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Immunotherapie (toripalimab) voor het voorkomen van herhaling na de operatie voor mismatch -reparatie deficiënt stadium IIB, IIC of III darmkanker

30 september 2026 bijgewerkt door: Oluwadunni Emiloju, Emory University

Een fase II -studie van adjuvante toripalimab bij gelokaliseerde darmkanker met een hoog risico met niet -overeenkomende reparatie -tekort

This phase II trial tests how well immunotherapy (toripalimab) works for reducing the risk of cancer recurrence after surgery in patients with mismatch repair deficient stage IIB, IIC, or III colon cancer.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

PRIMARY OBJECTIVE:

I. Evaluate the efficacy of adjuvant toripalimab in patients with resected stage IIB, IIC, and III mismatch repair deficient (dMMR) colon cancer by measuring 3-year disease-free survival.

SECONDARY OBJECTIVES:

I. Define the immune related toxicity profile of toripalimab in the adjuvant setting.

II. Further evaluate the efficacy of adjuvant toripalimab specifically by measuring 3-year relapse free survival (RFS), 5-year disease free survival (DFS), and 5-year overall survival.

TERTIARY/EXPLORATORY OBJECTIVES:

I. To explore immune, ctDNA, and omic markers associated with clinical efficacy (DFS).

II. To assess patient reported outcomes (PRO) and health related quality of life (QoL).

OUTLINE:

Eligible consenting participants will receive toripalimab intravenously every 3 weeks for 6 months (8 doses) in the absence of disease recurrence or unacceptable toxicity. After completion of study treatment, patients are followed up every 6 months until 5 years post-resection. After completion of study medication, participants undergo surveillance follow up with blood tests, computed tomography (CT) scans, colonoscopy at specified intervals until 5 years post-resection. Patient reported outcomes and quality of life will also be assessed with questionnaires.

Studietype

Ingrijpend

Inschrijving (Geschat)

40

Fase

  • Fase 2

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Studie Locaties

  • Verenigde Staten
    • Georgia
      • Atlanta, Georgia, Verenigde Staten, 30322
        • Werving
        • Emory University Hospital/Winship Cancer Institute
        • Hoofdonderzoeker:
          • Oluwadunni E. Emiloju, MBBS, MS
        • Contact:
      • Atlanta, Georgia, Verenigde Staten, 30308
        • Werving
        • Emory University Hospital Midtown
        • Contact:
        • Hoofdonderzoeker:
          • Oluwadunni E. Emiloju, MBBS, MS
      • Atlanta, Georgia, Verenigde Staten, 30342
        • Werving
        • Emory Saint Joseph's Hospital
        • Hoofdonderzoeker:
          • Oluwadunni E. Emiloju, MBBS, MS
        • Contact:
      • Atlanta, Georgia, Verenigde Staten, 30033
        • Werving
        • Emory Decatur Hospital
        • Hoofdonderzoeker:
          • Oluwadunni Emiloju
        • Contact:
      • Johns Creek, Georgia, Verenigde Staten, 30097
        • Werving
        • Emory Johns Creek Hospital
        • Hoofdonderzoeker:
          • Oluwadunni E. Emiloju, MBBS, MS
        • Contact:

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Patients with resected pathologic stage IIB, IIC and III dMMR colon cancer (American Joint Committee on Cancer [AJCC] 8)

  • Deficient mismatch repair (MMR) by immunohistochemistry or microsatellite instability (MSI-H) by polymerase chain reaction (PCR) or next generation sequencing (NGS)

  • Complete (R0) resection of pathologic stage IIB, IIC and III dMMR colon cancer 4 to 12 weeks prior to first dose of study drug

  • Available tissue sample from surgical specimen

  • Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2

  • Absolute neutrophil count (ANC) ≥ 1,000 /mcL

  • Platelets ≥ 75,000 / mcL

  • Hemoglobin ≥ 9 g/dL or ≥ 5.0 mmol/L

    • Transfusion is allowed to obtain an adequate hemoglobin level

  • Creatinine ≤ 1.5 x upper limit of normal (ULN) or measured or calculated creatinine clearance ≥ 40 mL/min for patient with creatinine levels > 1.5 x institutional ULN (glomerular filtration rate [GFR] can also be used in place of creatinine or creatinine clearance [CrCl])

    • Creatinine clearance should be calculated per institutional standard

  • Total bilirubin ≤ 1.5 x ULN or direct bilirubin ≤ ULN for patients with total bilirubin levels > 1.5 x ULN

    • Patients with previously diagnosed Gilbert syndrome can have total bilirubin < 3.0 mg/dL

  • Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 3 x ULN

  • Alkaline phosphatase ≤ 3 x ULN

  • Signed informed consent

  • Patients at least 18 years of age

  • Colonoscopy should be performed before surgery and if synchronous colon cancers are present, both must have deficient MMR and both must have undergone complete resection for patient to be eligible. If colonoscopy was not done pre-operatively, the patient may still be eligible if all other inclusion criteria are met. It should however be performed within 6 months after initial colon resection surgery

  • Women of child bearing potential (WOCBP) must have a negative serum (or urine) pregnancy test within 72 hours prior to the first dose of study treatment. WOCBP are women younger than 55 years (yrs) of age excluding those who are surgically unable to get pregnant due to prior hysterectomy and or bilateral salpingo-oophorectomy

  • Patients of childbearing / reproductive potential should use adequate birth control methods, as defined by the investigator, during the study treatment period and for a period of 90 days after the last dose of study drug. A highly effective method of birth control is defined as those which result in low failure rate (i.e. less than 1% per year) when used consistently and correctly. Abstinence is acceptable if this is established and preferred contraception for the patient and is accepted as a local standard

