Campus
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Minnesota
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Burnsville, Minnesota, Vereinigte Staaten, 55337
- Fairview Ridges Hospital
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Burnsville, Minnesota, Vereinigte Staaten, 55337
- Minnesota Oncology - Burnsville
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Coon Rapids, Minnesota, Vereinigte Staaten, 55433
- Mercy Hospital
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Edina, Minnesota, Vereinigte Staaten, 55435
- Fairview Southdale Hospital
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Fridley, Minnesota, Vereinigte Staaten, 55432
- Unity Hospital
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Maple Grove, Minnesota, Vereinigte Staaten, 55369
- Fairview Clinics and Surgery Center Maple Grove
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Maplewood, Minnesota, Vereinigte Staaten, 55109
- Saint John's Hospital - Healtheast
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Maplewood, Minnesota, Vereinigte Staaten, 55109
- Minnesota Oncology Hematology PA-Maplewood
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Minneapolis, Minnesota, Vereinigte Staaten, 55415
- Hennepin County Medical Center
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Minneapolis, Minnesota, Vereinigte Staaten, 55407
- Abbott-Northwestern Hospital
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Monticello, Minnesota, Vereinigte Staaten, 55362
- Monticello Cancer Center
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Robbinsdale, Minnesota, Vereinigte Staaten, 55422
- North Memorial Medical Health Center
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Rochester, Minnesota, Vereinigte Staaten, 55905
- Mayo Clinic in Rochester
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Saint Louis Park, Minnesota, Vereinigte Staaten, 55416
- Park Nicollet Clinic - Saint Louis Park
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Saint Paul, Minnesota, Vereinigte Staaten, 55101
- Regions Hospital
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Saint Paul, Minnesota, Vereinigte Staaten, 55102
- United Hospital
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Shakopee, Minnesota, Vereinigte Staaten, 55379
- Saint Francis Regional Medical Center
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Waconia, Minnesota, Vereinigte Staaten, 55387
- Ridgeview Medical Center
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Willmar, Minnesota, Vereinigte Staaten, 56201
- Rice Memorial Hospital
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Woodbury, Minnesota, Vereinigte Staaten, 55125
- Minnesota Oncology Hematology PA-Woodbury
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Missouri
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Ballwin, Missouri, Vereinigte Staaten, 63011
- Mercy Oncology and Hematology - Clayton-Clarkson
-
Bolivar, Missouri, Vereinigte Staaten, 65613
- Central Care Cancer Center - Bolivar
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Cape Girardeau, Missouri, Vereinigte Staaten, 63703
- Saint Francis Medical Center
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Cape Girardeau, Missouri, Vereinigte Staaten, 63703
- Mercy Cancer Center - Cape Girardeau
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Farmington, Missouri, Vereinigte Staaten, 63640
- Parkland Health Center - Farmington
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Jefferson City, Missouri, Vereinigte Staaten, 65109
- MU Health Care Goldschmidt Cancer Center
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Joplin, Missouri, Vereinigte Staaten, 64804
- Freeman Health System
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Joplin, Missouri, Vereinigte Staaten, 64804
- Mercy Hospital Joplin
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Rolla, Missouri, Vereinigte Staaten, 65401
- Mercy Clinic-Rolla-Cancer and Hematology
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Rolla, Missouri, Vereinigte Staaten, 65401
- Phelps Health Delbert Day Cancer Institute
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Saint Joseph, Missouri, Vereinigte Staaten, 64506
