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Locally Advanced Colon CancerPhase 3TORCH-C2NCT07877597

Chemotherapy Combined With or Without Short-Course Radiotherapy Versus Chemotherapy Alone as Neoadjuvant Therapy for High-Risk Locally Advanced Colon Cancer With pMMR/MSS

A Phase 3 study testing short-course radiotherapy, Serplulimab and CapOx(Capecitabine+ Oxaliplatin) in people with Locally Advanced Colon Cancer and pMMR, run by Fudan University at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Locally advanced colon cancer, particularly T4 disease or colon cancer with bulky nodes, carries a poor prognosis and limited efficacy with neoadjuvant chemotherapy. In our previous small-sample phase II study, PD-1 inhibitor plus CAPOX chemotherapy combined with short-course radiotherapy yielded a marked improvement… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Locally Advanced Colon Cancer, pMMR
What is being tested?
short-course radiotherapy, Serplulimab and CapOx(Capecitabine+ Oxaliplatin)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
480 participants
Where
1 siteChina
Study dates
15 Oct 2026to 31 Dec 2031
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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1. Aged ≥18 years, of any gender. 2. Colon adenocarcinoma confirmed by histopathology, with the tumour located >15 cm from the anal verge on colonoscopy.
  • 3. Locally high-risk disease demonstrated by contrast-enhanced abdominal CT or MRI, defined as tumour invasion beyond the serosa or into adjacent organs (cT4), or high-risk lymph nodes and tumour deposits. No distant metastasis (M0) identified on chest CT plus contrast-enhanced pelvic CT/MRI, or whole-body PET-CT.
  • 4. pMMR or MSS status confirmed by immunohistochemistry or genetic testing. 5. No prior anti-tumour therapy. 6. ECOG performance status 0-1, with an expected survival of ≥3 months. Patients must be willing to cooperate with adverse event and efficacy assessments.
  • 7. Adequate organ function:
  • Neutrophils ≥1.5×10⁹/L; platelets ≥100×10⁹/L; haemoglobin ≥9 g/dL (or ≥9 g/dL after transfusion or supportive care); serum albumin ≥3 g/dL.
  • Thyroid-stimulating hormone (TSH) ≤1×upper limit of normal (ULN), with T3 and T4 within normal ranges.
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  • Bilirubin ≤1.5×ULN; ALT and AST ≤2×ULN.
  • Serum creatinine ≤1.5×ULN; creatinine clearance ≥60 mL/min.
  • International normalised ratio (INR) or prothrombin time (PT) ≤1.5×ULN, unless the patient is on anticoagulation with PT within the expected therapeutic range of the anticoagulant; activated partial thromboplastin time (aPTT) ≤1.5×ULN.
  • 8. No severe concomitant disease that would limit life expectancy to less than 5 years.
  • 9. Female subjects of childbearing potential must have a negative pregnancy test; female subjects without childbearing potential are also eligible.
  • 10. Male patients of childbearing potential and female patients with childbearing potential and pregnancy risk must agree to use adequate contraception throughout the study period and for 12 months after completion of study treatment.
  • 11. Signed and dated informed consent form, indicating that the patient has been informed of all relevant aspects of the study.
  • 12. Patients who are willing and able to comply with scheduled visits, treatment plans, laboratory tests and other study procedures.

Who cannot join

  • 1. Histopathological diagnosis of other colonic neoplasms, such as gastrointestinal stromal tumour, lymphoma, etc.
  • 2. Prior treatment with PD-1 antibody, PD-L1 antibody or CTLA-4 antibody. 3. Previous or concurrent malignancy, except for adequately treated non-melanoma skin cancer, cervical carcinoma in situ and papillary thyroid carcinoma.
  • 4. Active autoimmune disease or a history of autoimmune disease (including but not limited to interstitial pneumonia, colitis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism and hypothyroidism). Exceptions include autoimmune-mediated hypothyroidism treated with a stable dose of thyroid replacement hormone; type 1 diabetes mellitus managed with stable-dose insulin; vitiligo; or childhood asthma/allergy that has resolved and requires no intervention in adulthood.
  • 5. History of immunodeficiency, including positive HIV test, other acquired or congenital immunodeficiency disorders, or a history of solid organ transplantation and allogeneic bone marrow transplantation.
  • 6. History of interstitial lung disease (excluding radiation pneumonitis not treated with steroids) or non-infectious pneumonitis.
  • 7. Subjects with active pulmonary tuberculosis identified by medical history or CT scan; those with a history of active pulmonary tuberculosis within 1 year prior to enrollment; or those with a history of active pulmonary tuberculosis more than 1 year previously who did not receive standard anti-tuberculosis treatment.
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  • 8. Subjects with active hepatitis B (HBV DNA ≥2000 IU/mL or 10⁴ copies/mL) or hepatitis C (positive hepatitis C antibody with HCV-RNA above the lower limit of quantification of the assay).
  • 9. Severe impairment of cardiac, pulmonary, renal or hepatic function. 10. Uncontrolled hypertension despite antihypertensive medication (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg).
  • 11. History of psychoactive substance abuse, alcoholism or illicit drug use. 12. Other factors judged by the investigator to compromise subject safety or trial compliance. Examples include severe diseases requiring concomitant treatment (including psychiatric disorders), significant laboratory abnormalities, or other familial or social factors.

