Short-Course Radiotherapy Combined with Intracavitary Brachytherapy Followed by Pucotenlimab, Bevacizumab, Oxaliplatin, and Trifluridine/Tipiracil (TAS-102) for Total Neoadjuvant Therapy of Microsatellite Stable (MSS) Locally Advanced Low Rectal Cancer

Trial statusNot yet recruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexAll
Age18+
SponsorSir Run Run Shaw Hospital

About this trial

A Prospective Single-Arm Study of Short-Course Radiotherapy Followed by PD-1 Monoclonal Antibody, Bevacizumab, Oxaliplatin, and Trifluridine/Tipiracil for Total Neoadjuvant Therapy in MSS Locally Advanced Low Rectal Cancer. This is a Non-Randomized, Single Group Assignment, Open Label, Phase: Phase II study. The Primary Objective is to assess the organ preservation rate (clinical complete response, cCR) after total neoadjuvant therapy. Secondary Objectives are Tumor regression grade (TRG), 3-year overall survival (OS) and disease-free survival (DFS), and Safety and quality of life (QoL). In this study, the investigators will perform the multi-dimensional omics study to explore the tumors microenvironments, explore the characteristics of the treatment benefit population, and try to construct an efficacy prediction model to screen the treatment benefit population early and implement precise treatment.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Patients who are willing to receive neoadjuvant therapy.

≧18 years old.

Diagnosed by digital rectal examination, colonoscopy, and high-resolution MRI of the pelvis, the tumor is less than or equal to 5 cm from the anus.

Histologically diagnosed as rectal adenocarcinoma.

Disqualifiers

History of other malignant diseases in the past 5 years.

Patients with metastases from other sites (stage IV patients).

Patients withT4b or positive lateral lymph nodes by pelvic contrast-enhanced CT and pelvic high-resolution MRI.

Patients with intestinal obstruction, intestinal perforation, intestinal bleeding, etc. requiring emergency surgery.

Trial design

Design model

Single group

Treatments tested in this trial

  • Pucotenlimab

    Drug

    Pucotenlimab (200 mg IV, q3w)

  • Bevacizumab

    Drug

    Bevacizumab (7.5 mg/kg IV, q3w)

  • Oxaliplatin

    Drug

    Oxaliplatin (130 mg/m² IV, q3w)

  • Trifluridine/Tipiracil Hydrochloride

    Drug

    TAS-102 (25 mg/m² orally, days 1-5 and 8-12).

  • Short-course radiotherapy

    Radiation

    (25 Gy/5 fractions)

  • intracavitary brachytherapy

    Radiation

    brachytherapy (3 Gy/3 fractions).

Treatment groups

33 Participants
are divided into 1 treatment group
Group A: POBTAS Trial ArmExperimental treatment 6 interventions

Trial outcomes

Primary outcomes

1

Organ preservation rate

The organ preservation rate was calculated as the percentage of participants who achieved cCR and were spared from total mesorectal excision (TME) surgery relative to the total study cohort. Clinical complete response (cCR) requires both histopathological confirmation (no viable tumor cells in biopsy specimens) and radiographic confirmation (absence of tumor on CT, MRI, or PET-CT).

Time frame
Up to 2 weeks (once evaluation or biopsy is done)

Secondary outcomes

1

Total mesorectal excision rate

Population who not achieve complete clinical response and have TME surgery after total neoadjuvant therapy

Time frame
After 2 weeks (once biopsy or local excision is done)
2

Total mesorectal excision rate after recurrence

Population who recurrent and have Salvage total mesorectal excision after achieving complete clinical response after total neoadjuvant therapy

Time frame
Through study completion, an average of 3 year
3

Tumor regression grade

Tumor Regression Grade(TRG)will be done via pathologic assessment on the surgical specimen with AJCC/CAP TRG system

Time frame
After 2 weeks (once biopsy or local excision is done)
4

Overall survival

The proportion of participants who remain survival at 3 years

Time frame
Up to 3 years

Other outcomes

Sponsors and contacts

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