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Rectal CancerPhase 2NCT07104604

Study on the Efficacy and Safety of Neoadjuvant Radiotherapy Combined With Tislelizumab, Liposomal Irinotecan, and Capecitabine in the Treatment of pMMR Locally Advanced Rectal Adenocarcinoma With Low Rectal Involvement

A Phase 2 study testing Liposomal Irinotecan+Tislelizumab+Capecitabine+Rradiotherapy in people with Rectal Cancer, run by Affiliated Cancer Hospital of Shantou University Medical College at 2 sites in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The goal of this clinical trial is to evaluating the efficacy and safety of radiotherapy combined with Tislelizumab, Liposomal Irinotecan, and Capecitabine in patients with locally advanced mid-lower rectal cancer with pMMR.. Patients would be included as:1. Aged between 18-75 years, with no gender restrictions; 2. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Rectal Cancer
What is being tested?
Liposomal Irinotecan+Tislelizumab+Capecitabine+Rradiotherapy
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
51 participants
Where
2 sitesChina
Study dates
20 Oct 2025to 30 Jun 2027
Phase
Phase 2
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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age: 18-75 years, no gender restriction
  • ECOG score 0-1
  • Biopsy-confirmed pMMR (proficient mismatch repair) localized advanced low rectal adenocarcinoma (tumor's lower edge ≤ 10 cm from the anus)
  • Presence of the following high-risk factors: T3N+/T4/N2/EMVI+/MRF+/lateral lymph node metastasis/inability to undergo sphincter-preserving surgery
  • Routine chest and abdominal CT scans showing no distant metastasis
  • Bone marrow function: Neutrophil count (ANC) ≥ 1.5 × 10^9/L, platelet count (PLT) ≥ 100 × 10^9/L, hemoglobin (Hb) ≥ 70 g/L
Show all 10Show fewer
  • Liver function: ALT, AST ≤ 2.5 × ULN (upper limit of normal); total bilirubin ≤ 1.5 × ULN; serum albumin ≥ 3 g/dL
  • Kidney function: Serum creatinine (Cr) ≤ 1.5 × ULN or creatinine clearance ≥ 60 ml/min (calculated using the Cockcroft-Gault formula)
  • For females and patients with reproductive potential, a negative pregnancy test must be done within 72 hours before starting the treatment, and the patient must agree to avoid pregnancy during the study treatment and for 6 months after the treatment. For males with reproductive potential partners, the patient must agree to use adequate medically approved contraception during and for 90 days after the final study treatment
  • Patients must agree to receive the study's neoadjuvant chemotherapy regimen and sign an informed consent form

Who cannot join

  • Patients with a history of other malignancies within the past 5 years (except for cured and non-recurring cancers such as in situ carcinoma, basal cell carcinoma of the skin, etc.)
  • Patients with active, uncontrolled bacterial, viral, or fungal infections requiring systemic treatment, defined by persistent signs/symptoms related to infection, which do not improve despite appropriate antibiotics, antiviral treatments, and/or other therapies
  • Patients with uncontrolled systemic diseases, including unstable angina, myocardial infarction, congestive heart failure, severe unstable ventricular arrhythmia, history of severe pericardial disease, or other cardiovascular diseases; uncontrolled hypertension (defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg despite appropriate antihypertensive treatment), or a history of hypertensive crisis, hypertensive encephalopathy; uncontrolled diabetes (fasting blood glucose ≥ 10 mmol/L), etc.
  • Patients known to be allergic or intolerant to the treatment drugs or excipients used in this study
  • Any clinical indicators showing contraindications to chemotherapy and surgery
  • Patients using strong inhibitors or inducers of enzymes such as CYP3A4, CYP2C8, and UGT1A1
Show all 9Show fewer
  • Pregnant or breastfeeding women, and female patients of reproductive potential who refuse to use appropriate contraceptive measures during the study
  • Patients who participated in other clinical trials within 4 weeks before enrollment
  • Patients whom the investigator deems unsuitable for participation in the study

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Jiarui Lin contact

86-13794112671

zljr@163.com

China2 sites, 2 recruiting
  • Shantou University Medical College Cancer Hospital

    Shantou, Guangdong, 515000

    Recruiting
  • The First Affiliated Hospital of Shantou University Medical College

    Shantou, Guangdong, 515041

    Xinxin Li, +86-135-3126-8157, Savageli23@163.com

    Not yet recruiting

Other trials in China

About this study

The goal of this clinical trial is to evaluating the efficacy and safety of radiotherapy combined with Tislelizumab, Liposomal Irinotecan, and Capecitabine in patients with locally advanced mid-lower rectal cancer with pMMR.. Patients would be included as:1. Aged between 18-75 years, with no gender restrictions; 2. Biopsy pathology confirmed as pMMR type locally advanced mid-lower rectal adenocarcinoma (tumor lower margin ≤ 10 cm from the anal verge); 3.With the following high-risk factors: T3N+/T4/N2/EMVI+/MRF+/lateral lymph node metastasis/inability to preserve anal function during surgery; 4. No distant metastasis observed in routine chest and abdominal CT scans.

