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| ID | Type | Description | Link |
|---|---|---|---|
| BFHHZML20240020 | Registry Identifier | Beijing Friendship Hospital, Capital Medical University |
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| Name | Class |
|---|---|
| Peking Union Medical College Hospital | OTHER |
| Peking University People's Hospital | OTHER |
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This is a multicenter, open-label, prospective, randomized controlled Phase II clinical study. All eligible subjects will be randomly assigned in a 1:1 ratio to either the triple therapy group or the double therapy group.
Triple therapy group: Subjects will receive Thymalfasin in combination with Regorafenib and Tislelizumab until iCPD is achieved per iRECIST (progressive disease (PD) per iRECIST), or until an intolerable toxicity occurs; Double therapy group: Subjects will receive Regorafenib and Tislelizumab until iCPD is achieved per iRECIST (PD per iRECIST), or until an intolerable toxicity occurs.
Assuming the following hypotheses:
H0: The mPFS of the test group minus the mPFS of the control group equals 0 H1: The mPFS of the test group minus the mPFS of the control group does not equal 0 Assuming an mPFS of 5.0 months for the test group and 1.8 months for the control group, with a two-sided alpha level of 0.05 and 80% power, at least 32 events need to be observed. Within a 9-month enrollment period and a total study duration of 15 months, 44 subjects need to be enrolled to achieve this. Considering an additional dropout rate of 15%, 26 subjects per group are required, totaling 52 subjects (using PASS 2023 Log-rank procedure).
Enrollment sites: Beijing Friendship Hospital, Capital Medical University, Peking Union Medical College Hospital, Peking University People's Hospital.
Allocation of enrollment across sites: Each site will compete for enrollment, with each site enrolling no less than 14 subjects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Triple therapy group | Experimental | Subjects will receive Thymalfasin in combination with Regorafenib and Tislelizumab |
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| Double therapy group | Active Comparator | Subjects will receive Regorafenib and Tislelizumab |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Thymalfasin (Thymosin alpha 1, Ta1) | Drug | Thymalfasin: 4.8 mg, administered subcutaneously twice weekly. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Progression-free survival (PFS) | Time from day of randomization to the date of documented tumor progression or death due to any cause | 48 WEEKS |
| Measure | Description | Time Frame |
|---|---|---|
| 18-week PFS rate | Proportion of patients without disease progression or death at 18 weeks after starting the study treatment. | 18 weeks |
| Objective response rate (ORR) | Proportion of patients with tumor size reduction of a predefined amount and maintaining for a certain time period, ORR = CR + PR |
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Inclusion Criteria:
Normal major organ function and hematological parameters (within 14 days prior to randomization):
Hematology tests must meet the following criteria:
WBCs≥2.0×10^9/L NEUT≥1.5×10^9/L Hb≥90g/L (9.0g/dL); PLT ≥100×10^9/L;
Biochemistry tests must meet the following criteria:
TBIL ≤ 1.5 × upper limit of normal (ULN); Without liver metastases, ALT or AST ≤ 3.0 ULN; with liver metastases, ALT or AST ≤ 5 ULN; Serum albumin level ≥ 30 g/L Serum Cr ≤ 1.5 ULN, with an endogenous creatinine clearance (CrCl) > 40 mL/min (using Cockcroft-Gault formula) For females: CrCl =((140-Age)×Weight(kg)× 0.85)/(72 × Cr (mg/dL)) For males: CrCl =((140-Age)×Weight(kg)× 1.00)/(72 × Cr (mg/dL)) Urine protein < 2+; if urine protein ≥ 2+, 24-hour urine protein must be < 1 g Prothrombin time or activated partial thromboplastin time and international normalized ratio ≤ 1.5 × ULN Able to swallow and absorb oral medication Females of childbearing potential must use appropriate contraceptive methods during the study and for 6 months after the last dose of the study drug. For males, they should be surgically sterilized or agree to use appropriate contraceptive methods during the study and for 6 months after the last dose of the study drug.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zhigang Bai, MD | Contact | 86-10-13511041528 | 86-10-63138712 | baizhigang@ccmu.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Zhongtao Zhang, Professor | Beijing Friendship Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Friendship Hospital, Capital Medical University | Recruiting | Beijing | China | 100050 | China |
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| ID | Term |
|---|---|
| D000077596 | Thymalfasin |
| C434723 | Trace amine-associated receptor 1 |
| C559147 | regorafenib |
| C000707970 | tislelizumab |
| ID | Term |
|---|---|
| D013947 | Thymosin |
| D013951 | Thymus Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
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| Regorafenib (BAY 73-4506) | Drug | Regorafenib: Start at 80 mg once daily, orally, taken at a fixed time for 2 consecutive weeks and then stopped for 1 week. If the patient tolerates it well, increase to 120 mg/d in Cycle 2. |
|
| Tislelizumab (BGB-A317) | Drug | Tislelizumab: 200 mg, iv.gtt, single infusion, 21 days as a cycle, Day 1. |
|
| 48 WEEKS |
| Disease control rate (DCR) | Proportion of patients with tumor control with tumor size reduction of a predefined amount and maintaining for a certain time period, DCR = CR + PR + SD | 48 WEEKS |
| Overall survival (OS) | Time from day of randomization to death due to any cause. | 3 Years |
| 1-year OS rate | Proportion of patients alive at 1 year after starting the study treatment. | 48 WEEKS |
| D036361 | Peptide Hormones |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |