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

NCT06951646 · Status: RECRUITING · Phase: PHASE2 · Type: INTERVENTIONAL · Enrollment: 70

Last updated 2026-03-09

No results posted yet for this study

Summary

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.

Conditions

  • Non Small Cell Lung Cancer
  • Immune Checkpoint Inhibitors (ICIs)

Interventions

DRUG

Ivonescimab

For ctDNA-positive patients, escalation treatment will be administrated Ivonescimab: Intravenous infusion (IV), 20 mg/kg, Day 1, every 3 weeks (Q3W); All enrolled participants will continue treatment until one of the following occurs, whichever comes first: * The investigator determines that there is no longer clinical benefit (based on imaging assessments and clinical status) * Unacceptable toxicity * Completion of 24 months of treatment * Other discontinuation criteria specified in the protocol are met.

DRUG

Docetaxel

For ctDNA-positive patients, escalation treatment will be administrated Docetaxel: IV, 75 mg/m², Day 1, Q3W (The investigator may adjust the chemotherapy dose and schedule based on the patient's tolerance during treatment.) All enrolled participants will continue treatment until one of the following occurs, whichever comes first: * The investigator determines that there is no longer clinical benefit (based on imaging assessments and clinical status) * Unacceptable toxicity * Completion of 24 months of treatment * Other discontinuation criteria specified in the protocol are met.

OTHER

Standard Treatment group

For ctDNA-positive patients, continuing the original immunotherapy maintenance or immunotherapy combined with chemotherapy

Sponsors & Collaborators

  • Nanjing Shihejiyin Technology, Inc.

    collaborator INDUSTRY

  • Akeso

    collaborator INDUSTRY

  • Second Xiangya Hospital of Central South University

    lead OTHER

Study Design

Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Model
PARALLEL

Eligibility

Min Age
18 Years
Max Age
75 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2026-03-10
Primary Completion
2028-07-01
Completion
2030-06-01

Countries

  • China

Study Locations

More Related Trials

Entities

Drugs
Companies

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT06951646 on ClinicalTrials.gov