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Based on the interaction between radiation therapy and immunotherapy and the potential potentiation of Probio-M9 for the treatment of ICIs, this study is planned to design an integrated treatment protocol for the first-line treatment of advanced gastrointestinal tumors through the use of macrofractionated radiotherapy as a means of immune activation, combined with the synergistic effect of Probio-M9 microbial agents and PD-1 inhibitors.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ARM A:Her-2 negative adenocarcinoma of the gastroesophageal junction/gastric adenocarcinoma | Experimental | patients will receive Probio-M9 ,RT followed by Immunotherapy-Based Systemic Therapy |
|
| ARM A*:Her-2 negative adenocarcinoma of the gastroesophageal junction/gastric adenocarcinoma | Placebo Comparator | patients will receive placebo ,RT followed by Immunotherapy-Based Systemic Therapy |
|
| ARM B: Liver adenocarcinoma | Experimental | patients will receive Probio-M9 ,RT followed by Immunotherapy-Based Systemic Therapy |
|
| ARM B*: Liver adenocarcinoma | Placebo Comparator | patients will receive placebo ,RT followed by Immunotherapy-Based Systemic Therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hypofractionated radiotherapy/SBRT(5-10Gy/fx,3-5 fx) | Radiation | RT: one primary or metastatic focus was selected for hypofractionated radiotherapy/SBRT (5-10 Gy/fx, 3-5 fx) in each round, the target area included only the GTV of the visible tumor lesion, and the GTV was expanded by 5-10 mm to generate the PTV, and the prophylactic lymphatic drainage area could not be irradiated. |
| Measure | Description | Time Frame |
|---|---|---|
| ORR | for off-target lesions of radiotherapy | ORR will be assessed 2 months after radiotherapy |
| Measure | Description | Time Frame |
|---|---|---|
| ORR | irradiated lesion | ORR will be assessed 2 months after radiotherapy |
| adverse effects rate | CTC 4.0 | From date of randomization until the date of death from any cause, assessed up to 5 years ] |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| zhu ji | Contact | 13501978674 | zhuji@zjcc.org.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zhengjiang Cancer Hospital | Recruiting | Hangzhou | Zhejiang | China |
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| ARM C: Malignant tumors of the biliary system |
| Experimental |
patients will receive Probio-M9 ,RT followed by Immunotherapy-Based Systemic Therapy |
|
| ARM C*: Malignant tumors of the biliary system | Placebo Comparator | patients will receive placebo ,RT followed by Immunotherapy-Based Systemic Therapy |
|
| ARM D:Colorectal cancer | Experimental | patients will receive Probio-M9 ,RT followed by Immunotherapy-Based Systemic Therapy |
|
| ARM D*:Colorectal cancer | Placebo Comparator | patients will receive placebo ,RT followed by Immunotherapy-Based Systemic Therapy |
|
|
| Anti-PD-1 monoclonal antibody | Drug | Sintilimab 200mg d1 iv q3w |
|
| Oxaliplatin and Capecitabine | Drug | Oxaliplatin130mg/m2 d1 iv;Capecitabine1000mg/m2 d1-d14 |
|
| Anti-VEGF 15mg/kg | Drug | Bevacizumab 15mg/kg d1 iv q3w |
|
| Anti-VEGF 7.5mg/kg | Drug | Bevacizumab 7.5mg/kg d1 iv q3w |
|
| Gemcitabine and Cisplatin | Drug | Gemcitabine1000mg/m2 d1 d8 iv;Cisplatin 25mg/m2 d1 d8 iv q3w |
|
| Qol | EORTC-C30 | From date of randomization until the date of death from any cause, assessed up to 10 years] |
| PFS | Rate of 3 year disease free survival | From the date of randomization to the date when progress was first recorded,assessed up to 36 months. |
| OS | Rate of 3 year overall survival | From date of randomization until the date of death from any cause, assessed up to 36 months |
| Qol | EQ-5D | From date of randomization until the date of death from any cause, assessed up to 10 years] |
| ID | Term |
|---|---|
| D006528 | Carcinoma, Hepatocellular |
| ID | Term |
|---|---|
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008113 | Liver Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
| D008107 | Liver Diseases |
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| ID | Term |
|---|---|
| C000711728 | spartalizumab |
| D000077150 | Oxaliplatin |
| D000069287 | Capecitabine |
| D000093542 | Gemcitabine |
| D002945 | Cisplatin |
| ID | Term |
|---|---|
| D056831 | Coordination Complexes |
| D009930 | Organic Chemicals |
| 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 |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
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