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The goal of this clinical trial is to evaluating the efficacy and safety of Oxaliplatin + Irinotecan Liposome + 5-FU/LV in patients with Locally Advanced Colorectal Cancer and Upper Rectal Cancer. Patients would be included as:1. Aged between 18-75 years, with no gender restrictions; 2. Biopsy pathology confirmed as advanced colon cancer and upper rectal cancer; 3. Clinical staging of T3N+ or T4Nany with initially resectable tumors; 4. No distant metastasis observed in routine chest and abdominal CT scans.
The main question it aims to answer is Major Pathological Response Rate, referring to the proportion of patients who experience a significant reduction in the size of their tumor or near-complete pathological regression after treatment, typically assessed through a biopsy or surgical resection.
Participants will be Chemotherapy administered before surgery, with 3-6 cycles of treatment, using the chemotherapy regimen of Oxaliplatin + Irinotecan Liposome + 5-FU/LV.
This study is a single-center, single-arm, prospective clinical trial. A total of 57 patients are expected to be enrolled over 24 months, with a 1-year follow-up observation period. Eligible participants who meet the inclusion criteria and do not meet the exclusion criteria will receive neoadjuvant treatment with irinotecan liposome combined with oxaliplatin + 5-FU/LV (NALIRIFOX). Treatment will be administered in 2-week cycles for 3-6 cycles, and surgery will be planned for those who meet surgical criteria. For those who do not meet surgical criteria, the subsequent treatment plan will be decided by the investigator. Postoperative adjuvant therapy will be determined by the investigator based on the patient's condition. The primary endpoint is the major pathological response (MPR) rate, and secondary endpoints include pathological complete response (pCR), R0 resection rate, objective response rate (ORR), disease control rate (DCR), disease-free survival (DFS), and safety.
Patients would be included as:1. Aged between 18-75 years, with no gender restrictions; 2. Biopsy pathology confirmed as advanced colon cancer and upper rectal cancer; 3. Clinical staging of T3N+ or T4Nany with initially resectable tumors; 4. No distant metastasis observed in routine chest and abdominal CT scans.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Oxaliplatin + Irinotecan Liposome + 5-FU/LV | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NALIRIFOX | Drug | The patients with Locally Advanced Colorectal Cancer and Upper Rectal Cancer will undergo neoadjuvant treatment with irinotecan liposome combined with oxaliplatin + 5-FU/LV (NALIRIFOX), with each treatment cycle lasting 2 weeks, for a total of 3-6 cycles. |
| Measure | Description | Time Frame |
|---|---|---|
| Major pathological response rate | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Pathological complete response rate | The Pathological Complete Response Rate (pCR) is typically expressed as a percentage (%). It refers to the proportion of patients in whom no cancer cells are detected in the tumor tissue after treatment, as assessed by pathological evaluation, indicating a complete response. | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| R0 resection rate | R0 resection rate is expressed as a percentage (%). It refers to the proportion of patients who can undergo a surgical resection (removal of a tumor or tissue) where the margins of the resected tissue are free from cancerous cells after the intervention of Oxaliplatin + Irinotecan Liposome + 5-FU/LV. | 24months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Muming Xv | Affiliated Cancer Hospital of Shantou University Medical College | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cancer Hospital of Shantou University Medical College | Shantou | Guangdong | 515000 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25446610 | Background | Wong SJ, Moughan J, Meropol NJ, Anne PR, Kachnic LA, Rashid A, Watson JC, Mitchell EP, Pollock J, Lee RJ, Haddock M, Erickson BA, Willett CG. Efficacy endpoints of radiation therapy group protocol 0247: a randomized, phase 2 study of neoadjuvant radiation therapy plus concurrent capecitabine and irinotecan or capecitabine and oxaliplatin for patients with locally advanced rectal cancer. Int J Radiat Oncol Biol Phys. 2015 Jan 1;91(1):116-23. doi: 10.1016/j.ijrobp.2014.09.031. Epub 2014 Nov 5. | |
| 25209376 |
| Label | URL |
|---|---|
| The study protocol has not been registered on other websites. The detailed protocol will be available for viewing on this website once the clinical trial registration is approved. | View source |
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| D012004 | Rectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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| objective response rate |
Objective response rate (ORR)is expressed as a percentage (%). It refers to the proportion of patients whose cancer shrinks or disappears after treatment, including complete Response (CR) or partial Response (PR).ORR= Number of patients with CR+ PR /Total number of patients in the study. |
| 24 months |
| disease-free survival | Disease-Free Survival (DFS) refers to the period during which a patient shows no evidence of the disease returning or progressing after they have received treatment. The unit of Disease-Free Survival is typically time, and it is most often measured in months or years. | 24 months |
| Adverse Event (AE) Incidence Rate | The Adverse Event (AE) Incidence Rate,as assessed by CTCAE v5.0,refers to the frequency or rate at which adverse events occur in a clinical trial or patient population.AE Incidence Rate= Number of patients experiencing at least one adverse event / Total number of patients in the study. | 24 months |
| Background |
| Fernandez-Martos C, Brown G, Estevan R, Salud A, Montagut C, Maurel J, Safont MJ, Aparicio J, Feliu J, Vera R, Alonso V, Gallego J, Martin M, Pera M, Sierra E, Serra J, Delgado S, Roig JV, Santos J, Pericay C. Preoperative chemotherapy in patients with intermediate-risk rectal adenocarcinoma selected by high-resolution magnetic resonance imaging: the GEMCAD 0801 Phase II Multicenter Trial. Oncologist. 2014 Oct;19(10):1042-3. doi: 10.1634/theoncologist.2014-0233. Epub 2014 Sep 10. |
| 33862000 | Background | Conroy T, Bosset JF, Etienne PL, Rio E, Francois E, Mesgouez-Nebout N, Vendrely V, Artignan X, Bouche O, Gargot D, Boige V, Bonichon-Lamichhane N, Louvet C, Morand C, de la Fouchardiere C, Lamfichekh N, Juzyna B, Jouffroy-Zeller C, Rullier E, Marchal F, Gourgou S, Castan F, Borg C; Unicancer Gastrointestinal Group and Partenariat de Recherche en Oncologie Digestive (PRODIGE) Group. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021 May;22(5):702-715. doi: 10.1016/S1470-2045(21)00079-6. Epub 2021 Apr 13. |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |