Chemoradiotherapy Combined With or Without PD-1 Blockade in Anal Canal Squamous Carcinoma Patients
Study Details
Study Description
Brief Summary
This is a phase III, multi-center, double-blind randomized controlled trial assessing the efficacy and safety of concurrent mitomycin C/5-Fu chemotherapy and long-course IMRT combined with PD-1 antibody Sintilimab for locally advanced anal canal squamous carcinoma patients, by comparing an experiment group (traditional chemoradiotherapy with PD-1 antibody Sintilimab) with a control group (traditional treatment without Sintilimab).
Condition or Disease | Intervention/Treatment | Phase |
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Phase 3 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Experimental Group Concurrent PD-1 antibody sintilimab combined with mytomicin C, 5-fluorouracil, and IMRT, followed by adjuvant sintilimab |
Drug: PD-1 inhibitor
Two cycles of concurrent PD-1 antibody sintilimab combined with mytomicin C, 5-fluorouracil and IMRT, followed by adjuvant sintilimab for six months
Other Names:
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Active Comparator: Control Group Concurrent mytomicin C and 5-fluorouracil combined with IMRT |
Radiation: concurrent chemoradiotherapy
Two cycles of concurrent mytomicin C and 5-fluorouracil combined with IMRT
Other Names:
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Outcome Measures
Primary Outcome Measures
- Progression free survival [from the end of treatment to 3 years after treatment]
progression free survival
- Overall survival [from the end of treatment to 3 years after treatment]
overall survival
- cCR rate [6 months after treatment]
cCR rate 6 months after treatment
Secondary Outcome Measures
- Acute toxicities [from the start of treatment to 3 months after treatment]
acute toxicities according to the NCI CTCAE (version 4.0)
- cCR rate [3 months after treatment]
cCR rate 3 months after treatment
- The rate of late toxicity according to the RTOG/EORTC scale [3 years]
The rate of late toxicity according to the RTOG/EORTC scale
- Colostomy rate [2 year]
colostomy rate
- Local recurrence rate [from the end of treatment to 3 years after treatment]
local recurrence rate
- Distant metastasis rate [from the end of treatment to 3 years after treatment]
distant metastasis rate
- Incidence rate of Grade ≥3 PD-1monoclonal antibody-related adverse events [1 year]
Incidence rate of Grade ≥3 PD-1monoclonal antibody-related adverse events
Eligibility Criteria
Criteria
Inclusion Criteria:
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Histology identified anal canal squamous carcinoma,
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Aged 18 to 75,
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Clinical staging III, Eastern Cooperative Oncology Group 0-2 score,
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The Staging method: All patients undergoing rectal anus palpation, high resolution MRI and chest-abdominal enhanced CT, clinical data should be re-evaluated and inclusive by center evaluation group when there is contradictory staging, distant metastasis were excluded by chest-abdominal enhanced CT and pelvic enhanced MRI,
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No previous anal canal surgery or anal tumor resection (except for biopsy),
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No previous chemotherapy or pelvic radiotherapy history,
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No biopharmaceutical treatment history (such as monoclonal antibody), immunotherapy (such as anti PD-1antibody, anti PD-L1 antibody, anti PD-L2 antibody or anti CTLA-4), or other research drug treatment in the previous 5 years,
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Adequate bone marrow, liver, and kidney function,
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Clinical complete response (cCR) (Chest, abdominal and pelvic enhanced CT or pelvic enhanced MRI or PET/CT),
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Informed consent assigned, Final inclusion criteria,
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Non-pregnant or breast-feeding women,
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No other malignant disease within 5 years before diagnosis of anal cancer squamous carcinoma (except endocervical cancer in situ or skin basal cell carcinoma which had been cured); no other malignant disease beside anal cancer squamous carcinoma,
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No other serious disease leading to shortened survival.
Exclusion Criteria:
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Diagnosed as stage I-II and well differentiated squamous cell carcinoma,
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Distant metastasis,
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Received radiation therapy in abdominal or pelvic regions,
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Pregnant, lactating woman patient or fertile but lacks adequate contraceptives,
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Arrhythmia need anti-arrhythmia treatment (except β-blocking agent or Digoxin), symptomatic coronary heart disease or myocardial ischemia (myocardial infarction within 6 months) or congestive heart-failure (CHF) > New York Heart Association grade II,
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Severe hypertension not well controlled by drugs,
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Active phase of chronic hepatitis B or hepatitis C (high copies of virus DNA),
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Patients with active tuberculosis (TB) are receiving anti-tuberculosis treatment or have received anti-tuberculosis treatment within 1 year before screening,
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Other active clinical severe infection (NCI-CTCAE (version 4.0) ),
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Dyscrasia, organ dysfunction,
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Known or suspicious allergy to any research-related drugs,
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Epilepsy needs treatments (Steroid or anti-epilepsy therapy),
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Other malignant tumor history within 5 years,
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Drug abuse and medical, psychological, or social factors that may interfere with patients' participation in the study or affect the evaluation of the study,
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Patients have any active autoimmune diseases or a history of autoimmune diseases (including but not restricted: interstitial pneumonia, uveitis, enteritis, hepatitis, hypophysitis, nephritis, hyperthyroidism and decreased thyroid function; patients with vitiligo or with complete remission of asthma in childhood and without any intervention in adulthood may be included; patients with asthma requiring bronchodilators intervention are not included,
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Any anti-infection vaccine 4 weeks before inclusion,
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Long-term exposure to immune-suppressor, combination of systemic or topical use of corticosteroids (dose>10mg/day prednisolone or equivalent hormone),
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Any unstable state might endanger the patients' safety and compliance,
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Refuses to sign informed consent.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | The Sixth Affiliated Hospital of Sun Yat-sen University | Guangzhou | Guangdong | China | 510630 |
Sponsors and Collaborators
- Sixth Affiliated Hospital, Sun Yat-sen University
Investigators
- Principal Investigator: Xiang-bo Wan, PhD, Sun Yat-sen University
Study Documents (Full-Text)
None provided.More Information
Publications
- E2021144