Conditions
Rectal Cancer
Being tested
Liposomal Irinotecan+Tislelizumab+Capecitabine+Rradiotherapy
Keywords
Neoadjuvant therapy, rectal cancer, liposomal irinotecan, radiotherapy, immunotherapy
Medical subject headings
Rectal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Liposomal Irinotecan+Tislelizumab+Capecitabine+RradiotherapyDrug

    Also called New Neoadjuvant Treatment Approach

    In this study, the novel drug liposomal irinotecan was added, replacing the conventional formulation of irinotecan, and used as an intensified chemotherapy regimen (liposomal irinotecan + capecitabine) combined with immunotherapy and radiotherapy for neoadjuvant treatment of mid-lower rectal cancer.

Study groups in NCT07104604
Study groupRoleWhat they receive
Liposomal IrinotecanExperimentalTreatment regimen: 1. During radiotherapy: Radiotherapy 50Gy/25F + liposomal irinotecan 30mg/m² ivgtt qw w1-w4 + capecitabine 625mg/m² Bid, orally on radiotherapy days + tislelizumab 200mg ivgtt q3w; 2. Radiotherapy-surgery interval: Liposomal irinotecan 70mg/m² ivgtt q3w + capecitabine 1000mg/m² Bid D1-D14 q3w + tislelizumab 200mg ivgtt q3w.
Receives: Drug: Liposomal Irinotecan+Tislelizumab+Capecitabine+Rradiotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Complete response (CR) rate

    The complete response (CR) rate is defined as the proportion of all evaluable participants who achieve either a pathological complete response (pCR) or a clinical complete response (cCR). A participant is classified as a responder if they achieve pCR (defined as no residual tumour on postoperative pathology, ypT0N0) for patients undergoing surgical resection, or confirmed cCR (defined as no clinical, endoscopic, or radiological evidence of residual tumour) for patients managed with organ preservation without resection. These two response categories are mutually exclusive, and the CR rate is calculated using a single shared denominator consisting of all evaluable participants.

    Measured: At surgery, or at the confirmatory organ-preservation assessment approximately 12-16 weeks after the start of neoadjuvant therapy.

Secondary outcomes (8)
  1. Major pathological response (MPR) rate

    The major pathological response (MPR) rate is defined as the proportion of resected participants with 10% or fewer residual viable tumour cells in the resection specimen (i.e., at least 90% of the tumour eliminated).

    Measured: At surgery

  2. Sphincter-preservation rate

    The proportion of resected participants who undergo sphincter-preserving surgery.

    Measured: At surgery

  3. R0 resection rate

    The proportion of resected participants achieving an R0 resection, defined as no tumour cells within 1 mm of the resection margin.

    Measured: At surgery

  4. Disease-free survival (DFS)

    For resected participants, disease-free survival (DFS) is defined as the time from surgery to tumour recurrence or death from any cause; for watch-and-wait participants, DFS is defined as the time from the date of confirmed cCR to local regrowth, distant metastasis, or death from any cause (local regrowth is counted as a DFS event). A supportive analysis of DFS measured from the start of neoadjuvant therapy will also be reported to provide a common time origin across both treatment pathways. Participants without an event will be censored at the last tumour assessment.

    Measured: Up to 24 months

  5. Local-regrowth-free survival and TME-free survival (watch-and-wait subgroup)

    Among participants managed by organ preservation, two endpoints will be reported separately to distinguish salvageable local regrowth from oncological failure: local-regrowth-free survival (time from confirmed cCR to local regrowth) and TME-free survival (time from confirmed cCR to any total mesorectal excision, performed either for regrowth or by patient choice).

    Measured: Up to 24 months

  6. Anorectal function (LARS score)

    Anorectal function assessed using the validated Low Anterior Resection Syndrome (LARS) score.

    Measured: 3, 6, and 12 months after stoma reversal (resected) or after confirmed cCR (watch-and-wait)

  7. Adverse events (safety and tolerability)

    Adverse events assessed systematically and graded according to NCI-CTCAE v5.0, including overall adverse-event rate, grade 3 or higher adverse-event rate, chemotherapy-related and immune-related adverse-event rates, and serious adverse-event rate.