- Heartland Regional Medical Center
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Sainte Genevieve, Missouri, Vereinigte Staaten, 63670
- Sainte Genevieve County Memorial Hospital
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Springfield, Missouri, Vereinigte Staaten, 65807
- CoxHealth South Hospital
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Springfield, Missouri, Vereinigte Staaten, 65804
- Mercy Hospital Springfield
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St Louis, Missouri, Vereinigte Staaten, 63131
- Missouri Baptist Medical Center
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St Louis, Missouri, Vereinigte Staaten, 63141
- Mercy Hospital Saint Louis
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St Louis, Missouri, Vereinigte Staaten, 63128
- Mercy Hospital South
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Sullivan, Missouri, Vereinigte Staaten, 63080
- Missouri Baptist Sullivan Hospital
-
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Montana
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Billings, Montana, Vereinigte Staaten, 59101
- Billings Clinic Cancer Center
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Bozeman, Montana, Vereinigte Staaten, 59715
- Bozeman Health Deaconess Hospital
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Great Falls, Montana, Vereinigte Staaten, 59405
- Great Falls Clinic
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Great Falls, Montana, Vereinigte Staaten, 59405
- Benefis Sletten Cancer Institute
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Kalispell, Montana, Vereinigte Staaten, 59901
- Logan Health Medical Center
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Missoula, Montana, Vereinigte Staaten, 59802
- Saint Patrick Hospital - Community Hospital
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Missoula, Montana, Vereinigte Staaten, 59804
- Community Medical Center
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Nebraska
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Grand Island, Nebraska, Vereinigte Staaten, 68803
- Nebraska Cancer Specialists/Oncology Hematology West PC
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Kearney, Nebraska, Vereinigte Staaten, 68847
- CHI Health Good Samaritan
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Omaha, Nebraska, Vereinigte Staaten, 68124
- Alegent Health Bergan Mercy Medical Center
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Omaha, Nebraska, Vereinigte Staaten, 68122
- Alegent Health Immanuel Medical Center
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Omaha, Nebraska, Vereinigte Staaten, 68130
- Alegent Health Lakeside Hospital
-
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Nevada
-
Henderson, Nevada, Vereinigte Staaten, 89052
- Comprehensive Cancer Centers of Nevada - Henderson
-
Henderson, Nevada, Vereinigte Staaten, 89074
- Oncology Las Vegas - Henderson
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Las Vegas, Nevada, Vereinigte Staaten, 89102
- OptumCare Cancer Care at Charleston
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Las Vegas, Nevada, Vereinigte Staaten, 89106
- Radiation Oncology Centers of Nevada Central
-
Las Vegas, Nevada, Vereinigte Staaten, 89119
- Radiation Oncology Centers of Nevada Southeast
-
Las Vegas, Nevada, Vereinigte Staaten, 89128
- Comprehensive Cancer Centers of Nevada - Northwest
-
Las Vegas, Nevada, Vereinigte Staaten, 89128
- OptumCare Cancer Care at MountainView
-
Las Vegas, Nevada, Vereinigte Staaten, 89135
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
-
Las Vegas, Nevada, Vereinigte Staaten, 89144
- Comprehensive Cancer Centers of Nevada - Town Center
-
Las Vegas, Nevada, Vereinigte Staaten, 89144
- Comprehensive Cancer Centers of Nevada-Summerlin
-
Las Vegas, Nevada, Vereinigte Staaten, 89148
- Comprehensive Cancer Centers of Nevada
-
Las Vegas, Nevada, Vereinigte Staaten, 89169
- Comprehensive Cancer Centers of Nevada - Central Valley
-
Las Vegas, Nevada, Vereinigte Staaten, 89183
- OptumCare Cancer Care at Fort Apache
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Reno, Nevada, Vereinigte Staaten, 89502
- Renown Regional Medical Center
