Determine the complete pathologic complete response (pCR) rate in patients with locally advanced rectal adenocarcinoma.
A phase II randomized trial 3:2 with short course radiotherapy followed by mFOLFOX chemotherapy prior to trans abdominal resection with or without an antiCD40 agonist antibody (APX005M). There will be continuous safety assessment for at least 6 patients. Planned accrual of 58 patients. An interim analysis after 30 patients have completed treatment and there will be early stopping criteria for futility or efficacy. Short course radiotherapy will consist of 5Gy x 5 to the pelvis and patients on APX005M arm will receive one infusion during radiotherapy course, have a two week break, then start FOLFOX with APX005M in conjunction with five out of six cycles of chemotherapy. Patients will be restaged and then undergo definitive surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
58
1. APX005M 0.3mg/kg intravenously on day 3 of radiation and on day 3 of cycles 1-5 of mFOLFOX 2. Short course radiation therapy 5 Gy x 5 days 3. Oxaliplatin 85mg/m2 intravenous day 1 of each cycle 4. Leucovorin 400mg/m2 IV Day 1 of each cycle 5. 5-FU 2400 mg/m2 continuous infusion over 46 hours of each cycle
1. Short course radiation therapy 5 Gy x 5 days 2. Oxaliplatin 85mg/m2 intravenous day 1 of each cycle 3. Leucovorin 400mg/m2 IV Day 1 of each cycle 4. 5-FU 2400 mg/m2 continuous infusion over 46 hours of each cycle
The University of Arizona Cancer Center
Tucson, Arizona, United States
Wake Forest Baptist Health Sciences
Winston-Salem, North Carolina, United States
Oregon Health & Science University
Portland, Oregon, United States
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
Dallas, Texas, United States
Pathological Complete Response Rate
The primary objective of this study is to determine the pathologic complete response (pCR) rate of the combined treatment modality.
Time frame: At time of surgery
Overall Survival
To evaluate overall survival (OS), defined as the time between date of randomization and the date of death due to any cause.
Time frame: 3 years
Toxicity analysis
To evaluate toxicity analysis comparing the experimental from the standard arm measured according to CTCAE v5.0.
Time frame: 3 years
Disease free survival
To evaluate the disease free survival (DFS) and patterns of failure at three years. DFS is defined as the time between the date of definitive surgery and the first date of documented disease progression or death.
Time frame: 3 years
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