A Prospective Single-arm Phase Ib/II Study on the Safety and Efficacy of Fruquintinib Plus Chidamide and Sintilimab in the Third and Later Line Treatment of MSS/pMMR Metastatic Colorectal Cancer
The prognosis of most patients with unresectable locally advanced or metastatic colorectal cancer (CRC) remains poor despite the advancements in chemotherapy and target therapy. CAPability-01 trial investigated the potential efficacy of combining the programmed cell death protein-1 (PD-1) monoclonal antibody sintilimab with the histone deacetylase inhibitor (HDACi) chidamide with or without the anti-vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab in patients with unresectable chemotherapy-refractory locally advanced or metastatic microsatellite stable/proficient mismatch repair (MSS/pMMR) colorectal cancer. Based on the previous findings of CAPability-01, we will further evaluate the efficacy and safety of sintilimab and chidamide in combination with fruquintinib in the same setting.
• Fully understand this study and voluntarily sign the informed consent form;
• Age between 18-75 years inclusive;
• Patients with histologically confirmed unresectable locally advanced, recurrent, or metastatic colorectal adenocarcinoma;
• Failure of standard second-line systemic treatment with measurable lesions;
• Tumor tissue tested for microsatellite stability (MSS) or low microsatellite instability (MSI-L) by PCR, or confirmed pMMR by immunohistochemistry for DNA mismatch repair (MMR) protein (including MLH1, MSH2, MSH6, and PMS2 protein expression);
• ECOG performance status of 0-2, with no deterioration within 7 days;
• BMI≥18;
• Expected survival ≥3 months;
• Major organ functions meet the following requirements (no use of any blood components and growth factors within 14 days before enrollment):
‣ Absolute neutrophil count ≥1.5×109/L, white blood cells ≥4.0×109/L;
⁃ Platelets ≥100×109/L;
⁃ Hemoglobin ≥90g/L;
⁃ Total bilirubin TBIL ≤1.5 times ULN;
⁃ ALT and AST ≤5 times ULN;
⁃ Urea/BUN and creatinine (Cr) ≤1.5×ULN (and creatinine clearance (CCr) ≥ 50mL/min);
⁃ Left ventricular ejection fraction (LVEF) ≥50%;
⁃ Corrected QT interval by Fridericia's formula (QTcF) \<470 milliseconds.
⁃ INR ≤1.5×ULN, APTT ≤1.5×ULN.
⁃ Women of childbearing age must use effective contraception;
⁃ Good compliance and cooperation with follow-up.