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
  • Fudan University Shanghai Cancer Center

    Shanghai, 200032

    Zhen Zhang, MD, +86-021-64175590, zhen_zhang@fudan.edu.cn

    Hui Zhang, MD, 18121299531, huizhang12@fudan.edu.cn

Other trials in China

About this study

Official title: A Prospective, Randomized, Multicenter, Phase III Clinical Study of Chemotherapy Combined With or Without Short-Course Radiotherapy Versus Chemotherapy Alone as Neoadjuvant Therapy for High-Risk Locally Advanced Colon Cancer With pMMR/MSS (TORCH-C2 Trial)

Locally advanced colon cancer, particularly T4 disease or colon cancer with bulky nodes, carries a poor prognosis and limited efficacy with neoadjuvant chemotherapy. In our previous small-sample phase II study, PD-1 inhibitor plus CAPOX chemotherapy combined with short-course radiotherapy yielded a marked improvement in the pCR rate compared with neoadjuvant CAPOX alone, though survival outcomes remain under follow-up. This prospective, multicentre, randomised, three-arm phase III study enrolls 480 patients with pMMR/MSS locally advanced high-risk colon cancer. Participants are randomised in a 2:2:1 ratio to three arms: short-course radiotherapy combined with chemotherapy and PD-1 inhibitor (25 Gy in 5 fractions of radiotherapy, followed by 4 cycles of CAPOX plus the PD-1 inhibitor serplulimab); chemotherapy plus PD-1 inhibitor (4 cycles of CAPOX combined with serplulimab); and chemotherapy alone (4 cycles of CAPOX). The primary endpoint is the 3-year event-free survival (EFS) rate. Secondary endpoints include the pCR rate, 5-year overall survival rate (5y OS), R0 resection rate, toxicity, surgical complications and quality of life.

Being tested
short-course radiotherapy, Serplulimab, CapOx(Capecitabine+ Oxaliplatin)
Keywords
colon cancer, radiotherapy, chemotherapy, immunotherapy
Medical subject headings
Colonic Neoplasms

What participants receive

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

  • short-course radiotherapyRadiation

    short-course radiotherapy with 25 Gy in 5 Fractions (25 Gy/5Fx)

  • SerplulimabDrug

    Also called immunotherapy, PD-1 inhibitor

    A fixed dose of 300 mg is administered by intravenous infusion on Day 1 (D1), once every 3 weeks (Q3W).

  • CapOx(Capecitabine+ Oxaliplatin)Drug

    Also called chemotherapy

    Oxaliplatin (130 mg/m²) is administered by intravenous infusion on Day 1. Capecitabine 1000 mg/m² is given orally twice daily (bid) from Day 1 to Day 14, repeated every 3 weeks (Q3W).

Study groups in NCT07877597
Study groupRoleWhat they receive
Group A (chemoradiotherapy+pd-1)ExperimentalGroup A receives 25 Gy in 5 fractions of radiotherapy, followed by 4 cycles of CAPOX plus the PD-1 inhibitor serplulimab
Receives: Radiation: short-course radiotherapy; Drug: Serplulimab; Drug: CapOx(Capecitabine+ Oxaliplatin)
Group B (immunochemotherapy)ExperimentalGroup B receives 4 cycles of CAPOX plus the PD-1 inhibitor serplulimab
Receives: Drug: Serplulimab; Drug: CapOx(Capecitabine+ Oxaliplatin)
Group C (chemotherapy)Active comparatorGroup C receives 4 cycles of CAPOX
Receives: Drug: CapOx(Capecitabine+ Oxaliplatin)

What is being measured

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

  1. 3-year event-free survival

    rate of 3-year event-free survival

    Measured: From the date of randomization until the date of first documented disease progression or toxicity during neoadjuvant therapy that prevent surgery, local regional recurrence, distant metastasis, or death, whichever came first, assessed up to 36 months.

