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(1) Evaluate the efficacy of apatinib in combination with standard second-line chemotherapy for advanced colorectal cancer. Whether it can prolong Progression Free Survival (PFS), overall survival (OS) in patients with advanced colorectal cancer and reduce symptoms and improve quality of life compared with standard second-line chemotherapy; (2) Observe the safety of apatinib for the treatment of advanced colorectal cancer.
Standard second line chemotherapy includes chemotherapy based on irinotecan or chemotherapy based on oxaliplatin.
Apatinib is a small-molecule tyrosine kinase inhibitor (TKI) that highly selectively binds to and strongly inhibits vascular endothelial growth factor receptor 2 (VEGFR-2), with a decrease in VEGF-mediated endothelial cell migration, proliferation, and tumor microvascular density. A phase II trail of Apatinib has been demonstrated that Apatinib is safe to treat the metastatic colorectal cancer and the disease control rate can reach 50%.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Apatinib group | Experimental | Apatinib combined with second-line chemotherapy (5-Fu combined with irinotecan or oxaliplatin standard regimen ) Apatinib tablets: 500 mg po qd . Continuous medication, the cycle is consistent with the chemotherapy cycle. Oxaliplatin: Day 1, 130mg/m2, IV infusion. Capecitabine: Day 1-14, 1000mg/m2 Twice Daily, po. A total of 6 cycles, 3 weeks apart of chemotherapy.(Take CAPEOX for example) |
|
| Control group | Placebo Comparator | Oxaliplatin: Day 1, 130mg/m2, IV infusion. Capecitabine: Day 1-14, 1000mg/m2 Twice Daily, po. A total of 6 cycles, 3 weeks apart of chemotherapy.(Take CAPEOX for example) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Apatinib | Drug | Apatinib in combination with standard second-line chemotherapy for advanced colorectal cancer |
|
| Measure | Description | Time Frame |
|---|---|---|
| Progression-free survival (PFS) | the time from randomize to progression or death; RECIST guidelines were used to define all responses after patients had received every 4 weeks of therapy | Approximately 2 year |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival (OS) | Defined as the time from randomize to death | Approximately 3 years |
| Objective Response Rate (ORR) | ORR=complete response (CR) + partial response (PR) |
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Inclusion Criteria:
Male or female aged 18 to 70 years old;
Histologically or cytologically proven patients with metastatic colorectal cancer have undergone a first-line standard regimen recommended by the NCCN guidelines for progression;
According to the RECIST 1.1 criteria, the patient has at least one target lesion that can measure the diameter;
ECOG PS ≤ 2;
Expected survival time of more than 12 weeks.
The level of organ function must meet the following requirements:
Bone marrow: neutrophil count (ANC) ≥ 1.5 × 10^9/L, platelet ≥ 75 × 10^9/L, hemoglobin ≥ 90g/L.
Liver: serum bilirubin ≤ 2 times the upper limit of normal, aminotransferase AST and ALT ≤ 2.5 times the normal upper limit.
Kidney: Serum creatinine ≤1.5 times upper limit of normal.
Patient compliance is good;
Understand and voluntarily sign a written informed consent.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Liqiang Zhong | Contact | 15283572951 | zhongliqiang@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Liqiang Zhong | Yibin Second People's Hospital | Study Chair |
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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| ID | Term |
|---|---|
| C553458 | apatinib |
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| standard second-line chemotherapy | Drug | The second line standard chemotherapy regimen recommended by the NCCN |
|
|
| Approximately 2 years |
| Disease control rate(DCR) | Defined as the rate of complete response , partial response and stable disease according to RECIST guidelines | Approximately 2 years |
| Quality of life(QoL) | As measured by the European Organization for Research and Treatment of Cancer questionnaire (EORTC QLQ C30) | Approximately 2 year |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |