ClinicalTrials.gg
RecruitingNCT05752136Updated Sep 24, 2026

Preoperative Short-course Radiation Followed by Envafolimab Plus CAPEOX for MSS Locally Advanced Rectal Adenocarcinoma

A Phase 3 interventional study of Envafolimab in Rectal Cancer, sponsored by Sir Run Run Shaw Hospital. Recruiting at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-24.

Sponsored by Sir Run Run Shaw Hospital · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2023; still recruiting 3 years 7 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
108
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study 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 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.

02

Conditions studied

  • Rectal Cancer

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03

In context

Rectal Neoplasms

2,400 studies on the registry are indexed under Rectal Neoplasms; 587 are open to participants now.

This study's planned enrollment of 108 is above the median of 65 across 1,751 interventional studies indexed under Rectal Neoplasms.

Browse Rectal Neoplasms studies →

Lead sponsor

Sir Run Run Shaw Hospital is the lead sponsor of 135 studies on the registry; 72 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Patients who are willing to receive therapy.
  2. ≧18 years old.
  3. 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.
  4. diagnosed as rectal adenocarcinoma.
  5. The clinical staging by pelvic contrast-enhanced CT and pelvic high-resolution MRI were cT2-4a N+, cT3/T4a N0.
  6. MMR protein detection or MSI gene detection of rectal cancer specimens confirmed pMMR or MSS before treatment .
  7. The patient has good compliance and can come to the hospital for re-examination as required.
  8. Scale of Performance Status score 0-1 point.
  9. Have not received anti-tumor and immunotherapy before enrollment.
  10. Laboratory inspections must meet the following standards:

    • White blood cell count>3.5×109/L, absolute value of neutrophils>1.8×109/L, count ≥75×109/L, ≥100g/L;

      • ≤1.5, and APTT≤1.5 times the or partial prothrombin time (PT) ≤1.5 times the upper limit of normal;

        • Total ≤ 1.25 times the upper limit of normal; and AST \< 5 times the upper limit of normal;

          • 24h >50mL/min or serum creatinine \<1.5 times the upper limit of normal.
  11. Voluntarily participate in this study and sign the .

Exclusion criteria

Exclusion Criteria:

  1. History of other malignant diseases in the past 5 years.
  2. Patients with from other sites (stage IV patients).
  3. Patients with clinical staging of T1-2N0 or T4b, or positive lateral lymph nodes by pelvic contrast-enhanced CT and pelvic high-resolution MRI.
  4. Patients with intestinal obstruction, intestinal perforation, intestinal bleeding, etc. requiring emergency surgery.
  5. Known allergic to oxaliplatin, capecitabine, monoclonal antibody and other drugs.
  6. Pathologically suggested signet ring cell carcinoma and mucinous adenocarcinoma.
  7. dMMR or MSI-H patients.
  8. 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.
  9. 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.
  10. Active disease that may worsen while receiving immunostimulants.
  11. Known history of positive test or known acquired immunodeficiency syndrome.
  12. Patients who are using agents, except for the following conditions:

    • Intranasal, inhaled, topical , 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).
  13. Received any other experimental drug treatment or participated in another interventional clinical trial within 30 days before screening
  14. 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 measures.
  15. Vulnerable groups, including mentally ill, cognitively impaired, critically ill patients, minors, etc.
  16. Other conditions that the investigator judges that the patient is not suitable to participate in the clinical study, etc.
Terms in these criteria, in plain language(18)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
108 participants (estimated)

Study arms

  • Experimental
    Neoadjuvant chemoradiotherapy combined with immunotherapy and total mesorectal excision

    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.

    Biological: Envafolimab

  • No intervention
    Neoadjuvant chemoradiotherapy and total mesorectal excision

    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.

Interventions

  • BiologicalEnvafolimab

    This product is administered by subcutaneous injection. The recommended dose of subcutaneous injection is 150 mg, administered weekly (QW).

06

What researchers measure

Primary outcomes

  1. 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

    Time frame: Up to 10 weeks (once surgery is done) ]

Secondary outcomes

  1. Tumor regression grade

    Tumor regression grade following short-course radiation then Envafolimab Plus CAPEOX as assessed by AJCC/CAP TRG system

    Time frame: Up to 10 weeks (once surgery is done)

  2. OS

    The proportion of participants who remain survival at 3 years

    Time frame: Up to 3 years

  3. PFS

    The proportion of participants who remain progression free at 3 years

    Time frame: Up to 3 years

  4. TRAEs

    Number of participants with treatment-related adverse events as assessed by NCI-CTCAE v5.0

    Time frame: Up to 3 years

  5. 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

    Time frame: Up to 24 weeks

  6. 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.

    Time frame: Up to 3 years

07

Study locations

1 of 1 sites recruiting
  • Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
    Hangzhou, Zhejiang 310016, China
    Recruiting
    • Xiujun Cai · Contact
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05752136
Responsible party
Sheng Dai (Principal Investigator, head of medical affairs, Sir Run Run Shaw Hospital) — Principal investigator
First posted
Mar 2, 2023
Start date
Apr 1, 2023
Primary completion
Nov 1, 2026 (estimated)
Completion
Dec 2028 (estimated)
Last update
Sep 24, 2026

Study contacts

Sheng Dai, MD&PhD
Contact
daimd@zju.edu.cn
13575472669
sheng dai
principal investigator · Sir Run Run Shaw Hospital

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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