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Perioperative Cadonilimab (AK104) in Locally Advanced MSI-H/dMMR Gastric or Gastroesophageal Junction and Colorectal Adenocarcinoma

2. november 2026 oppdatert av: Jiafu Ji, Peking University

A Multicenter, Open-Label, Phase II Study of Anti-PD-1/CTLA-4 Bispecific Antibody AK104 in the Perioperative Treatment of Locally Advanced Microsatellite Instability/Mismatch Repair Protein-Deficient Gastric and Colorectal Adenocarcinoma

The goal of this phase 2 clinical trial is to learn whether a medicine called cadonilimab (AK104) can safely and effectively treat certain stomach and colon cancers when it is given before and after surgery. Cadonilimab is a type of immunotherapy that targets PD-1 and CTLA-4. The study includes two groups of participants:

  • Cohort 1: people with locally advanced gastric or gastroesophageal junction adenocarcinoma
  • Cohort 2: people with locally advanced colorectal adenocarcinoma

All participants will have a tumor with a genetic change called MSI-H or dMMR and will be able to have surgery.The main question this study aims to answer is:• How many participants have no signs of cancer left in the tissue removed during surgery (pathologic complete response) after receiving cadonilimab?Other questions the study will look at include:

  • How long participants live overall and without the cancer coming back
  • How many participants have a major but not complete response in the removed tumor tissue
  • What side effects happen with cadonilimab before and after surgery

In this multicenter, single-arm trial, all participants will:

  • Receive cadonilimab by intravenous infusion every 3 weeks for 3 cycles before surgery
  • Have surgery to remove the tumor
  • May continue cadonilimab once a month for up to 6 months after surgery, or stop sooner if the cancer gets worse or side effects are not tolerable
  • Have regular clinic visits, blood tests, and scans so researchers can monitor their health and how the cancer responds to treatment

The study uses a two-stage design to decide whether cadonilimab shows enough benefit to justify further research.

Studieoversikt

Status

Aktiv, ikke rekrutterende

Studietype

Intervensjonell

Registrering (Antatt)

47

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Beijing Municipality
      • Beijing, Beijing Municipality, Kina, 100142
        • Peking University Cancer Hospital & Institute

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 80 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Written and signed informed consent.
  • Eastern Cooperative Oncology Group (ECOG) Performance Score of 0 or 1.
  • The estimated life expectancy of ≥3 months.
  • Confirmed MSI-H/dMMR status by the central laboratory.
  • For cohort 1, histologically or cytologically documented locally advanced gastric carcinoma(cT3-T4a, Nx, M0). For cohort 2, histologically or cytologically documented locally advanced colorectal cancer(cT3-T4a, Nx, M0).
  • Haven't received any chemotherapy or radiotherapy.
  • Adequate organ function.
  • All female and male subjects of reproductive potential must agree to use an effective method of contraception, as determined by the Investigator, during and for 120 days after the last dose of study treatment.

Exclusion Criteria:

  • Is currently participating in a study of an investigational agent or using an investigational device;
  • Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy within 2 years prior to the first dose of study treatment;
  • Has undergone major surgery within 30 days of Study Day 1;
  • Has a known additional malignancy that is progressing or requires systemic treatment. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer.
  • Has known active central nervous system (CNS) metastases;
  • Has carcinomatous meningitis;
  • Has an active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment NOTE: Subjects with vitiligo or resolved childhood asthma/atopy would be an exception to this rule. Subjects that require intermittent use of bronchodilators or local steroid injections would not be excluded from the study;
  • Has an active infection requiring systemic therapy;
  • Has known active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected);
  • History of myocardial infarction, unstable angina, cardiac or other vascular stenting, angioplasty, or surgery within 12 months prior to day 1 of study treatment;
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the best interest of this subject to participate, in the opinion of the treating investigator;
  • Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study;
  • Has received a live virus vaccine within 30 days of the planned first dose of study therapy;
  • Is pregnant, breastfeeding, or expecting to conceive or father a child within the projected duration of the study including 120 days following the last dose of study treatment;
  • Has any concurrent medical condition that, in the opinion of the Investigator, would complicate or compromise compliance with the study or the well-being of the subject.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: AK104 for Gastric/GEJ and Colorectal Adenocarcinoma

Participants with locally advanced MSI-H or dMMR gastric/GEJ and colorectal adenocarcinoma will receive neoadjuvant AK104 10 mg/kg by intravenous infusion every 3 weeks for 3 cycles. Surgery will be performed 3-6 weeks after completion of neoadjuvant treatment. After surgery, participants will receive postoperative AK104 6 mg/kg by intravenous infusion once monthly for up to 6 months or until disease progression, unacceptable toxicity, withdrawal of consent, or other discontinuation criteria are met.