Secondary outcomes (6)
  1. pathological complete response (pCR)

    Defined as the proportion of patients in the arm with no residual viable tumour cells in the primary lesion and lymph nodes on surgical specimens.

    Measured: one month after surgery

  2. R0 resection rate

    Defined as the proportion of patients in the trial arm who achieve curative resection with microscopically negative resection margins.

    Measured: one month after surgery

  3. Organ preservation rate:

    Defined as the proportion of patients in the trial arm without combined organ resection.

    Measured: one month after surgery

  4. 5-year overall survival

    Defined as the proportion of patients in the trial arm who are still alive at 5 years from randomisation.

    Measured: From the time of randomisation to 5 years.

  5. Grade ≥3 toxicity rate

    Defined as the proportion of all enrolled patients who experience grade 3 or higher adverse events related to radiotherapy, chemotherapy and immunotherapy during and after the combined treatment.

    Measured: From the time of randomization to 1 year after complete treatment

  6. Surgical complication rate

    Defined as the proportion of operated patients who develop surgical-related complications including wound infection, anastomotic leak, haemorrhage and others after surgery.

    Measured: From the time of surgery to 1 month after surgery

Timeline

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

  1. First posted16 Oct 2026
  2. Study start15 Oct 2026 (estimated)
  3. Primary completion31 Dec 2029 (estimated)
  4. Study completion31 Dec 2031 (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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
480 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07877597
Sponsor's protocol ID
FDRT-2026-404-5256
Acronym
TORCH-C2
Status last verified
Oct 2026
First submitted
23 Sep 2026
Last updated
16 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data (IPD) from this study will not be shared. The rationale includes restrictions imposed by the institutional review board, Chinese national data protection regulations, and patient privacy requirements. In addition, the study dataset contains sensitive clinical and genomic information of participants, and the research team has not established a dedicated data sharing platform for external IPD access. Study summary results will be published in peer-reviewed journals upon completion of the trial.

Publications

  • Zhao J, Zhang H, Yu L, Hu Y, Yang Y, Dong S, Mi J, Fang Y, Qiao J, Xia F, Hu W, Zhang Z. Diagnostic CT-guided online adaptive radiotherapy for locally advanced colon cancer: a prospective implementation and feasibility study. Clin Transl Radiat Oncol. 2026 Apr 16;59:101162. doi: 10.1016/j.ctro.2026.101162. eCollection 2026 Jul.

    PubMed 42028346
  • Hu H, Zhang J, Li Y, Wang X, Wang Z, Wang H, Kang L, Liu P, Lan P, Wu X, Zhen Y, Pei H, Huang Z, Zhang H, Chen W, Zeng Y, Lai J, Wei H, Huang X, Chen J, Chen J, Tao K, Xu Q, Peng X, Liang J, Cai G, Ding K, Ding Z, Hu M, Zhang W, Tang B, Hong C, Cao J, Huang Z, Cao W, Li F, Wang X, Wang C, Huang Y, Zhao Y, Cai Y, Ling J, Xie X, Wu Z, Shi L, Ling L, Liu H, Wang J, Huang M, Deng Y; OPTICAL study group. Neoadjuvant Chemotherapy With Oxaliplatin and Fluoropyrimidine Versus Upfront Surgery for Locally Advanced Colon Cancer: The Randomized, Phase III OPTICAL Trial. J Clin Oncol. 2024 Sep 1;42(25):2978-2988. doi: 10.1200/JCO.23.01889. Epub 2024 Apr 2.

    PubMed 38564700
  • Foxtrot Collaborative Group. Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: the pilot phase of a randomised controlled trial. Lancet Oncol. 2012 Nov;13(11):1152-60. doi: 10.1016/S1470-2045(12)70348-0. Epub 2012 Sep 25.

    PubMed 23017669

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing short-course radiotherapy, Serplulimab and CapOx(Capecitabine+ Oxaliplatin) in people with Locally Advanced Colon Cancer and pMMR, run by Fudan University 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 14 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: opening soon, as of the sponsor's last update on 16 Oct 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 Zhen Zhang, MD (+86-021-64175590, zhen_zhang@fudan.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

3-year event-free survival (time frame: From the date of randomization until the date of first documented disease progression or toxicity during neoadjuvant therapy that prevent surgery, local regional recurrence, distant metastasis, or death, whichever came first, assessed up to 36 months.). 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 NCT07877597, which also lists 3 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 16 Oct 2026.

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