Phase II Clinical Study of AC591 in Preventing Oxaliplatin-Induced Peripheral Neuropathy

This multicenter, randomized, double-blind, placebo-controlled trial aims to explore the effectiveness of AC591 particles in preventing oxaliplatin-induced peripheral neuropathy. Patients with colorectal adenocarcinoma who are prepared to receive CAPEOX (capecitabine tablets + oxaliplatin injection) postoperative adjuvant chemotherapy within 3 weeks to 2 months after surgery will be randomized in a 1:1 ratio. The subjects will be stratified based on the chemotherapy cycles they are prepared to receive CAPEOX (4 cycles vs 8 cycles).

Inclusion criteria

• Understand the experimental procedures and contents, and voluntarily sign a written informed consent;
• Male or female subjects aged 18 to 75 years (inclusive) when signing the informed consent;
• Patients with histologically confirmed colorectal adenocarcinoma. Prepare to receive CAPEOX postoperative adjuvant chemotherapy within 3 weeks to 2 months after surgery, and have never used oxaliplatin;
• Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1 before the first medication in the study;
• Organ function level before the first medication in the study meets the following requirements:

Peripheral blood cell count: white blood cell count ≥3×109/L and neutrophil ≥1.5×109/L, platelet count ≥75×109/L, hemoglobin ≥90g/L; Liver function: total bilirubin ≤1.5 times the upper limit of normal reference value; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 times the upper limit of normal reference value; Renal function: serum creatinine ≤1.5 times the upper limit of normal reference value.

• Male or female subjects of fertility are required to take effective medical contraceptive measures until 3 months after the last study administration.

Exclusion criteria

• known neurodegenerative disease (e.g., Parkinson's disease, Alzheimer's disease, Huntington's disease) or neuromuscular disease (e.g., multiple sclerosis, amyotrophic lateral sclerosis, poliomyelitis, hereditary neuromuscular disease);
• Patients diagnosed with damp-heat syndrome or liver depression-fire syndrome according to TCM during the screening period;
• Patients with severe diabetic peripheral neuropathy (such as muscle atrophy as the main stage) and abnormal electromyography;
• Patients with known allergic reactions to any component of the study drug;
• Patients with intestinal obstruction that requires treatment;
• Active severe clinical infection (> grade 2, National Cancer Institute-Common Adverse Event Evaluation Criteria [NCI-CTCAE V5.0]), including active tuberculosis;
• Uncontrolled diabetes, severe lung disease (such as acute lung disease, pulmonary fibrosis affecting lung function, interstitial lung disease, but excluding recovered radiation pneumonia), liver failure;
• Clinically significant cardiovascular disease, New York Heart Association [NYHA] grade III-IV congestive heart failure, unstable angina, myocardial infarction, etc. within 6 months before the first dose. Uncontrolled hypertension (systolic blood pressure ≥160mmHg and/or diastolic blood pressure ≥100mmHg after adequate treatment);
• Patients who need to take coumarin derivative anticoagulants (such as warfarin, phenprocoumon) regularly within 3 weeks before screening or during the study;
• Patients who have used drugs that interfere with the evaluation of neuropathic pain (such as antidepressants, antiepileptic drugs) within 2 weeks before the first dose;
• Renal replacement therapy;
• Previous history of organ transplantation, autologous/allogeneic stem cell transplantation;
• History of other malignant tumors except colorectal cancer in the past 5 years. However, cured basal cell carcinoma of the skin, carcinoma in situ of the cervix, or early papillary thyroid carcinoma are excluded;
• HIV infection, hepatitis B surface antigen positive (and peripheral blood hepatitis B virus deoxynucleotide HBV DNA ≥ 1×104 copies/mL or ≥ 2000IU/mL), hepatitis C virus antibody positive (and peripheral blood hepatitis C virus nucleotide HCV RNA ≥ 1×103 copies/ml or ≥ 200IU/mL) or active syphilis patients;
• Pregnancy (confirmed by menstrual pregnancy test) or lactation;
• Current alcohol or drug dependence;
• Suffering from known mental illness disorders that may affect trial compliance;
• Adverse events of previous anti-tumor treatment have not recovered to grade 1 (NCI-CTCAE V5.0) or abnormalities have no clinical significance;
• Subjects who have participated in other interventional clinical trials within 4 weeks before the first study drug;
• The investigator believes that the patient has other factors that affect the efficacy or safety evaluation of this study