Rectal CancerPhase 3NCT05752136
Preoperative Short-course Radiation Followed by Envafolimab Plus CAPEOX for MSS Locally Advanced Rectal Adenocarcinoma
A Phase 3 study testing Envafolimab in people with Rectal Cancer, run by Sir Run Run Shaw Hospital at 1 site in China.
Trial summary
Short-course radiotherapy combined with immunotherapy may bring revolutionary changes to the preoperative neoadjuvant treatment mode for locally advanced rectal cancer.In view of the shortcomings of the current preoperative neoadjuvant treatment model for locally advanced rectal cancer, we will explore the feasibility… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Rectal Cancer
- What is being tested?
- Envafolimab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 108 participants
- Where
- 1 siteChina
- Study dates
- 1 Apr 2023to Dec 2028
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients who are willing to receive neoadjuvant therapy.
- ≧18 years old.
- Diagnosed by digital rectal examination, colonoscopy, and high-resolution MRI of the pelvis, the tumor is less than or equal to 12 cm from the anus.
- Histologically diagnosed as rectal adenocarcinoma.
- The clinical staging by pelvic contrast-enhanced CT and pelvic high-resolution MRI were cT2-4a N+, cT3/T4a N0.
- MMR protein detection or MSI gene detection of rectal cancer specimens confirmed pMMR or MSS before treatment .
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- The patient has good compliance and can come to the hospital for re-examination as required.
- ECOG Scale of Performance Status score 0-1 point.
- Have not received anti-tumor and immunotherapy before enrollment.
- Laboratory inspections must meet the following standards:
- White blood cell count>3.5×109/L, absolute value of neutrophils>1.8×109/L, platelet count ≥75×109/L, hemoglobin ≥100g/L;
- INR≤1.5, and APTT≤1.5 times the upper limit of normal or partial prothrombin time (PT) ≤1.5 times the upper limit of normal;
- Total bilirubin ≤ 1.25 times the upper limit of normal; ALT and AST < 5 times the upper limit of normal;
- 24h creatinine clearance >50mL/min or serum creatinine <1.5 times the upper limit of normal.
- Voluntarily participate in this study and sign the informed consent.
Who cannot join
- History of other malignant diseases in the past 5 years.
- Patients with metastases from other sites (stage IV patients).
- Patients with clinical staging of T1-2N0 or T4b, or positive lateral lymph nodes by pelvic contrast-enhanced CT and pelvic high-resolution MRI.
- Patients with intestinal obstruction, intestinal perforation, intestinal bleeding, etc. requiring emergency surgery.
- Known allergic to oxaliplatin, capecitabine, PD-L1 monoclonal antibody and other drugs.
- Pathologically suggested signet ring cell carcinoma and mucinous adenocarcinoma.
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- dMMR or MSI-H patients.
- The patient is accompanied by any unstable systemic disease, including but not limited to: severe infection, uncontrolled diabetes, hypertension uncontrolled by medication, unstable angina, cerebrovascular accident or transient cerebral ischemia, myocardial Infarction, congestive heart failure, severe cardiac arrhythmia requiring medication, hepatic, renal or metabolic disease; disease affecting the patient's life.
- The disease (such as mental illness, etc.) or condition (such as alcoholism or drug abuse, etc.) associated with the patient will increase the risk of the patient receiving the trial drug treatment or affect the patient's compliance with the trial requirements, or may confuse the research results.
- Active autoimmune disease that may worsen while receiving immunostimulants.
- Known history of positive HIV test or known acquired immunodeficiency syndrome.
- Patients who are using immunosuppressive agents, except for the following conditions:
- Intranasal, inhaled, topical steroids, or topical steroid injections (eg, intra-articular injections);
- Physiological doses of systemic corticosteroids ≤10 mg/day prednisone or equivalent;
- Steroids used to prevent allergic reactions (eg, before CT scan).
- Received any other experimental drug treatment or participated in another interventional clinical trial within 30 days before screening
- Women who are pregnant or breastfeeding or who plan to become pregnant or breastfeeding during the study period; men or women who are unwilling to take effective contraceptive measures.
