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Not yet recruitingNCT07769853IT-CABLEUpdated Sep 15, 2026

Iparomlimab and Tuvonralimab Combined With Chemotherapy and Bevacizumab as Neoadjuvant Therapy for Locally Advanced Rectal Cancer

An interventional study of Iparomlimab and Tuvonralimab(QL-1706)combined with Chemotherapy and Bevacizumab in Locally Advanced Rectal Cancer (LARC) and 5-12cm to Anal Verge, sponsored by Zhejiang University. Not yet recruiting. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-15.

Sponsored by Zhejiang University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
56
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

This study aims to observe and evaluate the efficacy and safety of Iparomlimab and Tuvonralimab(QL-1706) combined with chemotherapy and bevacizumab ± radiotherapy as neoadjuvant therapy in patients with locally advanced rectal cancer, and to explore the value and implications of radiotherapy omission in this setting.

Read the detailed description

Colorectal cancer is the third most common cancer globally and the second leading cause of cancer-related death. For patients with T3-4/N+ locally advanced rectal cancer (LARC) without distant metastasis, achieving curative treatment while preserving organ function remains a significant challenge.

The current standard treatment for LARC is neoadjuvant chemoradiotherapy (NACRT) followed by total mesorectal excision (TME) surgery, aimed at reducing the risk of local recurrence. However, the overall complete response (CR) rate-including both cCR and pathologic complete response (pCR)-remains low. In addition, radiotherapy is detrimental to younger patients or women desiring fertility preservation, as pelvic radiotherapy can compromise fertility. Also, radiotherapy may reduce bone marrow reserve and impair tolerance to subsequent chemotherapy.

Recent studies have suggested that neoadjuvant chemotherapy alone is non-inferior to neoadjuvant chemoradiotherapy to avoid radiotherapy related adverse effects. On the other hand, a combination of chemotherapy and immune checkpoint blockers have shown synergistic anti-tumor effects. QL1706 (also known as PSB205) is an innovative bispecific MabPair™ antibody that simultaneously targets two immune checkpoint proteins-PD 1 (as IgG4) and CTLA 4 (as IgG1)-co expressed in a fixed ratio from a single cell line.

This study aims to observe and evaluate the efficacy and safety of Iparomlimab and Tuvonralimab(QL-1706) combined with chemotherapy and bevacizumab ± radiotherapy as neoadjuvant therapy in patients with locally advanced rectal cancer, and to explore the value and implications of radiotherapy omission in this setting.

The inclusion criteria: 5-12cm, rectal adenocarcinoma, cT3-4N0M0 or cTxN+M0, pMMR or MSS. The primary endpoints are: Clinical Complete Response (CCR) and Pathological Complete Response (pCR). The secondary endpoints are: surgery complications, 3-year disease-free survival, 3-year event-free survival, safety and quality of life.

02

Conditions studied

  • Locally Advanced Rectal Cancer (LARC)
  • 5-12cm to Anal Verge

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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 56 is below the median of 65 across 1,751 interventional studies indexed under Rectal Neoplasms.

Browse Rectal Neoplasms studies →

Lead sponsor

Zhejiang University is the lead sponsor of 356 studies on the registry; 166 are open to participants now.

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

04

Who can participate

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

  • The patient voluntarily consents to participate in this study, demonstrates good compliance, is able to meet the trial requirements for observation and follow-up, and has signed the form;
  • Age between 18 and 75 years, inclusive, regardless of gender (at the time of signing the informed consent);
  • Performance Status (PS) score of 0 or 1;
  • Expected survival time ≥12 weeks;
  • confirmed diagnosis of mid- or upper-rectal adenocarcinoma, with the tumor located 5-12 cm from the anal verge;
  • Colonoscopic specimens assessed by the pathology department at the study center show pMMR by immunohistochemistry or MSS by genetic testing (PCR or NGS method);
  • Clinical staging of cT3-4N0M0 or cTxN+M0;
  • No prior anti-tumor therapy (including but not limited to radiotherapy, chemotherapy, targeted therapy, or immunotherapy);
  • At least one : the lesion must have one clearly measurable diameter (recorded as the longest diameter), with the minimum size defined as follows:
  • CT scan: ≥10 mm (CT slice thickness should not exceed 5 mm);
  • Malignant lymph nodes: must be pathologically enlarged and measurable, with a short-axis diameter of ≥15 mm on CT (recommended slice thickness ≤5 mm);
  • Major organ functions must be adequate, meeting the following criteria:

Hematology (without hematopoietic growth factors or blood transfusion within 7 days):

  1. Neutrophils ≥1.5 × 10⁹/L
  2. ≥100 × 10⁹/L
  3. ≥90 g/L

Biochemistry:

e) Total ≤1.5 × f) and ALT ≤2.5 × ULN g) Serum creatinine ≤1.5 × ULN or ≥50 mL/min (calculated using the Cockcroft-Gault formula)

Coagulation:

h) Coagulation function must meet the following conditions: ≤1.5 PTT or aPTT ≤1.5 × ULN

- Subjects with must use appropriate methods during the study and for 120 days after its completion. Female participants must have a negative serum pregnancy test within 7 days before enrollment and must not be breastfeeding.

