Metastatic colorectal cancer is one of the common malignant tumors and the overall prognosis is poor. The introduction of immune-checkpoint inhibition (ICI) has led to a paradigm shift in the treatment of patients with metastatic cancer. Stereotactic body radiation therapy (SBRT) delivers a large dose of radiation to the tumor target with high precision while sparing irradiation of the surrounding normal tissues. It is suggested that SBRT could be the most appropriate radiotherapy modality to be combined with immunotherapy since it induces the expression of a series of cytokines and new tumour-associated antigens (TAAs) and is more likely to cause intense immune response and exert an abscopal effect than conventional radiotherapy. Thus, this study is to explore the use of SBRT in combination with ICI in colorectal cancer patients with oligometastasis, in order to get better local and systemic tumor control and improve progress-free survival (PFS).
The investigators plan to recruit patients with mCRC, who have received first-line systemic therapy for more than 3 months and achieved PR/SD. Than all the patients will receive SBRT followed by ICI therapy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Participants receive Toripalimab (240mg)/q3w till progression of disease after SBRT
Participants receive SBRT (BED\>80Gy) to oligometastatic lesions followed by Toripalimab (240mg)/q3w
Department of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
Beijing, Beijing Municipality, China
RECRUITINGDepartment of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
Beijing, Beijing Municipality, China
RECRUITINGDepartment of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
Beijing, China
RECRUITING1 year Progression-Free-Survival (PFS)
1 year PFS
Time frame: 1 year
Grade 3-5 acute adverse events
Grade 3-5 acute adverse events
Time frame: 6 months since last treatment of Toripalimab
Objective response rate
Objective response rate
Time frame: At the end of 4 cycles of Toripalimab (each cycle is 21 days)
2 year local control rate
2 year local control rate
Time frame: 2 year
2 year overall survival
2 year overall survival
Time frame: 2 year
T cell receptor repertoire and T cell clones in peripheral blood
Change of T cell receptor repertoire and T cell clones in peripheral blood
Time frame: At the end of 6 cycles of Toripalimab (each cycle is 21 days)
Expression of PD-1, ki-67 on T cell
Change of expression of PD-1, ki-67 on T cell
Time frame: At the end of 6 cycles of Toripalimab (each cycle is 21 days)
Expression of PD-L1 on Exosomes in peripheral blood
Change of expression of PD-L1 on Exosomes in peripheral blood
Time frame: At the end of 6 cycles of Toripalimab (each cycle is 21 days)
Expression of PD-L1 on circulation tumor cell
Change of expression of PD-L1 on circulation tumor cell
Time frame: At the end of 6 cycles of Toripalimab (each cycle is 21 days)
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