- Vulnerable groups, including mentally ill, cognitively impaired, critically ill patients, minors, etc.
- Other conditions that the investigator judges that the patient is not suitable to participate in the clinical study, etc.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
China1 site, 1 recruiting
- Recruiting
Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
Hangzhou, Zhejiang, 310016
Xiujun Cai
About this study
Official title: Preoperative Short-course Radiation Followed by Envafolimab Plus CAPEOX for MSS Locally Advanced Rectal Adenocarcinoma: a Prospective, Multicenter, Randomized Controlled Study (PRECAM-R)
Short-course radiotherapy combined with immunotherapy may bring revolutionary changes to the preoperative neoadjuvant treatment mode for locally advanced rectal cancer.In view of the shortcomings of the current preoperative neoadjuvant treatment model for locally advanced rectal cancer, we will explore the feasibility of a new model of short-course radiotherapy combined with immunotherapy, and develop a possible optimal plan based on the existing theoretical basis, namely "short-course radiotherapy + PD-L1 monoclonal antibody combined with CAPEOX chemotherapy for 2 cycles", and explore the efficacy and adverse effects of this model. The study will also attempt to explore the characteristics of the treatment beneficiary population, explore the characteristics of the treatment beneficiary population by multi-dimensional tumor and microenvironmental information through multi-omics sequencing analysis, attempt to build an efficacy prediction model, early screening of the treatment beneficiary population for precise treatment, and thus explore a new model of radiotherapy combined with immunotherapy.
- Conditions
- Rectal Cancer
- Being tested
- Envafolimab
- Medical subject headings
- Rectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
EnvafolimabBiological
This product is administered by subcutaneous injection. The recommended dose of subcutaneous injection is 150 mg, administered weekly (QW).
| Study group | Role | What they receive |
|---|---|---|
| Neoadjuvant chemoradiotherapy combined with immunotherapy and total mesorectal excision | Experimental | Drug: Envafolimab This product is administered by subcutaneous injection. The recommended dose of subcutaneous injection is 150 mg, administered weekly (QW).
Other Name: KN053
Drug: Oxaliplatin 130mg/m2,ivgtt,d1
Drug: Capecitabine 1000mg/m2,po,bid,d1-14
Radiation: Short-course Radiation Short-course radiotherapy, using three-dimensional conformal or intensity-modulated radiotherapy, the dose is divided into 5Gy/f, the total dose is 25Gy/5f, 1f/d, and the irradiation is completed within 7 days.
Procedure: TME surgery, total mesorectal excision The surgical method can choose open, laparoscopic or robotic according to the specific condition of the patient. Receives: Biological: Envafolimab |
| Neoadjuvant chemoradiotherapy and total mesorectal excision | No intervention | Drug: Oxaliplatin 130mg/m2,ivgtt,d1 Drug: Capecitabine 1000mg/m2,po,bid,d1-14 Radiation: Short-course Radiation Short-course radiotherapy, using three-dimensional conformal or intensity-modulated radiotherapy, the dose is divided into 5Gy/f, the total dose is 25Gy/5f, 1f/d, and the irradiation is completed within 7 days. Procedure: TME surgery, total mesorectal excision The surgical method can choose open, laparoscopic or robotic according to the specific condition of the patient. |
What is being measured
The primary outcome is the main question the study is designed to answer.
pCR rate
The primary objective of the study is to evaluate the pathologic complete response (pCR) rate following short-course radiation then Envafolimab Plus CAPEOX
Measured: Up to 10 weeks (once surgery is done) ]
Secondary outcomes (6)
Tumor regression grade
Tumor regression grade following short-course radiation then Envafolimab Plus CAPEOX as assessed by AJCC/CAP TRG system
Measured: Up to 10 weeks (once surgery is done)
OS
The proportion of participants who remain survival at 3 years
Measured: Up to 3 years
PFS
The proportion of participants who remain progression free at 3 years
Measured: Up to 3 years
TRAEs
Number of participants with treatment-related adverse events as assessed by NCI-CTCAE v5.0
Measured: Up to 3 years
Surgical Complications
Surgical Complications of total mesorectal resection procedure for patients after short-course radiation then Envafolimab Plus CAPEOX as assessed by Clavien-Dindo classification
Measured: Up to 24 weeks
QoL
Quality of life of the patients in two neoadjuvant settings of short-course radiation followed with or without Envafolimab Plus CAPEOX as assessed by Functional Assessment of Cancer Therapy - Colorectal (FACT-C) questionnaire liscenced from The Functional Assessment of Chronic Illness Therapy System ("FACIT System"). By using the Manual scoring template, some items are reverse scored. Subscale scores, total scores and TOI scores. The higher the score, the better the QOL.