Participants will receive AK104 10 mg/kg by intravenous infusion every 3 weeks for 3 cycles before surgery. Surgery will be performed 3-6 weeks after completion of neoadjuvant treatment. After surgery, participants will receive AK104 6 mg/kg by intravenous infusion once monthly for up to 6 months or until disease progression, unacceptable toxicity, withdrawal of consent, or other protocol-defined discontinuation criteria are met.

For participants with gastric or gastroesophageal junction adenocarcinoma, radical gastrectomy or gastroesophageal junction resection with appropriate lymphadenectomy will be performed according to tumor location and institutional standards. For participants with colorectal adenocarcinoma, radical colorectal resection with regional lymphadenectomy, will be performed according to tumor location and institutional standards.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
The rate of pathologic complete response
Tidsramme: After surgery, 3-6 weeks after the last neoadjuvant AK104 dose (up to 3 cycles; each cycle is 21 days).

Proportion of patients with locally advanced dMMR/MSI-H gastric or colorectal adenocarcinoma who receive neoadjuvant AK104 monotherapy and undergo surgery, who achieve a pathologic complete response based on blinded pathologic assessment by two pathologists with an associate senior professional title or higher.

After surgery, 3-6 weeks after the last neoadjuvant AK104 dose (up to 3 cycles; each cycle is 21 days).

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Major Pathologic Response (MPR) rate
Tidsramme: After surgery, 3-6 weeks after the last neoadjuvant AK104 dose (up to 3 cycles; each cycle is 21 days).

Proportion of participants who achieve a major pathologic response, defined as residual viable tumor (RVT) ≤10% in the resected primary tumor specimen.

After surgery, 3-6 weeks after the last neoadjuvant AK104 dose (up to 3 cycles; each cycle is 21 days).
R0 resection rate
Tidsramme: At surgery, 3-6 weeks after the last neoadjuvant AK104 dose (up to 3 cycles; each cycle is 21 days).

Proportion of participants who achieve an R0 resection, defined as microscopically margin-negative resection with no residual tumor at the resection margins.

At surgery, 3-6 weeks after the last neoadjuvant AK104 dose (up to 3 cycles; each cycle is 21 days).
Event-free survival (EFS)
Tidsramme: From the first dose of study treatment to the first EFS event or censoring, up to 5 years; EFS rates assessed at 12, 24, and 36 months.
From the first dose of study treatment to the first EFS event or censoring, up to 5 years; EFS rates assessed at 12, 24, and 36 months.
Disease-Free Survival (DFS)
Tidsramme: From the first dose of study treatment to the first DFS event or censoring, up to 5 years; DFS rates assessed at 12, 24, and 36 months.
From the first dose of study treatment to the first DFS event or censoring, up to 5 years; DFS rates assessed at 12, 24, and 36 months.
Overall survival (OS)
Tidsramme: From the first dose of study treatment to the first OS event or censoring, up to 5 years; OS rates assessed at 12, 24, and 36 months.
From the first dose of study treatment to the first OS event or censoring, up to 5 years; OS rates assessed at 12, 24, and 36 months.
Postoperative Complication Within 30 Days
Tidsramme: From the date of surgery through 30 days after surgery.
From the date of surgery through 30 days after surgery.
Adverse Events (AEs)
Tidsramme: From first dose to 30 days after the last study-treatment dose or start of other anticancer therapy, whichever occurs first; immune-related AEs through 90 days after the last AK104 dose, regardless of subsequent anticancer therapy.
From first dose to 30 days after the last study-treatment dose or start of other anticancer therapy, whichever occurs first; immune-related AEs through 90 days after the last AK104 dose, regardless of subsequent anticancer therapy.
Completion Rate of Postoperative Adjuvant Therapy
Tidsramme: From the first postoperative adjuvant dose to completion or discontinuation of the 6 planned cycles (each cycle is 28 days; planned duration is 24 weeks).
From the first postoperative adjuvant dose to completion or discontinuation of the 6 planned cycles (each cycle is 28 days; planned duration is 24 weeks).

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Hovedetterforsker: Jiafu Ji, Peking University Cancer Hospital & Institute

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. februar 2024

Primær fullføring (Antatt)

1. desember 2026

Studiet fullført (Antatt)

1. desember 2028

Datoer for studieregistrering

Først innsendt

14. september 2020

Først innsendt som oppfylte QC-kriteriene

14. september 2020

Først lagt ut (Faktiske)

21. september 2020

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

5. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

2. november 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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