    Measured: From first dose until 28 days after the last dose

  8. Treatment feasibility (regimen completion and dose intensity)

    Feasibility of the four-modality neoadjuvant regimen, assessed by the proportion of participants completing the planned neoadjuvant treatment and by the relative dose intensity of each systemic agent (tislelizumab, liposomal irinotecan, and capecitabine) and of radiotherapy.

    Measured: From first dose to completion of neoadjuvant therapy (approximately 12-16 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Aug 2025
  2. Study start20 Oct 2025
  3. Primary completion31 Mar 2027 (estimated)
  4. Study completion30 Jun 2027 (estimated)

Resources

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
51 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07104604
Sponsor's protocol ID
CancerShantouUMC 2
Status last verified
Jul 2026
First submitted
29 Jul 2025
Last updated
24 Jul 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Bang YJ, Li CP, Lee KH, Chiu CF, Park JO, Shan YS, Kim JS, Chen JS, Shim HJ, Rau KM, Choi HJ, Oh DY, Belanger B, Chen LT. Liposomal irinotecan in metastatic pancreatic adenocarcinoma in Asian patients: Subgroup analysis of the NAPOLI-1 study. Cancer Sci. 2020 Feb;111(2):513-527. doi: 10.1111/cas.14264. Epub 2019 Dec 20.

    PubMed 31789476
  • Wang-Gillam A, Li CP, Bodoky G, Dean A, Shan YS, Jameson G, Macarulla T, Lee KH, Cunningham D, Blanc JF, Hubner RA, Chiu CF, Schwartsmann G, Siveke JT, Braiteh F, Moyo V, Belanger B, Dhindsa N, Bayever E, Von Hoff DD, Chen LT; NAPOLI-1 Study Group. Nanoliposomal irinotecan with fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy (NAPOLI-1): a global, randomised, open-label, phase 3 trial. Lancet. 2016 Feb 6;387(10018):545-557. doi: 10.1016/S0140-6736(15)00986-1. Epub 2015 Nov 29.

    PubMed 26615328
  • Zhu J, Liu A, Sun X, Liu L, Zhu Y, Zhang T, Jia J, Tan S, Wu J, Wang X, Zhou J, Yang J, Zhang C, Zhang H, Zhao Y, Cai G, Zhang W, Xia F, Wan J, Zhang H, Shen L, Cai S, Zhang Z. Multicenter, Randomized, Phase III Trial of Neoadjuvant Chemoradiation With Capecitabine and Irinotecan Guided by UGT1A1 Status in Patients With Locally Advanced Rectal Cancer. J Clin Oncol. 2020 Dec 20;38(36):4231-4239. doi: 10.1200/JCO.20.01932. Epub 2020 Oct 29.

    PubMed 33119477
  • Yang Z, Gao J, Zheng J, Han J, Li A, Liu G, Sun Y, Zhang J, Chen G, Xu R, Zhang X, Liu Y, Bai Z, Deng W, He W, Yao H, Zhang Z. Efficacy and safety of PD-1 blockade plus long-course chemoradiotherapy in locally advanced rectal cancer (NECTAR): a multi-center phase 2 study. Signal Transduct Target Ther. 2024 Mar 11;9(1):56. doi: 10.1038/s41392-024-01762-y.

    PubMed 38462629
  • Rahma OE, Yothers G, Hong TS, Russell MM, You YN, Parker W, Jacobs SA, Colangelo LH, Lucas PC, Gollub MJ, Hall WA, Kachnic LA, Vijayvergia N, O'Rourke MA, Faller BA, Valicenti RK, Schefter TE, George S, Kainthla R, Stella PJ, Sigurdson E, Wolmark N, George TJ. Use of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: Initial Results From the Pembrolizumab Arm of a Phase 2 Randomized Clinical Trial. JAMA Oncol. 2021 Aug 1;7(8):1225-1230. doi: 10.1001/jamaoncol.2021.1683.

    PubMed 34196693

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Liposomal Irinotecan+Tislelizumab+Capecitabine+Rradiotherapy in people with Rectal Cancer, run by Affiliated Cancer Hospital of Shantou University Medical College at 2 sites 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 10 inclusion and 9 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 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 Jiarui Lin (86-13794112671, zljr@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Complete response (CR) rate (time frame: At surgery, or at the confirmatory organ-preservation assessment approximately 12-16 weeks after the start of neoadjuvant therapy.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07104604, which also lists 5 linked publications.

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 Jul 2026.

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