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RecruitingNCT07239466Updated Nov 13, 2026

A Pilot Study Evaluating β-hydroxybutyrate Supplementation Concomitant to Short-Course Radiotherapy Followed by Immunotherapy Combined With CAPEOX Neoadjuvant Therapy in Patients With Locally Advanced Rectal Cancer

A Phase 2 interventional study of Short-course radiotherapy and Capecitabine in Rectal Cancer, Radiotherapy and Immunotherapy, sponsored by Tao Zhang. Recruiting at 1 site in China. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-11-13.

Sponsored by Tao Zhang · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jan 2026; still recruiting 10 months later.
Updated Nov 13, 2026Eligibility revisedGo to Updates ↓

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Phase
Phase 2
Study type
Interventional
Enrollment
25
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 462 studies in Rectal Neoplasms with a site in China — 227 open to participants now, 266 under way, 42 of them phase 3. Rectal Neoplasms · China.

Planned enrollment
341st of 372
25 · median 100
Started
2026
with 49 others
Phase 2
155 of 462
95 open now
Primary completion
2026-12
later than 130 of 265 live
Registered
392nd of 462
by date

Among the 462 studies in Rectal Neoplasms with a site in China, this one is the 341st largest by planned enrollment of the 372 interventional ones that give a count, is one of 50 that started in 2026, is one of 155 in phase 2, reaches primary completion later than 130 of the 265 other live ones, and was the 392nd registered.

Rectal Neoplasms

2,402 studies on the registry are indexed under Rectal Neoplasms; 589 are open to participants now.

Browse Rectal Neoplasms studies →

Open to participants now

227 of the 462 studies in Rectal Neoplasms with a site in China are open now. Recruiting first, the newest first:

222 more — sign in →

All 227 open studies →

A study can be open while its sites in China have not opened yet or have stopped. Only those recruiting at a site in China →

Who these studies take

Of the 405 Rectal Neoplasms studies recruiting now, 210 (52%) set no upper age limit and 143 (35%) stop at 75 or younger; 19 take children under 18; 16 take healthy volunteers.

This study: 18 Years to 75 Years · all sexes · no healthy volunteers.

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02

Study summary

This study is a prospective phase II clinical trial aimed at exploring the potential benefits of supplementing β-hydroxybutyrate with existing short course radiotherapy sequential immunotherapy and CAPEOX therapy.

03

Conditions studied

  • Rectal Cancer
  • Radiotherapy
  • Immunotherapy
  • Chemotherapy

Browse trials for

04

Who can participate

The criteria were revised on the registry on Nov 13, 2026. See what changed

Ages eligible
18 Years to 75 Years
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 or their family members agree to participate in the study and sign the form;
  2. Age 18-75 years, male or female;
  3. confirmed proficient mismatch repair (pMMR)/microsatellite-stable (MSS) LARC;
  4. Inferior margin ≤ 10 cm from the anal verge;
  5. performance status score is 0-1;
  6. Untreated with anti-tumor therapy for rectal cancer, including radiotherapy, chemotherapy, surgery, etc;
  7. There was no operative ;
  8. Laboratory tests were required to meet the following requirements: White blood cell (WBC) ≥ 4×109/L; (ANC) ≥ 1.5×109/L; count ≥ 100×109/L; ≥90 g/L; Serum total ≤ 1.5 × (ULN); Serum (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN; Serum creatinine ≤1.5 × ULN or rate ≥ 50 mL/min; (INR) ≤ 1.5 × ULN; Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN;
  9. Urinary protein \< 2+ or 24-hour urinary protein excretion \< 1 g at baseline.

Exclusion criteria

Exclusion Criteria:

  1. Patients with deficient mismatch repair (dMMR)/microsatellite instability-high (MSI-H) LARC;
  2. Subjects who have previously received any form of immunotherapy, including but not limited to , immune checkpoint agonists, immune cell therapy, or any other treatment targeting tumor immunomodulatory mechanisms;
  3. Presence of any concurrent disease or condition (including laboratory abnormalities), or any history of substance abuse or current evidence of such abuse, which, in the investigator's judgment, may compromise subject safety, interfere with the process, affect subject compliance, or confound the safety assessment of the product.
Terms in these criteria, in plain language(14)

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.

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.

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.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

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).

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.

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.

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.

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.

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.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
25 participants (estimated)

Study arms

  • Experimental
    experimental group

    Radiotherapy (SCRT): Total dose 25 Gy delivered in 5 fractions (5 Gy per fraction, once daily over 5 consecutive days). β-hydroxybutyrate: Oral β-hydroxybutyrate supplement (5g/day, starting from the day of first radiotherapy, lasting for 2 weeks). Immunotherapy (PD-1 monoclonal antibody): 200 mg via intravenous infusion every 3 weeks (q3w) for 6 cycles, initiated 1 week after radiotherapy completion. Chemotherapy (CAPEOX regimen): Oxaliplatin: 130 mg/m² IV infusion over 120 minutes on Day 1. Capecitabine: 1000 mg/m² orally twice daily (morning and evening, 30 minutes after meals) on Days 1-14. Cycle duration: 3 weeks per cycle; total of 6 cycles during the neoadjuvant phase.

    Radiation: Short-course radiotherapy · Drug: Capecitabine · Drug: Oxaliplatin · Procedure: TME surgery · Dietary Supplement: β-hydroxybutyrate

Interventions

  • RadiationShort-course radiotherapy

    Eligible subjects will receive short-course radiotherapy (SCRT). One week after the end of treatment, subjects continued to receive neoadjuvant chemotherapy.

