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The investigators plan to initiate a prospective, multicenter, phase II study, recruiting 30 patients with advanced colon cancer patients with liver metastasis who have not received prior treatment. This study plans to reconstruct intestinal microecology through fecal microbiota transplantation (FMT), and combine with QL1706+Bevacizumab+XELOX to enhance the anti-tumor immune effect at the same time, thereby improving the prognosis of colon cancer patients with liver metastasis.
This is a prospective, single-arm, multi-center, exploratory clinical study. Patients with previously untreated, newly diagnosed advanced colon cancer with liver metastasis, who could be diagnosed by histological or cytological means, ECOG PS 0-1, excluded Ras, Raf wild type left colon and rectum, excluded dMMR/MSI-H. Eligible subjects who met the inclusion criteria were screened and signed informed consent.
FMT was performed 2 days before treatment with QL1706, bevacizumab, and chemotherapy. QL1706, bevacizumab, and chemotherapy (XELOX) were administered every 3 weeks according to the patient's body surface area. A total of 6 cycles were performed. Subsequent maintenance therapy was at the discretion of the investigator.
RECIST v1.1 was used for tumor evaluation every 6 weeks during treatment. NCI-CTCAE 5.0 was used for safety assessment every 3 weeks. Adverse events were recorded throughout the study to 90 days after the end of treatment. Treatment continues until disease progression, subject withdraws informed consent, loss of follow-up, or death. Patients should provide 10ml whole blood samples and fecal samples at baseline, after two cycles of treatment, after four cycles of treatment, before maintenance treatment for the detection of efficacy prediction markers (each cycle is 21 days).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FMT+QL1706+Bevacizumab+XELOX | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FMT+QL1706+Bevacizumab+XELOX | Combination Product | Participants will receive FMT combined with QL1706+Bevacizumab+XELOX for 6 cycles. If there is no progression of the disease after 6 cycles of the first-line treatment, then patients will enter the maintenance treatment stage. The therapy of maintenance treatment stage was at the discretion of the investigator. |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) | Objective response rate will be assessed by investigators. | up to 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Median Progression-Free Survival (mPFS) | Observation for mPFS will be recorded until the end of follow-up after the start of 1st cycle of treatment. | up to 24 months |
| Median Overall Survival (mOS) |
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Inclusion Criteria:
1) Blood routine: ANC ≥ 1.5 × 10^9/L, Platelet count ≥ 100 × 10^9/L, HGB ≥100 g/L (no blood transfusion or erythropoietin dependence within 14 days); 2) Liver function: TBIL ≤1.5 x ULN; ALT/AST ≤ 5 x ULN; ALP ≤5×ULN; 3) Renal function: Cr ≤1.5×ULN, or creatinine clearance ≥50 mL/min: Urine routine results showed urinary protein < 2+; 4) Coagulation function: INR or PT ≤1.5 x ULN. 9.For female subjects of reproductive age, a urine or serum pregnancy test should be performed and the result is negative 3 days prior to receiving the initial study drug administration.
10. For women of childbearing potential (WOCBP): agreement to refrain from heterosexual intercourse or use contraception.
11. For men: agreement to refrain from heterosexual intercourse or use a condom, and agreement to refrain from donating sperm.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hua Jiang MD | Contact | +86-18015852711 | czeyjh@njmu.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Second People's Hospital of Changzhou | Recruiting | Changzhou | China |
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The time from the first treatment to death from any cause.
| up to 24 months |
| 6-Months Progression-Free Survival Rate (6month-PFS) | The proportion of patients whose disease did not progress 6 months after treatment | up to 6 months |
| 12-Months Progression-Free Survival Rate (12month-PFS) | The proportion of patients whose disease did not progress 12 months after treatment | up to 12 months |
| 18-Months Progression-Free Survival Rate (18month-PFS) | The proportion of patients whose disease did not progress 18 months after treatment | up to 18 months |
| 6-Months overall survival rate(6-Months-OS Rate) | The proportion of patients who have not died after 6-Months of treatment | up to 6 months |
| 12-Months overall survival rate(12-Months-OS Rate) | The proportion of patients whose disease did not progress 12 months after treatment | up to 12 months |
| 18-Months overall survival rate(18-Monthsr-OS Rate) | The proportion of patients who have not died after 18 months of treatment | up to 18 months |
| Objective Response Rate (ORR) of liver metastases | Objective response rate will be assessed by investigators. | up to 24 months |
| Disease Control Rate (DCR) | The proportion of patients whose tumors achieve a response (CR+PR) and stable disease (SD) after treatment for the minimum duration required. | up to 24 months |
| Surgical conversion rate | Proportion of inoperable patients converted to operable. | up to 24 months |
| Incidence of Adverse events (AEs) | Therapy-related adverse events will be recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0). | up to 24 months |
| Quality of Life (QoL) | QoL(quality of life) will be evaluated by EORTC-QLQ-C30.The total score ranges from 0 to 60, with higher scores indicating better quality of life | up to 24 months |
| The Diversity of Fecal Microbiota | This will be detected by 16s rRNA sequencing or metagenomes. | up to 24 months |