Measured: Up to 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Mar 2023
- Study start1 Apr 2023
- Primary completion1 Nov 2026 (estimated)
- Study completionDec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Rectal CancerStudies of the same condition, open and under way.
- More trials run by Sir Run Run Shaw HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- The 54 enrolled patients with MSS-type advanced middle-low rectal cancer in the experimental arm will receive neoadjuvant chemoradiotherapy plus envafolimab immunotherapy followed by total mesorectal excision (TME surgery). The other 54 patients with MSS-type advanced middle-low rectal cancer in the control arm will receive neoadjuvant chemoradiotherapy followed by total mesorectal excision (TME surgery). Meanwhile, to prevent adverse events following immunotherapy, patients receiving chemoradiotherapy combined with immunotherapy will take oral vitamin B6 at a dose of 20 mg daily for 6 weeks during immunotherapy. This study aims to explore the feasibility of this strategy for the prevention and mitigation of immune checkpoint inhibitor-related adverse events.
- Masking
- None (open label)
- Enrolment
- 108 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Sir Run Run Shaw Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Sheng Dai, Sir Run Run Shaw Hospital
- Investigators
- sheng dai, Principal investigator, Sir Run Run Shaw Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05752136
- Sponsor's protocol ID
- LXSHYJ-20221129-02
- Status last verified
- Sep 2026
- First submitted
- 20 Feb 2023
- Last updated
- 24 Sep 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 24 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Preoperative Short-course Radiation Followed by Envafolimab Plus CAPEOX for MSS Locally Advanced Rectal Adenocarcinoma: a Prospective, Multicenter, Randomized Controlled Study (PRECAM-R)
- ClinicalTrials.gov ID
- NCT05752136
- Acronym / sponsor ID
- LXSHYJ-20221129-02
- Conditions
- Rectal Cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 108 participants (estimated)
- Lead sponsor
- Sir Run Run Shaw HospitalUniversity, hospital or other
- Study start
- 1 Apr 2023 (actual)
- Primary completion
- 1 Nov 2026 (estimated)
- Study completion
- Dec 2028 (estimated)
- First posted
- 2 Mar 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Short-course radiotherapy combined with immunotherapy may bring revolutionary changes to the preoperative neoadjuvant treatment mode for locally advanced rectal cancer.In view of the shortcomings of the current preoperative neoadjuvant treatment model for locally advanced rectal cancer, we will explore the feasibility of a new model of short-course radiotherapy combined with immunotherapy, and develop a possible optimal plan based on the existing theoretical basis, namely "short-course radiotherapy + PD-L1 monoclonal antibody combined with CAPEOX chemotherapy for 2 cycles", and explore the efficacy and adverse effects of this model. The study will also attempt to explore the characteristics of the treatment beneficiary population, explore the characteristics of the treatment beneficiary population by multi-dimensional tumor and microenvironmental information through multi-omics sequencing analysis, attempt to build an efficacy prediction model, early screening of the treatment beneficiary population for precise treatment, and thus explore a new model of radiotherapy combined with immunotherapy.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- The 54 enrolled patients with MSS-type advanced middle-low rectal cancer in the experimental arm will receive neoadjuvant chemoradiotherapy plus envafolimab immunotherapy followed by total mesorectal excision (TME surgery). The other 54 patients with MSS-type advanced middle-low rectal cancer in the control arm will receive neoadjuvant chemoradiotherapy followed by total mesorectal excision (TME surgery). Meanwhile, to prevent adverse events following immunotherapy, patients receiving chemoradiotherapy combined with immunotherapy will take oral vitamin B6 at a dose of 20 mg daily for 6 weeks during immunotherapy. This study aims to explore the feasibility of this strategy for the prevention and mitigation of immune checkpoint inhibitor-related adverse events.