  • 1000mg/m2, bid, po, d1-14,q3w

  • 130mg/m2, ivgtt, d1,q3w

  • ProcedureTME surgery

    The surgery was performed 1 week after the end of neoadjuvant therapy.

  • Dietary supplementβ-hydroxybutyrate

    Oral β-hydroxybutyrate supplement (5g/day, starting from the day of first radiotherapy, lasting for 2 weeks).

06

What researchers measure

Primary outcomes

  1. complete response (CR) rate

    Defined as pathological complete response (pCR) + Clinical complete response (cCR)

    Time frame: an expected average of 12 months

Secondary outcomes

  1. 3-year disease-Free Survival

    The time from the first day of disease free (operation date) to local or distant recurrence, or the death event caused by any reason, whichever occurs first

    Time frame: an expected average of 3 years

  2. Overall Survival

    The time from the date of randomization to the death caused by any cause

    Time frame: an expected average of 5 years

  3. Adverse events (AEs) were graded according to the NCI CTCAE version 5·0

    Adverse events and surgical safety

    Time frame: an expected average of 1.5 years

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jan 2026 (actual). Primary completion is estimated for Dec 2026, 11 months after the start.

Of 227 non-industry phase 2 interventional studies under Rectal Neoplasms, half reached primary completion within 48 months of starting (the median), counting those still running; a quarter within 32 and three quarters within 80. This study's planned 11 months is below that.

Counting every sponsor, half of 241 studies reached it within 46 months; a quarter within 31 and three quarters within 75.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 15, 2025
First posted
Nov 20, 2025
StartActual
Jan 1, 2026
Primary completionEst.
Dec 31, 2026
CompletionEst.
Jun 1, 2027
Last update
Nov 13, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Eligibility
2 inclusion criteria edited; 2 exclusion criteria edited
What changed in the criteria
Inclusion criteria
  • ChangedBefore Histologically confirmed Locally Advanced rectal adenocarcinoma;Now Histologically confirmed proficient mismatch repair (pMMR)/microsatellite-stable (MSS) LARC;
  • EditedLaboratory tests were required to meet the following requirements: whiteWhite blood cell (WBC) ≥ 4×109/L; Absolute neutrophil count (ANC) ≥ 1.5×109/L; Platelet count ≥ 100×109/L; Hemoglobin ≥90 g/L; Serum total bilirubin ≤ 1.5 × upper limit of normal (ULN); Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN; Serum creatinine ≤1.5 times the upper limit of normal value× ULN or creatinine clearance rate ≥ 50 mL/min; International normalized ratio (INR) ≤ 1.5 × ULN; Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN;
Exclusion criteria
  • ChangedBefore Patients with non-pMMR LARC;Now Patients with deficient mismatch repair (dMMR)/microsatellite instability-high (MSI-H) LARC;
  • EditedPresence of any concurrent disease, or condition (including laboratory abnormalityabnormalities), or any history of substance abuse, or current evidence thereofof such abuse, which, in the investigator's judgment of the Investigator, may compromise subject safety, interfere with the process of obtaining informed consent process, affect subject compliance, or confound the safety assessment of the investigational product(s).
Nov 13, 2026
Show all 1 update
  1. Nov 13, 2026
    Eligibility 2 inclusion criteria edited; 2 exclusion criteria edited
    What changed in the criteria
    Inclusion criteria
    • ChangedBefore Histologically confirmed Locally Advanced rectal adenocarcinoma;Now Histologically confirmed proficient mismatch repair (pMMR)/microsatellite-stable (MSS) LARC;
    • EditedLaboratory tests were required to meet the following requirements: whiteWhite blood cell (WBC) ≥ 4×109/L; Absolute neutrophil count (ANC) ≥ 1.5×109/L; Platelet count ≥ 100×109/L; Hemoglobin ≥90 g/L; Serum total bilirubin ≤ 1.5 × upper limit of normal (ULN); Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN; Serum creatinine ≤1.5 times the upper limit of normal value× ULN or creatinine clearance rate ≥ 50 mL/min; International normalized ratio (INR) ≤ 1.5 × ULN; Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN;
    Exclusion criteria
    • ChangedBefore Patients with non-pMMR LARC;Now Patients with deficient mismatch repair (dMMR)/microsatellite instability-high (MSI-H) LARC;
    • EditedPresence of any concurrent disease, or condition (including laboratory abnormalityabnormalities), or any history of substance abuse, or current evidence thereofof such abuse, which, in the investigator's judgment of the Investigator, may compromise subject safety, interfere with the process of obtaining informed consent process, affect subject compliance, or confound the safety assessment of the investigational product(s).
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07239466
Lead sponsor
Tao Zhang
Responsible party
Tao Zhang (MD, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) — Sponsor-investigator
First posted
Nov 20, 2025
Start date
Jan 1, 2026
Primary completion
Dec 31, 2026 (estimated)
Completion
Jun 1, 2027 (estimated)
Last update
Nov 13, 2026

Study contacts

Zhenyu Lin, MD
Contact
whxhlzy@hust.edu.cn
027-83262683
Tao Zhang, MD
Contact
whxhlzy@hust.edu.cn
Zhenyu Lin
principal investigator · Huazhong University of Science and Technology Tongji Medical College Union Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: 3-Hydroxybutyric Acid

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