Non-Operative Management and Following Immunotherapy for Colorectal Cancer and Other GI Cancers (NOMIC)
Non-Operative Management and Following Immunotherapy for Colorectal Cancer and Other GI Cancers (NOMIC Trial)
Studieöversikt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Studietyp
Studietyp
Inskrivning (Beräknad)
Inskrivning
Kontakter och platser
Studiekontakt
Studiekontakt
- Namn: Lin Wang Prof., M.D.
- Telefonnummer: 13910975011
- E-post: wanglinmd@foxmail.com
Studera Kontakt Backup
- Namn: Xiaokang Lei Dr., M.D.
Studieorter
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Haidian District
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Beijing, Haidian District, Kina, 100142
- Peking University Cancer Hospital
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Kontakt:
- Xiaokang Lei Dr., M.D.
- Telefonnummer: 18811181993
- E-post: lxkpku@163.com
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Deltagandekriterier
Urvalskriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Barn
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Testmetod
Studera befolkning
Beskrivning
Inclusion Criteria:
Retrospective Cohort Inclusion Criteria
- Pathologically confirmed gastrointestinal malignancy determined as MSI-H/dMMR or POLE mutation, and initially resectable.
- Completed prior immunotherapy.
- No evidence of distant metastasis.
- Managed with W&W, LE, endoscopic surgery, or radical operation after treatment.
Prospective Cohort Inclusion Criteria
- Pathologically confirmed gastrointestinal malignancy determined as MSI-H/dMMR or POLE mutation, and initially resectable.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
- Immunotherapy status: naive, currently receiving, or completed treatment, and evaluated by the PKUCH-NOMIC research group as cCR/near-cCR or Non-cCR (≤ ymrT2N0).
- No evidence of distant metastasis.
- Absence of emergencies requiring immediate surgery (e.g., hemorrhage, perforation, obstruction).
Exclusion Criteria:
- Recurrent gastrointestinal tumors.Initial presence of unresectable distant metastases.
- Serum creatinine > 1.5 times upper limit of normal (ULN).
- History of pelvic radiation therapy.Inability to tolerate MRI examinations.
- History of other malignancies within the past 5 years with a survival rate significantly lower than the historical rectal cancer survival data of this center (except adequately treated basal cell carcinoma, cutaneous squamous cell carcinoma, small renal cell carcinoma, breast cancer, and papillary thyroid carcinoma).
- Arterial thromboembolic events within the past 6 months (e.g., angina, myocardial infarction, transient ischemic attack [TIA], cerebral vascular accident [CVA]).
- Prior receipt of other types of investigational anti-tumor therapies.
- Pregnant or lactating women.
- Concomitant diseases or mental health conditions that may interfere with study participation.
Studieplan
Hur är studien utformad?
Designdetaljer
Antal grupper/kohorter
Kohorter och interventioner
Grupp / KohortGrupp / Kohort |
Intervention / BehandlingIntervention / Behandling |
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Experimental Cohort (NOM)
Patients achieving a clinical complete response (cCR) or near-cCR may undergo a "Watch & Wait" (W&W) strategy, while those with near-cCR or non-cCR (≤ymrT2N0$) may undergo local excision (LE) or endoscopic resection (ESD/EMR).
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Patients achieving a clinical complete response (cCR) or near-cCR may undergo a "Watch & Wait" (W&W) strategy, while those with near-cCR or non-cCR (≤ymrT2N0) may undergo local excision (LE) or endoscopic resection (ESD/EMR).
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Control arm
Patients undergoing radical operation (RO) will serve as the control cohort to compare oncological outcomes and safety data.
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Patients undergoing radical operation (RO) will serve as the control cohort to compare oncological outcomes and safety data.
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Vad mäter studien?
Primära resultatmått
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Organ Preservation Rate
Tidsram: 3 years after the completion of neoadjuvant immunotherapy.
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The proportion of patients successfully managed with NOM without the need for supplementary radical surgery, loss of organ function, or a permanent stoma (specifically for rectal cancer patients).
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3 years after the completion of neoadjuvant immunotherapy.
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Sekundära resultatmått
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Övergripande överlevnad (OS)
Tidsram: Upp till 5 år.
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Tid från början av behandlingen till döden från någon orsak.
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Upp till 5 år.
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Surgical Safety and Postoperative Complications
Tidsram: 3 years after the completion of neoadjuvant immunotherapy.
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Incidence and severity of perioperative complications classified by the Clavien-Dindo grading system, comparing RO, LE, and endoscopic resection (ESD/EMR).
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3 years after the completion of neoadjuvant immunotherapy.
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Distribution of Pathological Response (RO Group Only)
Tidsram: At the time of radical surgery (typically 4-12 weeks post-immunotherapy).
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Percentage of patients achieving ypCR, ypTisN0, ypT1-2N0, and ypT3+ in the radical surgery cohort to characterize pathological response after immunotherapy.
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At the time of radical surgery (typically 4-12 weeks post-immunotherapy).
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Local Regrowth Rate
Tidsram: Regular follow-up every 3-6 months for up to 3 years.
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The proportion of patients experiencing local tumor regrowth in the W&W group or after local/endoscopic excision.
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Regular follow-up every 3-6 months for up to 3 years.
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Disease-Free Survival (DFS)
Tidsram: Up to 5 years from enrollment/treatment initiation.
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Time from the initiation of neoadjuvant immunotherapy to the first documentation of disease recurrence (local, regional, or distant), progression, or death from any cause, comparing the NOM/OPFS group with the RO group.
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Up to 5 years from enrollment/treatment initiation.
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Samarbetspartners och utredare
Sponsor
Sponsor
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Studiestart
Primärt slutförande (Beräknad)
Primärt slutförande
Avslutad studie (Beräknad)
Avslutad studie
Studieregistreringsdatum
Först inskickad
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Första postat
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste uppdatering publicerad
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
Andra studie-ID-nummer
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