| Arm | Type | Receives |
|---|---|---|
| Neoadjuvant chemoradiotherapy combined with immunotherapy and total mesorectal excision | Experimental | Biological: EnvafolimabDrug: Envafolimab This product is administered by subcutaneous injection. The recommended dose of subcutaneous injection is 150 mg, administered weekly (QW). Other Name: KN053 Drug: Oxaliplatin 130mg/m2,ivgtt,d1 Drug: Capecitabine 1000mg/m2,po,bid,d1-14 Radiation: Short-course Radiation Short-course radiotherapy, using three-dimensional conformal or intensity-modulated radiotherapy, the dose is divided into 5Gy/f, the total dose is 25Gy/5f, 1f/d, and the irradiation is completed within 7 days. Procedure: TME surgery, total mesorectal excision The surgical method can choose open, laparoscopic or robotic according to the specific condition of the patient. |
| Neoadjuvant chemoradiotherapy and total mesorectal excision | No intervention | –Drug: Oxaliplatin 130mg/m2,ivgtt,d1 Drug: Capecitabine 1000mg/m2,po,bid,d1-14 Radiation: Short-course Radiation Short-course radiotherapy, using three-dimensional conformal or intensity-modulated radiotherapy, the dose is divided into 5Gy/f, the total dose is 25Gy/5f, 1f/d, and the irradiation is completed within 7 days. Procedure: TME surgery, total mesorectal excision The surgical method can choose open, laparoscopic or robotic according to the specific condition of the patient. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (15 listed)
- Patients who are willing to receive neoadjuvant therapy.
- ≧18 years old.
- Diagnosed by digital rectal examination, colonoscopy, and high-resolution MRI of the pelvis, the tumor is less than or equal to 12 cm from the anus.
- Histologically diagnosed as rectal adenocarcinoma.
- The clinical staging by pelvic contrast-enhanced CT and pelvic high-resolution MRI were cT2-4a N+, cT3/T4a N0.
Key exclusion criteria (19 listed)
- History of other malignant diseases in the past 5 years.
- Patients with metastases from other sites (stage IV patients).
- Patients with clinical staging of T1-2N0 or T4b, or positive lateral lymph nodes by pelvic contrast-enhanced CT and pelvic high-resolution MRI.
- Patients with intestinal obstruction, intestinal perforation, intestinal bleeding, etc. requiring emergency surgery.
- Known allergic to oxaliplatin, capecitabine, PD-L1 monoclonal antibody and other drugs.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| EnvafolimabThis product is administered by subcutaneous injection. The recommended dose of subcutaneous injection is 150 mg, administered weekly (QW). | Biological | Neoadjuvant chemoradiotherapy combined with immunotherapy and total mesorectal excision |
Primary outcome
pCR rate
Time frame: Up to 10 weeks (once surgery is done) ]
The primary objective of the study is to evaluate the pathologic complete response (pCR) rate following short-course radiation then Envafolimab Plus CAPEOX
6 secondary outcomes
Tumor regression grade
Time frame: Up to 10 weeks (once surgery is done)
OS
Time frame: Up to 3 years
PFS
Time frame: Up to 3 years
TRAEs
Time frame: Up to 3 years
Surgical Complications
Time frame: Up to 24 weeks
QoL
Time frame: Up to 3 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Sep 2026.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
sheng dai principal investigator
Sir Run Run Shaw Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Envafolimab in people with Rectal Cancer, run by Sir Run Run Shaw Hospital at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 15 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 24 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Sheng Dai, MD&PhD (13575472669, daimd@zju.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
pCR rate (time frame: Up to 10 weeks (once surgery is done) ]). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Sep 2026; AzTrials last refreshed its copy on 7 Nov 2026.