Exclusion criteria

Exclusion Criteria:

  • Clinical stage cT4b and low rectal cancer (tumor located less than 5 cm from the anal verge);
  • Prior rectal cancer surgery before enrollment, excluding stoma procedures;
  • History of , except for cured carcinoma in situ of the cervix, basal cell or squamous cell carcinoma of the skin, superficial bladder cancer, or early-stage thyroid cancer;
  • Severe or allergic reactions to humanized antibodies or fusion proteins in the past;
  • Pregnant or breastfeeding women, or women of who are not using ;
  • Diagnosed immunodeficiency or receiving systemic or other therapy within 14 days prior to the first dose of study treatment. Physiological doses of glucocorticoids (≤10 mg/day prednisone or equivalent) are allowed;
  • Active, known, or suspected diseases (e.g., interstitial pneumonia, colitis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism, hypothyroidism, etc.) are excluded. However, patients with type 1 diabetes, hypothyroidism requiring only hormone replacement therapy, or skin conditions not requiring systemic treatment (e.g., vitiligo, psoriasis, or alopecia), or conditions not expected to recur without an external trigger, may be enrolled;
  • Severe pre-existing cardiac conditions, including: congestive heart failure, uncontrolled high-risk arrhythmias, unstable angina, myocardial infarction, or severe valvular heart disease;
  • Hypertension that is poorly controlled with antihypertensive medication (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg). Patients are eligible if BP is well controlled with treatment. Patients with a history of hypertensive crisis or hypertensive encephalopathy are excluded;
  • Active (HBV DNA ≥2000 IU/ml or 10⁴ copies/ml) or (positive anti-HCV antibody and HCV-RNA above detection threshold);
  • Active tuberculosis (TB) infection, as determined by chest X-ray, sputum test, and clinical examination. Patients with a history of active TB infection within the past year are excluded even if treated. Those with TB infection more than a year ago are also excluded unless prior anti-TB treatment was appropriate in both duration and regimen;
  • Major surgery, incisional , or significant traumatic injury within 28 days prior to randomization;
  • Imaging indicates tumor invasion of major blood vessels, or in the investigator's opinion, the tumor is likely to invade major blood vessels during the study and pose a risk of fatal hemorrhage;
  • Any signs or history of bleeding disorders, regardless of severity; patients who had any bleeding event ≥ Grade 3 () within 4 weeks prior to randomization; patients with unhealed wounds, ulcers, or fractures;
  • Arterial or venous thrombotic events (e.g., stroke, , deep vein thrombosis, or pulmonary embolism) within the past 6 months;
  • Uncontrolled neurological or psychiatric disorders or mental illness leading to poor compliance or inability to report treatment response;
  • Any comorbid condition that, in the investigator's judgment, could seriously jeopardize patient safety or interfere with study completion;
  • Other conditions deemed inappropriate for enrollment by the investigator.
Terms in these criteria, in plain language(24)

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.

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.

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.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

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.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

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.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

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.

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.

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.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

05

Study design

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

Study arms

  • Experimental
    Experimental group

    Drug: Iparomlimab and Tuvonralimab(QL-1706)combined with Chemotherapy and Bevacizumab

Interventions

  • DrugIparomlimab and Tuvonralimab(QL-1706)combined with Chemotherapy and Bevacizumab

    The QL1706 dosage is 5 mg/kg, administered via intravenous infusion once every 3 weeks, for a total of 4 doses, or until intolerable toxicity occurs or the subject withdraws informed consent. The bevacizumab injection dosage is 7.5 mg/kg, administered via intravenous infusion once every 3 weeks, for a total of 4 doses, or until intolerable toxicity occurs or the subject withdraws informed consent. Within 21 days after completing the 4th cycle of adjuvant treatment, the patient will be evaluated to determine whether additional radiotherapy would be required before surgery.

    Also known as: Radiotherapy, Surgery

06

What researchers measure

Primary outcomes

  1. Clinical Complete Response (CCR)

    absence of detectable tumor on clinical, radiological, endoscopic, and digital rectal examination

    Time frame: 3 weeks After last round of neoadjuvant treatment

  2. Pathological Complete Response (pCR)

    Pathological Complete Response means no residual viable tumor cells in the surgical specimen, including both the primary tumor site and regional lymph nodes, after neoadjuvant therapy and surgery.

    Time frame: 1 month after surgery

Secondary outcomes

  1. surgery complications

    postoperative bleeding, anastomic leak, intra abdominal and intra pelvic infection, ect.

    Time frame: up to 6 weeks after surgery

  2. 3-year disease-free survival

    The proportion of patients who remain alive and free of any signs or symptoms of the original cancer (no recurrence or metastasis) for three years after treatment (usually surgery or curative therapy).

    Time frame: 3 years after surgery

  3. 3-year Event-Free Survival (EFS)

    The proportion of patients who do not experience any predefined "event" (such as progression, recurrence, new cancer, or death) within three years of treatment initiation.

    Time frame: 3 years after surgery

  4. Adverse Effects

    Drug related adverse effects

    Time frame: 3 months after surgery

  5. Quality of Life Score

    Quality of Life Score measured on a QoL scale

    Time frame: 3 years after surgery

07

Study locations

No study locations are listed for this record.

08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 15, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07769853
Responsible party
Ding Ke-Feng (Professor, Zhejiang University) — Principal investigator
First posted
Aug 18, 2026
Start date
Sep 1, 2026 (estimated)
Primary completion
Jul 1, 2027 (estimated)
Completion
Dec 12, 2029 (estimated)
Last update
Sep 15, 2026

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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