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OncoMatch/Clinical Trials/NCT06903858

Neoadjuvant Toripalimab Plus Celecoxib for dMMR/MSI-H Locally Advanced Colorectal Cancer

Is NCT06903858 recruiting? Yes, currently enrolling (May 2026). This Phase 2 trial studies Toripalimab combined with celecoxib for colorectal cancer (crc).

Phase 2RecruitingSun Yat-sen UniversityNCT06903858Data as of May 2026

Treatment: Toripalimab combined with celecoxibSeveral Phase II studies have demonstrated the feasibility, effectiveness, and good tolerability of neoadjuvant immune checkpoint inhibitor (ICI) treatment for localized dMMR colorectal and rectal cancers. The significant clinical and pathological complete response rates offer the possibility of avoiding surgical resection. dMMR colorectal cancers are generally larger and more advanced than pMMR tumors, often requiring more extensive surgery with associated risks such as anastomotic leakage, ureteral injury, and infection. If oncological outcomes are not affected (requiring long-term follow-up), non-surgical treatment becomes an attractive option for localized dMMR colorectal cancer. Moreover, pelvic radiotherapy, the standard for locally advanced rectal cancer, causes both short-term and long-term adverse effects (e.g., bowel and bladder dysfunction, fistula, infertility), significantly impacting quality of life. Total mesorectal excision also carries risks of complications and sexual dysfunction, often requiring a stoma, making organ preservation a more urgent need for rectal cancer patients. Phase II trials and the international "watch-and-wait" database have confirmed the feasibility and safety of organ preservation for pMMR locally advanced rectal cancer. Therefore, the high clinical and pathological complete response rates achieved by neoadjuvant immunotherapy for dMMR/MSI-H rectal cancer offer promising prospects for non-surgical treatment.

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Extracted eligibility criteria

Cancer type

Colorectal Cancer

Biomarker criteria

Required: MMR deficient mismatch repair

dMMR (IHC)

Required: MSI microsatellite instability-high

MSI-H (PCR)

Performance status

ECOG 0–1(Restricted strenuous activity)

Prior therapy

No prior treatment (treatment-naive required)
Max 0 prior lines

Cannot have received: anti-PD-1 therapy

Prior treatment with anti-PD-1/PD-L1 antibodies

Cannot have received: anti-PD-L1 therapy

Prior treatment with anti-PD-1/PD-L1 antibodies

Cannot have received: anti-CTLA-4 therapy

Prior treatment with anti-CTLA-4 antibodies

Cannot have received: checkpoint inhibitor

other drugs/antibodies targeting T-cell co-stimulation or checkpoint pathways

Cannot have received: systemic chemotherapy

No prior anti-cancer therapy for colonrectal cancer (surgery/chemotherapy/targeted therapy/radiation)

Cannot have received: targeted therapy

No prior anti-cancer therapy for colonrectal cancer (surgery/chemotherapy/targeted therapy/radiation)

Cannot have received: radiation therapy

No prior anti-cancer therapy for colonrectal cancer (surgery/chemotherapy/targeted therapy/radiation)

Cannot have received: surgery

No prior anti-cancer therapy for colonrectal cancer (surgery/chemotherapy/targeted therapy/radiation)

Lab requirements

Blood counts

Kidney function

Liver function

Adequate organ function

Structured fields extracted by AI. May contain errors — verify against the official protocol.

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