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This study is a prospective, multi-cohort, single-centre, phase II clinical trial designed to initially explore the efficacy and safety of sequential fluzoparib with chemoradiotherapy in pan-solid tumours. The study is designed for patients with untreated surgically resectable rectal cancer and untreated locally advanced unresectable non-small cell lung cancer, oesophageal squamous cancer, and cervical cancer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| untreated surgically resectable rectal cancer | Experimental |
| |
| untreated locally advanced unresectable non-small cell lung cancer | Experimental |
| |
| untreated locally advanced unresectable esophageal squamous cell carcinoma | Experimental |
| |
| untreated locally advanced unresectable cervical carcinoma | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fluzoparib monotherapy or Fluzoparib with Camrelizumab(Only non-small cell lung cancer arm) ,or Fluzoparib combined with capecitabine (only rectal cancer arm)) | Drug | Arm A: untreated surgically resectable rectal cancer. Patients accept preoperative long-range synchronous chemoradiotherapy → fluzoparib combined with capecitabine (Q3W, 4 treatment cycles) → surgery → observation and follow-up Arm B, C and D: include untreated locally advanced unresectable non-small cell lung cancer, esophageal squamous cell carcinoma and cervical carcinoma. Patients accept radical synchronous chemoradiotherapy following → fluzoparib combined with camrelizumab or fluzoparib monotherapy maintenance treatment for 17 cycles |
| Measure | Description | Time Frame |
|---|---|---|
| pCR | Pathological Complete Response | within 14 working days after operation |
| PFS rate | 12-month Progression-Free Survival Rate | from initially chemoradiotherapy follow up 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| MPR | Main Pathological Remission | within 14 working days after operation |
| R0 resection rate | R0 resection rate | within 14 working days after operation |
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Inclusion Criteria:
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Subjects must meet all of the following criteria to be enrolled in this study:
subjects voluntarily enrolled in this study, signed informed consent, good compliance, and co-operated with follow-up visits;
age 18-75 years (calculated on the date of signing the informed consent);
histologically or cytologically confirmed solid tumours as follows: Cohort A: patients with resectable locally advanced rectal adenocarcinoma not previously treated for rectal cancer (clinical stage T3-4 or N+ as assessed by MRI, according to AJCC 8th edition staging), with the lower edge of the tumour ≤ 10 cm away from the anal verge, with R0 resection predicted and planned for surgery after neoadjuvant therapy, and with no contraindications to surgery; Cohort B: patients with locally advanced, unresectable NSCLC with histologically or cytologically confirmed diagnosis who have not previously received treatment for lung cancer (IIIA, IIIB, IIIC, according to the International Manual of Thoracic Oncology Lung Cancer Staging Studies 8th edition staging); Cohort C: patients with locally advanced, unresectable or contraindicated for or refusing surgery for squamous oesophageal cancer with histological or cytological confirmation who had not received previous treatment for oesophageal cancer (clinical staging T1b-4bN0M0/T1-4bN+M0, according to AJCC 8th edition staging); Cohort D: Cervical squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma of the cervix that has not received prior treatment for cervical cancer (excluding surgical pathological staging) and that has been confirmed by pathohistology. Clinical staging or imaging staging or surgical pathological staging of locally advanced cervical cancer (2018 FIGO staging of IB3, Stage IIA2-IVA patients);
NSCLC without sensitive EGFR, ALK or ROS1 gene mutations confirmed by histological or cytological specimens;
ECOG PS score: 0 to 1;
subjects with normal swallowing function;
normal major organ function, including:
a) Routine blood tests (no transfusion of blood or blood products, no correction with G-CSF and other haematopoietic stimulating factors within 14 days prior to the first treatment): i. Neutrophil count ≥ 1.5 × 109/L ii. Platelet count ≥ 100×109/L iii. Haemoglobin ≥ 90 g/L. b) Blood biochemistry: i. Total bilirubin ≤ 1.5×ULN ii. ALT ≤ 2.5×ULN, AST ≤ 2.5×ULN. iii. iii. serum creatinine ≤ 1.5 × ULN, or creatinine clearance ≥ 50 mL/min c) Coagulation function: i. International Normalised Ratio (INR) ≤ 1.5 x ULN ii. Activated partial thromboplastin time (APTT) ≤ 1.5 x ULN
Female subjects of childbearing potential are required to have a negative serum pregnancy test within 72 hours prior to the first dose and are not breastfeeding and are using effective contraception (e.g., IUD, birth control pills, or condoms) for the duration of the trial, and for 6 months after the last administration of fluzoparib/chemotherapy, or 2 months after the last administration of karelizumab, whichever is longer; for male subjects whose partner is a female of childbearing potential, the results of the serum pregnancy test must be negative and they must be not breastfeeding. male subjects whose partner is a female of childbearing potential should be surgically sterilised or agree to use effective contraception for the duration of the trial and for 6 months after the last administration of fluzoparib/chemotherapy or 2 months after the last administration of carrelizumab, whichever is longer, and sperm donation is not permitted during the study.
patients judged by the investigator to be acceptable for the study intervention programme.
Exclusion Criteria:
Subjects with any of the following traits or conditions will not be allowed to enter this study:
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4 arms include rectal cancer, non-small cell lung cancer, oesophageal squamous cancer, and cervical cancer, accept sequential fluzoparib after chemoradiotherapy
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|
| PFS | Progression-Free-Survival | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months |
| OS | Overall Survival | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months |
| ORR | Objective Response Rate | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months |
| AEs | adverse events | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months |
| ID | Term |
|---|---|
| D000077277 | Esophageal Squamous Cell Carcinoma |
| ID | Term |
|---|---|
| D002294 | Carcinoma, Squamous Cell |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D018307 | Neoplasms, Squamous Cell |
| D004938 | Esophageal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D006258 | Head and Neck Neoplasms |
| D004066 | Digestive System Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
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| ID | Term |
|---|---|
| C000722917 | fluzoparib |
| D000069287 | Capecitabine |
| ID | Term |
|---|---|
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D005472 | Fluorouracil |
| D014498 | Uracil |
| D011744 | Pyrimidinones |
| D003853 | Deoxyribonucleosides |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
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