  • Female patients who are breast feeding should discontinue nursing prior to the first dose of study treatment and until 90 days after the last dose of study drug

Exclusion Criteria:

  • Neoadjuvant treatment for dMMR colon cancer
  • Presence of metastatic dMMR colon cancer
  • Underlying medical conditions that, in the investigator's opinion, will make the administration of the study drug hazardous or obscure the interpretation of adverse events
  • Uncontrolled psychiatric illness or psychological condition potentially hampering compliance with the study protocol and follow-up schedule
  • History of pneumonitis requiring treatment with steroids, or history of interstitial lung disease
  • History of prior malignancy other than the cancer under study, that is progressing or has required active treatment within the past 3 years. Exceptions include adequately treated basal cell or squamous cell carcinoma of skin, superficial bladder cancer, in situ cervical cancer, in situ breast cancer, other in situ cancers, prostate cancer with a Gleason score ≤6 that does not need therapy or other local tumors that are considered cured.
  • Autoimmune disease that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. Patients with vitiligo, diabetes mellitus type 1, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, controlled psoriasis or resolved childhood asthma/atopy not requiring systemic treatment can be enrolled
  • Active hepatitis B or hepatitis C
  • Systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment
  • Treatment with live vaccines within 30 days prior to the first dose of study medication. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, chicken pox, yellow fever, nasal seasonal flu, H1N1 flu, rabies, Bacille Calmette Guerin (BCG) and typhoid vaccine
  • Prior treatment with any immune checkpoint inhibitor
  • Current pregnancy or breastfeeding

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Treatment (toripalimab)

Eligible consenting participants receive toripalimab intravenously every 3 weeks for 6 months (8 doses) in the absence of disease recurrence or unacceptable toxicity. Following this, patients undergo surveillance follow up with blood tests, computed tomography (CT) scans, colonoscopy at specified intervals until 5 years post-resection. For patients who have a recurrence, a biopsy will be performed at the time of recurrence.
Procedure: Computed Tomography

Undergo CT

Andere namen:
  • CT
  • Computergestuurde tomografie
  • CT-scan
  • Computertomografie (CT)-scan
Ander: Questionnaire Administration

Ancillary studies

Procedure: Biopsy Procedure

Undergo biopsy

Andere namen:
  • BIOSY_TYPE
  • Biopsie
Procedure: Biospecimen Collection

Undergo collection of blood samples

Andere namen:
  • Specimenverzameling
Procedure: Colonoscopy

Undergo colonoscopy

Geneesmiddel: Toripalimab

Given IV

Andere namen:
  • JS-001
  • Loqtorzi
  • Toripalimab-tpzi
  • Anti-PD-1 monoklonaal antilichaam JS001

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
3-year Disease free survival (DFS)
Tijdsspanne: Time between the date of registration and the first date of documented recurrence or death due to any cause assessed up to 3 years

Time between the date of registration and the first date of documented recurrence, regardless of discontinuation of study drug, or death due to any cause, assessed at 3 years
Time between the date of registration and the first date of documented recurrence or death due to any cause assessed up to 3 years

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Incidence of treatment-related adverse events
Tijdsspanne: Up to 5 years

Safety will be determined according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5. Treatment-related adverse events (defined as potentially, probably and definitely) will be summarized in preferred term by system organ class and listed on an individual subject basis at patient level. Immune-related adverse events will also be tabulated.
Up to 5 years
3-year Relapse free survival (RFS)
Tijdsspanne: Time between the date of registration and the first date of documented disease recurrence assessed up to 3 years.

Time between the date of registration and the first date of documented disease recurrence, assessed at 3 years
Time between the date of registration and the first date of documented disease recurrence assessed up to 3 years.
5-year DFS
Tijdsspanne: Time between the date of registration and the first date of documented recurrence, or death due to any cause assessed up to 5 years

Time between the date of registration and the first date of documented recurrence, regardless of discontinuation of study drug, or death due to any cause, assessed at 5 years.
Time between the date of registration and the first date of documented recurrence, or death due to any cause assessed up to 5 years
Colon cancer specific survival (CCSC)
Tijdsspanne: Time between the date of registration and the date of death due to colon cancer, assessed up to 5 years

CCSC is the time between the date of registration and the date of death due to colon cancer, assessed up to 5 years
Time between the date of registration and the date of death due to colon cancer, assessed up to 5 years
Overall survival (OS)
Tijdsspanne: Time between the date of registration and the date of death due to any cause, assessed up to 5 years

Time between the date of registration and the date of death due to any cause.
Time between the date of registration and the date of death due to any cause, assessed up to 5 years

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Emory University

Medewerkers

National Cancer Institute (NCI)
Coherus Oncology, Inc.

Onderzoekers

  • Hoofdonderzoeker: Oluwadunni E. Emiloju, MBBS, MS, Emory University Hospital/Winship Cancer Institute

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

19 september 2025

Primaire voltooiing (Geschat)

31 juli 2029

Studie voltooiing (Geschat)

31 december 2031

Studieregistratiedata

Eerst ingediend

22 augustus 2025

Eerst ingediend dat voldeed aan de QC-criteria

22 augustus 2025

Eerst geplaatst (Werkelijk)

25 augustus 2025

Updates van studierecords

Laatste update geplaatst (Werkelijk)

2 oktober 2026

Laatste update ingediend die voldeed aan QC-criteria

30 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • STUDY00008833
  • P30CA138292 (Subsidie/contract van de Amerikaanse NIH)
  • STUDY00008833 (Andere identificatie: Emory University Hospital/Winship Cancer Institute)
  • NCI-2025-05423 (Register-ID: CTRP (Clinical Trial Reporting Program))
  • WINSHIP6483-24 (Andere identificatie: Emory University Hospital/Winship Cancer Institute)

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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