-
Reno, Nevada, Vereinigte Staaten, 89503
- Saint Mary's Regional Medical Center
-
Reno, Nevada, Vereinigte Staaten, 89509
- Radiation Oncology Associates
-
-
New Hampshire
-
Concord, New Hampshire, Vereinigte Staaten, 03301
- New Hampshire Oncology Hematology PA-Concord
-
Lebanon, New Hampshire, Vereinigte Staaten, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
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Manchester, New Hampshire, Vereinigte Staaten, 03103
- Solinsky Center for Cancer Care
-
-
New York
-
Lake Success, New York, Vereinigte Staaten, 11042
- Northwell Health/Center for Advanced Medicine
-
Middletown, New York, Vereinigte Staaten, 10940
- Garnet Health Medical Center
-
Mount Kisco, New York, Vereinigte Staaten, 10549
- Northern Westchester Hospital
-
New York, New York, Vereinigte Staaten, 10075
- Lenox Hill Hospital
-
New York, New York, Vereinigte Staaten, 10065
- Manhattan Eye Ear and Throat Hospital
-
-
Ohio
-
Cincinnati, Ohio, Vereinigte Staaten, 45220
- Good Samaritan Hospital - Cincinnati
-
Cincinnati, Ohio, Vereinigte Staaten, 45242
- Bethesda North Hospital
-
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Oklahoma
-
Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
- University of Oklahoma Health Sciences Center
-
Oklahoma City, Oklahoma, Vereinigte Staaten, 73120
- Mercy Hospital Oklahoma City
-
-
Oregon
-
Bend, Oregon, Vereinigte Staaten, 97701
- Saint Charles Health System
-
Clackamas, Oregon, Vereinigte Staaten, 97015
- Clackamas Radiation Oncology Center
-
Clackamas, Oregon, Vereinigte Staaten, 97015
- Providence Cancer Institute Clackamas Clinic
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Coos Bay, Oregon, Vereinigte Staaten, 97420
- Bay Area Hospital
-
Newberg, Oregon, Vereinigte Staaten, 97132
- Providence Newberg Medical Center
-
Portland, Oregon, Vereinigte Staaten, 97213
- Providence Portland Medical Center
-
Portland, Oregon, Vereinigte Staaten, 97225
- Providence Saint Vincent Medical Center
-
-
Pennsylvania
-
Chadds Ford, Pennsylvania, Vereinigte Staaten, 19317
- Christiana Care Health System-Concord Health Center
-
-
South Dakota
-
Rapid City, South Dakota, Vereinigte Staaten, 57701
- Rapid City Regional Hospital
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Sioux Falls, South Dakota, Vereinigte Staaten, 57105
- Avera Cancer Institute
-
-
Tennessee
-
Nashville, Tennessee, Vereinigte Staaten, 37232
- Vanderbilt University/Ingram Cancer Center
-
Nashville, Tennessee, Vereinigte Staaten, 37204
- Vanderbilt Breast Center at One Hundred Oaks
-
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Texas
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Bryan, Texas, Vereinigte Staaten, 77802
- Saint Joseph Regional Cancer Center
-
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Vermont
-
Saint Johnsbury, Vermont, Vereinigte Staaten, 05819
- Dartmouth Cancer Center - North
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Washington
-
Aberdeen, Washington, Vereinigte Staaten, 98520
- Providence Regional Cancer System-Aberdeen
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Bellevue, Washington, Vereinigte Staaten, 98004
- Overlake Medical Center
-
Bellingham, Washington, Vereinigte Staaten, 98225
- PeaceHealth Saint Joseph Medical Center
-
Burien, Washington, Vereinigte Staaten, 98166
- Saint Anne Hospital
-
Centralia, Washington, Vereinigte Staaten, 98531
- Providence Regional Cancer System-Centralia
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Edmonds, Washington, Vereinigte Staaten, 98026
- Swedish Cancer Institute-Edmonds
-
Everett, Washington, Vereinigte Staaten, 98201
- Providence Regional Cancer Partnership
-
Issaquah, Washington, Vereinigte Staaten, 98029
- Swedish Cancer Institute-Issaquah
-
Lacey, Washington, Vereinigte Staaten, 98503
- Providence Regional Cancer System-Lacey
-
Longview, Washington, Vereinigte Staaten, 98632
- PeaceHealth Saint John Medical Center
-
Renton, Washington, Vereinigte Staaten, 98055
- Valley Medical Center
-
Seattle, Washington, Vereinigte Staaten, 98107
- Swedish Medical Center-Ballard Campus
-
Seattle, Washington, Vereinigte Staaten, 98122
- Swedish Medical Center-First Hill
-
Sedro-Woolley, Washington, Vereinigte Staaten, 98284
