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NCT Number: NCT06459869

NG-350A Plus Chemoradiotherapy for Locally Advanced Rectal Cancer

The FORTRESS trial (NG-350A-03) is an open-label, single-arm, and multicentre trial of NG-350A in combination with chemoradiotherapy (CRT) in adult patients with locally advanced rectal cancer (LARC) and at least one risk factor for local or distant recurrence.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

University College London NHS FT, London, United Kingdom

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Selected Inclusion Criteria:

  • Histologically confirmed adenocarcinoma of the rectum.
  • Locally advanced disease (clinical stage II-III based on pelvic MRI) selected by a multidisciplinary team for treatment with neoadjuvant CRT (which may be followed by CNCT to comprise planned TNT). Patients with oligometastatic disease are permitted provided that the site-specific multidisciplinary team deems them suitable for radical treatment/chemoradiation.
  • Confirmed microsatellite stable (MSS)/proficient mismatch repair (pMMR) status.
  • Provide written informed consent to participate.
  • ECOG Performance Status 0 or 1.
  • Must not be pregnant or breastfeeding.
  • Patients who are sexually active (with either sex) must agree to comply with contraceptive requirements.
  • Adequate lung reserve, renal function, hepatic function, and bone marrow/hematological function assessed ≤ 10 days prior to first dose.

Selected Exclusion Criteria:

  • Recurrent rectal cancer.
  • Distant metastatic disease not amenable to radical treatment/chemoradiation.
  • Other prior malignancy active within the previous 3 years, except for local or organ confined early-stage cancer that has been definitively treated with curative intent, does not require ongoing treatment, has no evidence of residual disease, and has a negligible risk of recurrence and is therefore unlikely to interfere with the primary and secondary endpoints of the trial, including response rate and safety.
  • Splenectomy (patients with prior partial resection remain eligible if the Investigator considers splenic function to not be significantly compromised).
  • Active autoimmune disease that has required systemic therapy in the past 2 years, immunocompromised status in the opinion of the Investigator, or current treatment with systemic immunosuppressive therapy (daily prednisone equivalent for chronic system replacement not to exceed 10mg per day).
  • Infectious or inflammatory bowel disease in the 3 months before the first dose of study treatment.
  • Any clinically significant cardiovascular, peripheral vascular, cerebrovascular, or thromboembolic event in the last 1 month before the first dose of study treatment.
  • Major surgery in the 14 days before the first dose of study treatment or any surgical wounds that are not fully healed and free of infection or dehiscence.
  • Any prior surgery for rectal cancer or pelvic radiotherapy.
  • Any other anti-cancer or experimental therapy within the previous 12 months or that is planned during the active study treatment period.
  • Treatment with any other enadenotucirev-based virus (parent virus or transgene-modified variants), or anti-CD40 antibody at any time.
  • History of prior Grade 3-4 acute kidney injury or other clinically significant renal impairment.
  • Any ongoing Common Terminology Criteria for Adverse Events (CTCAE) Grade ≥2 coagulation abnormality/coagulopathy.

URL:

https://www.FortressStudy.org

Treatment and study plan

NG-350A IV administration

Drug

a tumour-selective anti-CD40-expressing adenoviral vector

Capecitabine oral administration

Drug

chemotherapy

Radiotherapy

Radiation

long-course intensity-modulated radiotherapy

Primary outcomes

  1. Proportion of patients achieving a response (ncCR / cCR)

    Time frame: 12 weeks after initiating NG-350A in combination with chemoradiotherapy (CRT)

Secondary outcomes

  1. Incidence and severity of adverse events graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0

    Time frame: 1-3 years

  2. Clinical response (CR) outcome

    Time frame: 12, 18, and 36 weeks after initiating NG-350A plus chemoradiotherapy (CRT)

  3. MRI-based tumor regression grade (mrTRG)

    Time frame: 12, 18, and 36 weeks after initiating NG-350A plus chemoradiotherapy (CRT)

Study contacts

Contact information is provided by the study sponsor or research team.

Vice President Head of Clinical Operations

CONTACT

[email protected]

+1 (484) 362-8918

https://www.FortressStudy.org

CONTACT

[email protected]

Sponsors and collaborators

Lead sponsor

Akamis Bio

Industry

Registry information

Official study title

A Multicentre, Open-label, Non-randomized, Phase 1b Trial of NG-350A, a Tumour-selective Anti-CD40-expressing Adenoviral Vector, in Combination With Chemoradiotherapy in Locally Advanced Rectal Cancer (FORTRESS)

Acronym: FORTRESS

Important dates

Study start
2025
Primary completion
2026
Study completion
2028
First posted
Jun 14, 2024
Registry last updated
Jun 12, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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