Sintilimab Plus Hypofractionated Radiotherapy for MSI-H/dMMR Rectal Cancer

Launched by WEST CHINA HOSPITAL · Nov 14, 2020

Keywords

ClinConnect Summary

This clinical trial is investigating a new treatment approach for patients with a specific type of rectal cancer known as microsatellite instability-high (MSI-H) or DNA mismatch repair-deficient (dMMR) rectal cancer. The study is looking at the combination of a medication called Sintilimab, which helps the immune system fight cancer, along with a type of radiation therapy that delivers targeted doses over fewer sessions. The goal is to see how safe and effective this combination is for patients who have not received any prior treatment for their rectal cancer.

To participate in this trial, candidates must be at least 18 years old and have a confirmed diagnosis of rectal adenocarcinoma that meets specific criteria. They should not have received any previous treatments for their rectal cancer and must have cancer that is localized (not spread to distant parts of the body). Participants can expect close monitoring throughout the study to assess how well the treatment works and to ensure their safety. It is important to note that individuals with certain health conditions, recent infections, or allergies to the study medications may not be eligible. This study is currently recruiting participants, and those interested should discuss it with their healthcare provider to see if they qualify.

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Eligibility criteria

• Inclusion Criteria:
• • 1. Histologically confirmed rectal adenocarcinoma;
• • 2. With DNA mismatch repair-deficient (dMMR) or microsatellite instability-high (MSI-H) status, whether or not being Lynch syndrome;
• • 3. Not received any anti-rectal cancer treatment previously; for patients with Lynch syndrome, not received any anti-tumor therapy about rectal cancer diagnosed this time;
• • 4. No distant metastasis except for lateral lymph nodes on thoracic and abdominal enhanced computed tomography (CT) scans; the distance between tumor's lower edge and anus within 15cm; clinical T stage ≥T2 on high-resolution pelvic magnetic resonance imaging (MRI)；
• • 5. Men and women ≥18 years of age;
• • 6. Eastern Cooperative Oncology Group performance status score 0 or 1;
• • 7. Adequate hematologic, hepatic, renal, thyroid and cardiac function: hemoglobin ≥90 g/L, neutrophils ≥1500/mm3, platelets ≥75,000/mm3; aspartate aminotransferase and alanine aminotransferase ≤3.0 × upper limit of normal (ULN), bilirubin ≤1.5 × ULN; creatinine ≤1.5 × ULN, creatinine clearance ≥50 mL/min; activated partial thromboplastin time, prothrombin time and international normalized ratio ≤1.5 × ULN; serum albumin ≥28 g/L；thyroid stimulating hormone and free thyroxine within ±10% of normal levels; no obvious abnormality in electrocardiogram;
• • 8. Not received blood, blood products and hematopoietic growth factor (e.g. granulocyte colony-stimulating factor) within 2 weeks before inclusion;
• • 9. Informed consent form signed;
• • 10. Life expectancy of ≥3 months.
• Exclusion Criteria:
• • 1. Allergic disease history, severe hypersensitivity to drugs, antibody products or Sintilimab;
• • 2. Other malignancy history with disease free survival \<5 years, except for curative in situ cervical cancer, curative skin basal cell carcinoma and curative gastrointestinal cancer by endoscopic mucoresection;
• • 3. Current or past history of autoimmune diseases, including but not limited to: interstitial lung disease, uveitis, enteritis，active hepatitis (HBV DNA≥103 copies/mL after regular antiviral therapy)，nephritis, hyperthyroidism and hypothyroidism;
• • 4. Immunosuppressant or corticosteroid (systemic or local) use to suppress immune function within 2 weeks before inclusion;
• • 5. Severe infection needing intravenous antibiotics, antifungal agents or antiviral drugs, et al;
• • 6. Congenital or acquired immunodeficiency such as HIV infection; active Hepatitis B (HBV DNA≥103 copies/mL after regular antiviral therapy);
• • 7. Having one of the following complications: massive gastrointestinal hemorrhage, gastrointestinal perforation or obstruction; symptomatic heart diseases including unstable angina, myocardial infarction and heart failure; uncontrollable diabetes mellitus or hypertension; uncontrollable diarrhea (interfering with daily activities although receiving adequate treatment);
• • 8. Bleeding tendency or receiving thrombolytic or anticoagulant therapy;
• • 9. Pregnant or breastfeeding female; male and female unwilling to take any contraceptive measures;
• • 10. Psychiatric disorders that would interfere with cooperation with the requirements of the study;
• • 11. Other conditions that investigators consider not suitable for this study.