- PeaceHealth United General Medical Center
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Silverdale, Washington, Vereinigte Staaten, 98383
- Saint Joseph Medical Center Hematology and Oncology - Silverdale
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Vancouver, Washington, Vereinigte Staaten, 98664
- PeaceHealth Southwest Medical Center
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Walla Walla, Washington, Vereinigte Staaten, 99362
- Providence Saint Mary Regional Cancer Center
-
Yakima, Washington, Vereinigte Staaten, 98902
- North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
-
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Wisconsin
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Appleton, Wisconsin, Vereinigte Staaten, 54911
- ThedaCare Regional Cancer Center
-
New Richmond, Wisconsin, Vereinigte Staaten, 54017
- Cancer Center of Western Wisconsin
-
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Wyoming
-
Sheridan, Wyoming, Vereinigte Staaten, 82801
- Welch Cancer Center
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
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)
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Experimental: 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
Andere Namen:
Undergo CT
Andere Namen:
Undergo MRI
Andere Namen:
Given IV
Andere Namen:
Undergo sigmoidoscopy
Andere Namen:
Undergo short-course radiation therapy
Andere Namen:
Undergo TME
Andere Namen:
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
|---|---|
|
Pathologische vollständige Remission
Zeitfenster: Zum Zeitpunkt der totalen mesorektalen Exzision
|
Zum Zeitpunkt der totalen mesorektalen Exzision
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Rate of sphincter preservation in low-lying tumors
Zeitfenster: Up to 5 years
|
95% confidence interval will be estimated. |
Up to 5 years
|
|
Disease free survival
Zeitfenster: Up to 5 years
|
Kaplan-Meier method will be used. |
Up to 5 years
|
|
Overall survival
Zeitfenster: Up to 5 years
|
Kaplan-Meier method will be used. |
Up to 5 years
|
|
Incidence of adverse events
Zeitfenster: 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
|
Mitarbeiter und Ermittler
Sponsor
Ermittler
- Hauptermittler: Kristen K Ciombor, ECOG-ACRIN Cancer Research Group
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Neubildungen nach Standort
- Neubildungen
- Darmerkrankungen
- Gastrointestinale Neubildungen
- Neoplasmen des Verdauungssystems
- Erkrankungen des Verdauungssystems
- Magen-Darm-Erkrankungen
- Kolorektale Neubildungen
- Darmtumoren
- Rektale Erkrankungen
- Rektale Neoplasien
- Aminosäuren, Peptide und Proteine
- Proteine
- Untersuchungstechniken
- Therapeutika
- Diagnosetechniken und Verfahren
- Diagnose
- Chirurgische Eingriffe, operativ
- Minimal invasive chirurgische Verfahren
- Biologische Faktoren
- Physikalische Phänomene
- Antikörper, monoklonal, humanisiert
- Antikörper, monoklonal
- Antikörper
- Immunglobuline
- Immunoproteine
- Blutproteine
- Serumglobuline
- Globuline
- Diagnosetechniken, chirurgisch
- Endoskopie, gastrointestinal
- Endoskopie, Verdauungssystem
- Diagnosetechniken, Verdauungssystem
- Endoskopie
- Chirurgische Verfahren des Verdauungssystems
- Chemie -Techniken, analytisch
- Spektrumanalyse
- Rezeptoren, Zelloberfläche
- Membranproteine
- Antigene
- Koloskopie
- Antigene, Oberfläche
- Biomarker
- Rezeptoren, immunologisch
- Antigene, Differenzierung, T-Lymphozyten
- Antigene, Differenzierung
- Immun -Checkpoint -Proteine
- Kostimulierende und inhibitorische T-Zell-Rezeptoren
- Nivolumab
- Ipilimumab
- Strahlentherapie
- Strahlung
- Magnetresonanzspektroskopie
- Sigmoidoskopie
- CTLA-4-Antigen
Andere Studien-ID-Nummern
- NCI-2021-00912
- U10CA180820 (US NIH Stipendium/Vertrag)
- NCI-2021-00912 (Registrierungskennung: CTRP (Clinical Trial Reporting Program))
- EA2201 (Andere Kennung: CTEP)
- EA2201 (Andere Kennung: ECOG-ACRIN Cancer Research Group)
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
Beschreibung des IPD-Plans
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.
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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