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This study focuses on the treatment of liver metastases from three common cancers: colorectal cancer, triple-negative breast cancer and melanoma. Currently, there are limitations in the treatment of liver metastases of these cancers. Multimodal thermophysical ablation therapy can reshape the tumor microenvironment, release neoantigens, and act as an in-situ vaccine. On this basis, the combination of multimodal ablation with immunotherapeutic drugs such as pucotenlimab will be explored. The efficacy and safety of this combination therapy in patients with liver metastases of solid tumors will be investigated, with the expectation of breaking through the existing treatment limitations.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| A | Experimental | Colorectal Cancer Cohort |
|
| B | Experimental | Triple-Negative Breast Cancer Cohort |
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| C | Experimental | Melanoma Cohort |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MTT(Multimodal Tumor Thermal Therapy System)- Colorectal Cancer | Combination Product | Multimodal ablation combined with cadonilimab and fruquintinib |
|
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate | It refers to the proportion of patients whose tumors have reduced by a certain amount and maintained for a certain period,including cases of Complete Response(CR)and Partial Response(PR).Objective tumor responses are assessed using the Response Evaluation Criteria in Solid Tumors(RECIST 1.1).Subjects must have measurable tumor lesions at baseline,and the criteria for efficacy assessment are classified according to RECIST 1.1 as Complete Response(CR),Partial Response(PR),Stable Disease(SD),and Progressive Disease(PD). | Up to 2 years. |
| Measure | Description | Time Frame |
|---|---|---|
| Disease Control Rate | It includes the percentage of patients with confirmed cases of Complete Response(CR),Partial Response(PR),and Stable Disease(SD)out of those who are evaluable for efficacy.Subjects must have measurable tumor lesions at baseline,and the criteria for efficacy assessment are classified according to RECIST 1.1 as Complete Response(CR),Partial Response(PR),Stable Disease(SD),and Progressive Disease(PD). |
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Inclusion Criteria i. Common eligibility criteria for all cohorts:
1. Age between 18-80 years,gender not limited; 2. The number of liver metastases is≥3.Besides the ablation lesions,there must be at least one measurable lesion(≥1cm),and the diameter of the ablation lesions is<5cm; 3. Expected survival≥3 months; 4. ECOG performance status score of 0-1; 5. Within 14 days before the first dose,laboratory tests indicate adequate organ function:
a) Hematology:WBC≥3.0×10^9/L;ANC≥1.5×10^9/L;PLT≥75×10^9/L;HGB≥90 g/L b) Liver function:Child-Pugh score≤7,AST≤5.0×ULN;ALT≤5.0×ULN;TBIL≤1.5×ULN c) Renal function:Cr≤1.5×ULN or CrCl≥60 mL/min d) Coagulation function:INR≤1.5×ULN(for patients on anticoagulant therapy,≤3×ULN,anticoagulants must be discontinued one week before ablation);APTT≤1.5×ULN ii. Additional eligibility criteria for each cohort:
Colorectal Cancer:
a) Clinically or pathologically confirmed colorectal cancer with liver metastases that are unresectable, or the patient is intolerant to or refuses surgery; b) Patients who have failed standard second-line drug therapy.
Triple-negative breast cancer :
Melanoma :
Exclusion Criteria:
i. Common exclusion criteria for all cohorts:
ii. Additional exclusion criteria for each cohort:
Colorectal Cancer :
a) Patients with uncontrolled hypertension, defined as: patients with hypertension that cannot be well-controlled with a single antihypertensive agent (SBP ≥150 mmHg or DBP ≥100 mmHg); or patients who require two or more antihypertensive medications to control blood pressure.
b)Patients with urine dipstick proteinuria ≥2+ and a 24-hour urinary protein level >1.0 g.
c)Patients with gastrointestinal diseases such as active gastric or duodenal ulcers, ulcerative colitis, or active bleeding from an unresected tumor; or other conditions judged by the investigator as potentially causing gastrointestinal bleeding or perforation.
d)Patients with evidence or history of a significant bleeding tendency within 3 months prior to enrollment (e.g., bleeding >30 mL, hematemesis, melena, hematochezia), hemoptysis (>5 mL of fresh blood within 4 weeks), or a thromboembolic event (including stroke and/or transient ischemic attack) within the past 12 months.
e)Patients with clinically significant cardiovascular disease, including but not limited to, acute myocardial infarction, severe/unstable angina, or coronary artery bypass grafting within 6 months prior to enrollment.
f)Congestive heart failure of New York Heart Association (NYHA) class > II; ventricular arrhythmias requiring medication; or an ECG showing a QTc interval ≥480 milliseconds.
g)Patients who are unable to take fruquintinib orally.
Triple-negative breast cancer :
a) Patients who have previously received Pucotenlimab treatment;
Melanoma :
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hongxia Wang, MD | Contact | +86 021-64175590 | wanghongxia@shca.org.cn | |
| Wentao Li, MD | Contact |
| Name | Affiliation | Role |
|---|---|---|
| Hongxia Wang, MD | Fudan University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fudan University Shanghai Cancer Center | Recruiting | Shanghai | China |
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| MTT(Multimodal Tumor Thermal Therapy System)- Triple-Negative Breast Cancer | Combination Product | Multimodal ablation combined with pucotenlimab and TPC or sacituzumab govitecan, eribulin,gemcitabine,UTD1 |
|
| MTT(Multimodal Tumor Thermal Therapy System)- Melanoma | Combination Product | Multimodal ablation combined with pucotenlimab, with other specific agents determined based on the first-line treatment regimen and the melanoma subtype. |
|
| Up to 2 years. |
| Duration of Response | The duration of response is defined as the time interval from the start of the response(when CR or PR is first confirmed)to the time of progression or death(whichever occurs first). | Up to 2 years. |
| Progression-Free Survival | It refers to the time from the date of enrollment to the date of the first recorded disease progression(PD)or death,whichever occurs first. | Up to 2 years. |
| Overall Survival | Overall Survival(OS) refers to the time from the date of enrollment to the date of death due to any cause. | Up to 2 years. |
| Safety and Tolerability | Safety refers to the extent to which a drug does not cause unacceptable harm or side effects when applied in the human body.Tolerability refers to the degree to which patients accept the side effects that occur after treatment,reflecting their ability to endure the side effects of the medication.All adverse events will be recorded and assessed for severity based on the NCI-CTC AE 5.0 grading criteria.During the follow-up period,all subjects will be continuously monitored,and the occurrence,duration,severity,and treatment-relatedness of adverse events will be documented. | Up to 2 years. |
| ID | Term |
|---|---|
| D064726 | Triple Negative Breast Neoplasms |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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