The study evaluates the addition of immunotherapy of PD-1 antibody in neoadjuvant chemoradiotherapy in microsatellite stability-high (MSI-H) locally advanced rectal cancer (LARC). A total of 50 MSI-H LARC patients will receive 2 cycles of PD-1 antibody, followed by capecitabine plus irinotecan radiosensitized neoadjuvant chemoradiotherapy, and another 3 cycles of PD-1 antibody, finally received the total mesorectal excision (TME) and 6 cycles of adjuvant chemotherapy of XELOX. The tumor response grade, adverse effects and long-term prognosis will be analyzed.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Before neo-CRT: 2 cycles of PD-1 antibody After neo-CRT: 3 cycles of PD-1 antibody
During neo-CRT: 625mg/m2 bid Monday-Friday per week
During neo-CRT: 80mg/m2 qw (UGT1A1\*28 6/6) or 65mg/m2 qw (UGT1A1\*28 6/7)
IMRT DT: 50Gy/25Fx
Zhen Zhang
Shanghai, Shanghai Municipality, China
Pathologic Complete Response Rate
Pathologic Complete Response Rate
Time frame: The pathologic complete response rate was evaluated after surgery, which was scheduled 7-8 weeks after the end of chemoradiotherapy.
Disease free survival
3 year disease free survival rate
Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 36 months.
Local recurrence free survival
3 year local recurrence free survival rate
Time frame: From date of randomization until the date of first documented pelvic failure, assessed up to 36 months.
Overall survival
3 year overall survival rate
Time frame: From date of randomization until the date of death from any cause, assessed up to 36 months.
Adverse effects
Chemoradiation-related or immunotherapy-related adverse events
Time frame: From date of randomization until the date of death from any cause, assessed up to 5 years
Surgical complications
Surgical complications, such as intraoperative hemorrhage, anastomotic leakage, intestinal obstruction, etc.
Time frame: The surgery was scheduled 7-8 weeks after the end of chemoradiotherapy. And the surgical complications were assessed up to 5 years from the surgery.
Performance Status (Zubrod-ECOG-WHO method), range 0-5. The higher scores mean a worse quality of life.
Quality of life will be evaluated
Time frame: From date of randomization until the date of death from any cause, assessed up to 10 years
Karnofsky Performance Status, range 0-100. The higher scores mean a better quality of life.
Quality of life will be evaluated
Time frame: From date of randomization until the date of death from any cause, assessed up to 10 years
Quality of Life Scale, range 0-60. It evaluates the quality of life from 12 aspects, including appetite, mental status, sleep quality, fatigue, etc. The higher scores mean a better quality of life.
Quality of life will be evaluated
Time frame: From date of randomization until the date of death from any cause, assessed up to 10 years
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