ctDNA-MRD Guided Escalation of Ivonescimab and Docetaxel in Advanced NSCLC With Long-Term Responses to First-line Immunotherapy (CR1STAL-Adaptive)

Trial statusRecruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexAll
Age18-75
SponsorSecond Xiangya Hospital of Central South University

About this trial

The CR1STAL-Adaptive study is a randomized, open-label, phase II multicenter interventional trial designed to evaluate the safety and efficacy of Ivonescimab (PD-1/VEGF bispecific antibody) combined with docetaxel versus standard treatment in patients with advanced NSCLC who have achieved long-term benefit from first-line immune checkpoint inhibitors (ICIs), but are ctDNA-MRD positive. Building upon insights from previous CR1STAL study (NCT05198154), the CR1STAL-Adaptive study supports the development of precision-guided, adaptive treatment strategies to delay progression and improve outcomes in NSCLC patients with a long-term response to immunotherapy. It represents a step forward in integrating dynamic molecular monitoring with individualized intervention strategies in the era of immunotherapy.

Eligibility criteria

Qualifiers

Sign written informed consent prior to any study-related procedures, be willing and able to complete the visits, treatment regimen, and laboratory tests specified in the schedule, and comply with other requirements of the study;

Aged ≥18 and ≤75 years old;

ECOG PS score 0-1;

Expected survival time ≥ 12 weeks;

Disqualifiers

Concurrent participation in another interventional clinical study or receipt of another investigational drug, unless participating in an observational clinical study;

Systemic therapy with proprietary Chinese medicines with anti-tumor indications or immunomodulatory drugs (including thiopeptides, interferons, interleukins, except those used locally for the control of hydrothorax or ascites) within 2 weeks prior to the first dose;

No measurable lesions as defined by RECIST 1.1 due to prior radical treatment (e.g., surgery or radiotherapy)

Subjects who have received systemic antiangiogenic therapy;

Trial design

Treatments tested in this trial

  • Ivonescimab
  • Docetaxel
  • Standard Treatment group

Treatment groups

70 Participants
are divided into 2 treatment groups

Locations

20
Changsha Central Hospital Changsha China
Hunan Cancer Hospital410011, Changsha China
The First Hospital of Changsha Changsha China
The Second Xiangya Hospital of Central South University410011, Changsha China

Sponsors and collaborators

Second Xiangya Hospital of Central South University

Lead sponsor

Nanjing Shihejiyin Technology, Inc.

Collaborator

Akeso

Collaborator