The goal of this clinical trial is to etablish whether adding Mitazalimab to standard chemotherapy is more effective than standard chemotherapy alone in people with advanced bile duct cancer. It will also learn about the safety of Mitazalimab. The main questions it aims to answer are: * Does the addition of Mitazalimab enhance efficacy? * What medical problems do participants have when taking Mitazalimab + mFOLFOX? Participants will: * Take drug mFOLFOX every two weeks until disease progression or mFOLFOX every two weeks plus mitazalimab in addition to mFOLFOX, with a first injection 7 days before the first mFOLFOX chemotherapy and then 3 days after the start of each mFOLFOX cycle. * Visit the clinic once every 2 weeks for checkups and tests * Have a radiological assessment every 8 weeks during treatment. After stopping treatment, participants will be monitored at the hospital every 8 weeks if no progression is observed, or every 12 weeks after disease progression.
Multicenter, open-label, randomized phase II/III trial evaluating the efficacity of mitazalimab in combination with mFOLFOX compared to mFOLFOX alone in participant advanced BTC
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
160
oxaliplatin 85 mg/m² intravenous infusion (IV), folinic acid 400 mg/m² IV (or L-folinic acid 200 mg/m²), and fluorouracil (5-FU) 400 mg/m² IV bolus; followed by 5 FU 2400 mg/m² as a 46-hours continuous IV infusion: * every two week (14-day cycles) until disease progression on control arm * at D8 the first cycle and at D1 for subsequent cycles (14-day cycles) until disease progression on experimental arm
The first cycle of treatment (21-day cycle): Mitazalimab 900 µg/kg by intravenous infusion (IV) at D1 and D10 Subsequent cycles (14-day cycles): Mitazalimab 900 µg/kg by intravenous infusion (IV) at D3 of each cycle until disease progression
Institut de cancérologie de l'Ouest - Site Paul Papin
Angers, France
CHU de Bordeaux - Hopital Haut Leveque
Bordeaux, France
CHU Brest
Brest, France
Centre François Baclesse
Caen, France
CHU Estaing
Clermont-Ferrand, France
CHU de Dijon
Dijon, France
CHU Grenoble Alpes
Grenoble, France
CHU Lille
Lille, France
Centre Léon Bérard
Lyon, France
CHU de Lyon
Lyon, France
...and 12 more locations
6 months overall survival rate of participants
Proportion of participant still alive 6 months after randomisation
Time frame: From randomisation to 6 months after randomisation
Safety of the treatments
Adverse events will be collected and scored according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) common criteria v 6.0. This scale, divided into 5 grades (1 = "mild", 2 = "moderate", 3 = "severe", 4 = "life-threatening", and 5 = "death") determined by the investigator, will make it possible to assess the severity of the disorders.
Time frame: From inclusion to completion of the study, up to 64 months
Objective response rate of participants (ORR)
The objective response rate is defined as the percentage of participants with a complete response (CR) or a partial response (PR) on CT-scan for a given treatment
Time frame: Time from randomisation to disease progression, up to 64 months
Disease control rate (DCR)
Proportion of participants with stable disease, or partial response or complete response on CT-Scan
Time frame: Time from randomisation to disease progression, up to 64 months
Progression-free survival (PFS)
The Progression free survival is the lengh of time during and after the treatment of a disease that a patient lives with the disease but it does not get worse
Time frame: Time from randomisation to disease progression or death, up to 64 months
Duration of overall response (DOR)
Time from first documented response (compared to baseline measurement taken at randomisation) until the date of disease progression or death from any cause, whichever occurs first
Time frame: Time from randomisation to disease progression or death, up to 64 months
Overall survival (OS)
The overall survival is the length of time from randomization that patients enrolled in the study are still alive.
Time frame: From randomisation to death from any cause, up to 64 months
Quality of life questionnaire - Core Function 17 (QLQ-F17)
Developed by the EORTC, this self-reported questionnaire assesses the health-related quality of life of cancer patients in clinical trials. The questionnaire contains 15 items organized into five functional scales (physical, everyday activity, cognitive, emotional, and social) and 2 items for health/quality of life overall scale. The 15 items are rated on a four-point Likert-type scale (1 = "not at all", 2 = "a little", 3 = "quite a bit", and 4 = "very much") and are linearly transformed to a 0-100 scale, with higher scores indicating more severe symptoms. The 2 last items for health/quality of life overall are rated on 7 point scale (from 1 = "very poor" to 7 = "excellent")
Time frame: Baseline and every 2 months during the first year after randomisation
Quality of life Questionnaire - Biliary tract cancer module (QLQ-BIL21)
This EORTC cholangiocarcinoma and gallbladder cancer specific questionnaire is intended to supplement the QLQ-C30. The QLQ-BIL21 contains 21 items to assess symptoms. 3 single-item assessments relating to treatment side effects, difficulties with drainage bags/tubes and concerns regarding weight loss, and 18 items grouped into 5 scales: eating symptoms (4 items), jaundice symptoms (3 items), tiredness (3 items), pain symptoms (4 items) and anxiety symptoms (4 items). All items are rated on a four-point Likert-type scale (1 = "not at all", 2 = "a little", 3 = "quite a bit", and 4 = "very much"), and are linearly transformed to a 0-100 scale, with higher scores indicating more severe symptoms.
Time frame: Baseline and every 2 months during the first year after randomisation
The Developed 5-level version of EQ-5D (EQ-5D-5L) questionnaire
Developed by the EuroQol group, the self-reported questionnaire assesses the health-related quality of life of cancer patients in clinical trials consists of a descriptive system and a visual analogue scale (VAS). The EQ-5D-5L descriptive system comprises five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each dimension has 5 levels (1 = "no problems", 2 = "slight problems", 3 = "moderate problems", 4 = "severe problems", and 5 = "extreme problems"). This questionnaire provide a 5-digit score which generate a health state profile. The VAS records the patient's self-rated health on a vertical visual analogue scale where the score range from 0 (The best health you can image) to 100 (The worst health you can image). The VAS is used as a quantitative measure of health outcome that reflects the patient's own judgement.
Time frame: At Baseline and every 2 months during the first year after randomisation
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