QL1706 Injection Plus Bevacizumab and XELOX vs Placebo Plus Bevacizumab and XELOX as First-Line Treatment of Unresectable Metastatic Colorectal Cancer

Official title

A Randomized, Double-blind, Multicenter Phase 3 Study of QL1706 Injection in Combination With Bevacizumab and XELOX Versus Placebo in Combination With Bevacizumab and XELOX as First-line Therapy for the Treatment of Patients With Unresectable Metastatic Colorectal Cancer (mCRC)

Overview

The purpose of this study is to evaluate the efficacy and safety of QL1706 Injection in combination with bevacizumab and XELOX compared with placebo in combination with bevacizumab and XELOX for first-line treatment in patients with unresectable mCRC.

Interventions

• Drug QL1706
  QL1706 will be administered by IV infusion at 5mg/kg on Day 1 of each 21-day cycle until disease progression (PD), intolerable toxicity, initiation of a new anti-tumor therapy, death, withdrawal of informed consent, loss to follow-up or other conditions requiring termination of the treatment (whichever occurs first). The administration of QL1706 lasts for up to 2 years.
• Drug Bevacizumab
  Bevacizumab will be administered by IV infusion at 7.5mg/kg on Day 1 of each 21-day cycle until disease progression (PD), intolerable toxicity, initiation of a new anti-tumor therapy, death, withdrawal of informed consent, loss to follow-up or other conditions requiring termination of the treatment (whichever occurs first). The administration of Bevacizumab lasts for up to 2 years.
• Drug Oxaliplatin
  Oxaliplatin will be administered by IV infusion at 130 mg/m2 on Day 1 of each 21-day cycle up to 8 treatment cycles.
• Drug Capecitabine
  Capecitabine will be administered orally at 1000 mg/m2 twice daily for 2 consecutive weeks, followed by one-week rest in each 21-day cycle until disease progression (PD), intolerable toxicity, initiation of a new anti-tumor therapy, death, withdrawal of informed consent, loss to follow-up or other conditions requiring termination of the treatment (whichever occurs first). The administration of Capecitabine lasts for up to 2 years.
• Drug Placebo
  Placebo will be administered by IV infusion at 5mg/kg on Day 1 of each 21-day cycle until disease progression (PD), intolerable toxicity, initiation of a new anti-tumor therapy, death, withdrawal of informed consent, loss to follow-up or other conditions requiring termination of the treatment (whichever occurs first). The administration of Placebo lasts for up to 2 years.

Primary outcome measures

• Progression Free Survival (PFS) Assessed by the Independent Radiology Review Committee (IRRC) [Time frame: Up to approximately 2 years]

Secondary outcome measures (5)

• Overall Survival (OS) [Time frame: Approximately 66 months]
• Progression Free Survival (PFS) Assessed by Investigator [Time frame: Up to approximately 2 years]
• Objective Response Rate (ORR) [Time frame: Approximately 36 months]
• Duration Of Response (DOR) [Time frame: Approximately 36 months]
• Incidence of AEs, SAEs and treatment-emergent adverse events (TEAEs). [Time frame: From the subject signs the ICF to 30 days after the last dose of study drug is administered]

Eligibility criteria

Inclusion criteria

• Patients who voluntarily sign the informed consent form (ICF) and can understand and comply with the study requirements;
• Males and females aged 18 to 75 years old (including boundary value) on the date of signing ICF;
• Unresectable metastatic colorectal adenocarcinoma confirmed by histopathology examination;
• No previous systemic anti-tumor drug therapy for metastatic colorectal adenocarcinoma;
• At least one target lesion as judged by the investigator per RECIST v1.1 (lesions previously treated with topical treatment such as radiotherapy should not be considered as target lesions, unless it is confirmed that there has been definite progression of lesions located in the previous radiotherapy region);
• Be able to provide sufficient previously archived tumor tissue samples or agree to collect tumor tissue samples (≥ 5 unstained pathological tissue sections) by biopsy for biomarker testing. If sufficient tissue samples cannot be provided, it should be determined with the sponsor;
• ECOG PS score of 0 or 1 within 7 days before the first dose;
• Adequate liver, bone marrow, and renal organ function.

Exclusion criteria

• Patients had other active malignant tumors within 5 years prior to the first dose. Patients with localized tumors that have been cured, such as basal cell carcinoma of the skin, squamous cell carcinoma of skin, superficial bladder carcinoma, carcinoma in situ of prostate, cervical carcinoma in situ, and breast carcinoma in situ, can be enrolled.
• Previous treatment with radiotherapy at any site within 4 weeks prior to the first dose.
• Previous treatment with postoperative adjuvant therapy with targeted drugs targeting epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF) or its receptor (VEGFR), including but not limited to Bevacizumab, Cetuximab, Panitumumab, Aflibercept, Regorafenib or Anlotinib;
• Previous treatment with any T cell costimulation or immune checkpoint inhibitors, including but not limited to anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4, anti-OX-40 or anti-CD137 monoclonal antibodies;
• Participation in a clinical study and treatment with study drug or device within 4 weeks prior to the first dose, or traditional Chinese medicine treatment < 2 weeks from the first dose;
• Patients who have a history of severe (≥ Grade 3) gastrointestinal ulcers, gastrointestinal perforation, fistula formation, intra-abdominal inflammation/abscess, intra-abdominal pneumatosis not due to puncture or surgery, macroscopic digestive tract hemorrhage/melena (excluding hemorrhoidal hemorrhage), and hemoptysis (about 3 mL or more) within 6 months prior to the first dose;
• Uncontrollable pleural effusion, pericardial effusion or ascites requiring drainage;
• Presence of dysphagia and unable to swallow the investigational product;

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Quadruple blind

Primary purpose

Treatment

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07025239 · QL1706-309

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