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This study is a single-arm, multi-center, multi-cohort, prospective clinical study initiated by the investigator.
The indication of this study is: patients with advanced metastatic pancreatic cancer who have progressed after first-line chemotherapy. Eligible patients will be assigned to liposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU)/leucovorin (LV) (nal-IRI/5-FU/LV) combined with benmelstobart and anlotinib ± SBRT.
The total sample size for this study is expected to be 56 subjects.
For patients with advanced metastatic pancreatic cancer who failed first-line treatment, the screening and enrollment will be completed according to the enrollment and exclusion criteria described in the study protocol, and the informed consent form will be signed after full communication. After enrollment, patients will be treated with cohort A) or cohort B), and followed up regularly.
Cohort A: nal-IRI/5-FU/LV + PD-L1 inhibitor + multi-target anti-angiogenic small molecule:
Irinotecan liposome: 50mg/m2 IV D1, D15 LV: 400mg/m2 IV D1, D15 5-FU :2.4g/m2 CIV 46h D1, D15 bemosubaemab: 1200mg IV Q3W Anlotinib: 12mg po D1-D14 Q3W
Cohort B: nal-IRI/5-FU/LV + PD-L1 inhibitor+ multi-target anti-angiogenic small molecule+SBRT Group:
Irinotecan liposomes: 50mg/m2 IV D1, D15 LV: 400mg/m2 IV D1, D15 5-FU :2.4g/m2 CIV 46h D1, D15 bemosubaemab: 1200mg IV Q3W Anlotinib: 12mg po D1-D14 Q3W SBRT
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| nal-IRI/5-FU/LV + benmelstobart + anlotinib ± SBRT | Experimental | liposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU)/leucovorin (LV) (nal-IRI/5-FU/LV) combined with benmelstobart and anlotinib ± SBRT |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| nal-IRI,5-fu,LV, benmelstobart, anlotinib | Drug | liposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU)/leucovorin (LV) (nal-IRI/5-FU/LV) combined with benmelstobart and anlotinib ± SBRT |
| Measure | Description | Time Frame |
|---|---|---|
| Objective effective rate (ORR) | The overall response rate, including complete response (CR) + partial response (PR), refers to the proportion of patients whose tumor shrinks to a certain amount and remains for a certain period of time. | 28 days per cycle, with ≤6 cycles of treatment expected per patient |
| Measure | Description | Time Frame |
|---|---|---|
| Disease control rate (DCR) | Refers to the proportion of patients whose tumors have shrunk or stable and remain for a certain period of time, including complete remission (CR), partial remission (PR) and stable (SD) cases. | 28 days per cycle, with ≤6 cycles of treatment expected per patient |
| Median overall survival (mOS) |
| Measure | Description | Time Frame |
|---|---|---|
| Exploring potential efficacy prediction biomarkers | Explore potential efficacy prediction biomarkers: including patients' tumor-related serological indicators, such as peripheral blood lymphocyte count, twelve cytokine tests (IL-2, IFN-γ, TNF-α, IL-4, IL-5, IL6, IL-10, IL-17, IL-1β, IL-8, IFN-α, IL-12p70) and ctDNA detection. This type of index was collected once at the baseline of the patient, and again after every 2 cycles of treatment until the patient entered the maintenance phase or the disease progressed. |
Inclusion Criteria:
Patients need to meet the following hematologic indicators e1. Neutrophil count ≥ 1.5×109/L e2. Hemoglobin ≥ 10 g/dL e3. Platelet count ≥ 100×109/L f. Patients need to meet the following biochemical parameters f1. Total bilirubin ≤ 1.5× upper limit of normal (ULN) f2. AST and ALT <1.5×ULN f3. Creatinine clearance ≥ 60ml/min g. Patients of childbearing age need to take appropriate protective measures (contraception or other methods of birth control) before enrollment and during the trial.
H. Has signed an informed consent form. i. Able to follow the study protocol and follow-up process.
Exclusion Criteria:
Patient has HIV, HCV, HBV infection, uncontrolled coronary artery disease or asthma, uncontrolled cerebrovascular disease or other disease deemed non-enrollable by the investigator.
f. Patients with autoimmune diseases or immunodeficiencies who should be treated with immunosuppressive drugs.
g. Pregnant and lactating women. Women of childbearing potential must have a negative pregnancy test within 7 days prior to enrollment.
h. Substance abuse, clinical or psychological, or social factors that compromise informed consent or study conduct.
i. Those who may be allergic to treatment drugs.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Juan Du, M.D. Ph.D | Contact | +86-025-83106666 | dujunglyy@163.com | |
| DU | Contact | dujunglyy@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Juan Du | The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School | Recruiting | Nanjing | Jiangsu | 025 | China |
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Refers to the numerical value in which the survival time of all patients is arranged in the order from smallest to largest in clinical research, and is located in the middle position. |
| 28 days per cycle, with ≤6 cycles of treatment expected per patient |
| Median progression-free survival (mPFS) | Refers to the value in which all patients are sorted according to the length of progression-free survival time in clinical studies, and is located in the middle position. | 28 days per cycle, with ≤6 cycles of treatment expected per patient |
| 28 days per cycle, with ≤6 cycles of treatment expected per patient |
| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
| D004066 | Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| C000625192 | anlotinib |
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