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Low-dose Immunotherapy in Metastatic and Locally Advanced Colorectal and Gastric MSI/dMMR Cancers
Sponsor: Blokhin's Russian Cancer Research Center
Summary
It is planned to study the effectiveness of low-dose immunotherapy (IT) nivolumab 40 mg for either 2 courses of therapy or 6 courses as preoperative therapy in patients with dMMR/MSI locally advanced CRC. Parallel recruitment into subgroups of patients by randomization is assumed. For dMMR/MSI locally advanced gastric cancer, it is planned to study the effectiveness of low-dose immunotherapy nivolumab 40 mg with or without the addition of chemotherapy (CT) in the FOLFOX regimen as preoperative therapy. Subgroup A includes 6 cycles of IV CT FOLFOX + IV administration of nivolumab 40 mg once every 14 days, subgroup B - 2 cycles of intravenous administration of nivolumab at a dose of 40 mg once every 14 days, and subgroup C - 6 cycles of intravenous administration of nivolumab at a dose of 40 mg once a day 14 days. Thus, it is planned to gradually include patients in the treatment subgroups. The frequency of complete therapeutic tumor pathomorphoses (pCR, TRG1) will be evaluated as the primary endpoint. Secondary goals are to study the safety of drug doses, to assess the frequency of pronounced therapeutic tumor pathomorphoses (MPR, TRG 1-2), to assess disease-free survival (PFS), the frequency of R0 resections, overall survival(S), and the frequency of objective response. To study the use of low-dose immunotherapy in combination with chemotherapy in patients with metastatic dMMR/MSI CRC and gastric cancer in the first line of therapy, it is planned to use a combination of nivolumab 40 mg with FOLFOX regimen once every 14 days for 8 treatment cycles, followed by a switch to supportive intravenous monotherapy with nivolumab 40 mg.
Official title: Phase II Open-lable Single-center Clinical Study of the Efficacy and Safety of Low-dose Immunotherapy in the Treatment of Patients With Metastatic and Locally Advanced Colorectal and Gastric Cancers With Microsatellite Unstable Phenotype (MSI)/Deficiency of Mismatch Repair System (dMMR)
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
128
Start Date
2025-06-03
Completion Date
2028-03-31
Last Updated
2026-04-24
Healthy Volunteers
No
Conditions
Interventions
Low-dose nivolumab
nivolumab 40 mg
Low-dose nivolumab with/without chemotherapy
Subgroup A - 6 cycles of IV CT FOLFOX + nivolumab 40 mg once every 14 days; Subgroup B - 2 cycles of IV of nivolumab 40 mg once every 14 days; Subgroup C - 6 cycles of of nivolumab 40 mg once a day 14 days.
Low-dose nivolumab combined with chemotherapy
Metastatic dMMR/MSI CRC and gastric cancer in the first line - the use of low-dose immunotherapy in combination with chemotherapy (nivolumab 40 mg + FOLFOX regimen once every 14 days for 8 cycles + maintenance monotherapy nivolumab 40 mg)
Locations (1)
N.N. Blokhin NMRCO
Moscow, Russia