ctDNA-MRD Guided Escalation of Ivonescimab and Docetaxel in Advanced NSCLC With Long-Term Responses to First-line Immunotherapy (CR1STAL-Adaptive)

Trial statusRecruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexAll
Age18-75
SponsorSecond Xiangya Hospital of Central South University

About this trial

The CR1STAL-Adaptive study is a randomized, open-label, phase II multicenter interventional trial designed to evaluate the safety and efficacy of Ivonescimab (PD-1/VEGF bispecific antibody) combined with docetaxel versus standard treatment in patients with advanced NSCLC who have achieved long-term benefit from first-line immune checkpoint inhibitors (ICIs), but are ctDNA-MRD positive. Building upon insights from previous CR1STAL study (NCT05198154), the CR1STAL-Adaptive study supports the development of precision-guided, adaptive treatment strategies to delay progression and improve outcomes in NSCLC patients with a long-term response to immunotherapy. It represents a step forward in integrating dynamic molecular monitoring with individualized intervention strategies in the era of immunotherapy.

Eligibility criteria

Qualifiers

Sign written informed consent prior to any study-related procedures, be willing and able to complete the visits, treatment regimen, and laboratory tests specified in the schedule, and comply with other requirements of the study;

Aged ≥18 and ≤75 years old;

ECOG PS score 0-1;

Expected survival time ≥ 12 weeks;

Disqualifiers

Concurrent participation in another interventional clinical study or receipt of another investigational drug, unless participating in an observational clinical study;

Systemic therapy with proprietary Chinese medicines with anti-tumor indications or immunomodulatory drugs (including thiopeptides, interferons, interleukins, except those used locally for the control of hydrothorax or ascites) within 2 weeks prior to the first dose;

No measurable lesions as defined by RECIST 1.1 due to prior radical treatment (e.g., surgery or radiotherapy)

Subjects who have received systemic antiangiogenic therapy;

Trial design

Treatments tested in this trial

  • Ivonescimab
  • Docetaxel
  • Standard Treatment group

Treatment groups

70 Participants
are divided into 2 treatment groups

Sponsors and collaborators

Second Xiangya Hospital of Central South University

Lead sponsor

Nanjing Shihejiyin Technology, Inc.

Collaborator

Akeso

Collaborator