Study of ONO-4578 and nivolumab with drug combination for first-line treatment in patients with PD-L1 positive advanced colorectal cancer

2 1 1 1

What is this study about?

This clinical trial focuses on patients with PD-L1 positive advanced colorectal cancer. The study evaluates a new combination treatment approach that includes several medications: ONO-4578 (taken as tablets), Opdivo (nivolumab), bevacizumab, and a chemotherapy combination called mFOLFOX6 which consists of oxaliplatin, fluorouracil, and leucovorin.

The purpose of this research is to determine if two different dose levels of ONO-4578 given together with Opdivo and standard treatment (mFOLFOX6 plus bevacizumab) are safe and effective compared to the usual standard treatment alone. The medications will be given in different ways – some as tablets taken by mouth and others through an intravenous infusion into a vein.

During the study, participants will be randomly assigned to receive either the new combination treatment or the standard treatment. The study team will monitor how well the treatment works and track any side effects that may occur. Participants will have regular check-ups, including physical examinations and various medical tests to evaluate their response to treatment and ensure their safety throughout the study period.

1 Initial treatment phase

You will receive a combination of medications through different methods of administration:

ONO-4578 as film-coated tablets taken by mouth

Opdivo (nivolumab) given through intravenous infusion

mFOLFOX6 regimen consisting of:

• Calcium folinate through intravenous infusion

• Oxaliplatin through intravenous infusion

• Fluorouracil through intravenous infusion

Bevacizumab given through intravenous infusion

2 Regular assessments

Throughout the study, you will undergo regular evaluations including:

– Physical examinations

– Laboratory tests to check blood, chemistry, and urine values

– Heart monitoring through ECG (electrocardiogram)

– Imaging scans to measure tumor response

3 Response monitoring

Your response to treatment will be evaluated through:

– Regular imaging scans to measure tumor size

– Assessment of any changes in your cancer

– Monitoring of side effects

Independent experts will review your imaging results to evaluate how the treatment is working

4 Safety monitoring

Throughout the study, you will be monitored for:

– Side effects and serious health events

– Any needed adjustments to medication doses

– Changes in laboratory test results

Your doctor may adjust or stop treatment based on how your body responds

Who Can Join the Study?

  • Age 18 years or older
  • Must be able and willing to provide informed consent and follow all study requirements
  • Diagnosed with advanced colorectal cancer that cannot be treated with surgery
  • Must have ECOG Performance Status of 0-1 (meaning able to carry out light daily activities with minimal or no assistance)
  • Must have test results available showing:
    • Microsatellite stability or mismatch repair status
    • BRAF mutation status in tumor
    • PD-L1 positive status (Combined Positive Score of 1 or higher)
  • No previous systemic treatment for advanced colorectal cancer
  • Must have at least one measurable tumor that can be seen on imaging scans
  • Must have adequate tumor tissue sample available for testing that has not been previously treated with radiation
  • Must have adequate:
    • Bone marrow function
    • Kidney function
    • Liver function
  • Must agree to use effective birth control methods during the study (both male and female participants)

Who Cannot Join the Study?

  • Age below 18 years or above 75 years
  • History of autoimmune diseases (conditions where the body’s immune system attacks healthy cells)
  • Previous treatment with immunotherapy (medications that help your immune system fight cancer)
  • Active or untreated brain metastases (cancer that has spread to the brain)
  • Significant heart conditions including uncontrolled hypertension (high blood pressure)
  • Active infections requiring systemic treatment (medications that affect the whole body)
  • Known HIV, hepatitis B, or hepatitis C infection
  • Other active cancers requiring treatment
  • Pregnancy or breastfeeding
  • Severe kidney or liver problems
  • Known allergies to study medications
  • Participation in other clinical trials within the past 30 days
  • Mental conditions that could interfere with study compliance
  • Any condition that, in the investigator’s opinion, makes the patient unsuitable for the study

Where you can join this trial?

Verified and Recommended Sites

No sites found in this category

Verified Sites

Other Sites

Site Name City Country Status
Istituto Oncologico Veneto Padua Italy
Istituto Europeo Di Oncologia S.r.l. Milan Italy
IRCCS Istituto Nazionale Tumori Fondazione Pascale Naples Italy
Centre Hospitalier Universitaire De Poitiers Poitiers France
Hospital Universitario 12 De Octubre Madrid Spain
Virgen del Rocío University Hospital Sevilla Spain
ASST Grande Ospedale Metropolitano Niguarda Milan Italy
Hospital General Universitario De Valencia Valencia Spain
Centre Hospitalier Universitaire De Nantes Nantes France
Hopital Beaujon Clichy France
Cflzuo Lkqb Bfggtf Lyon France
Akphqjlggs Pjagrdht Hclordco Dk Mqqyjfemp Marseille France
Bobrerpn Uouxocscsl Hbpghzks Cqqhcs Besançon France
Hnznuuiw Uopyebtfcftsp Hngpmjmz Twvcf y Phtrpm Iqevsrda Cyzbyp durglyogglmkwvhzr (nyzi Badalona Spain
Hxytslxo Vvih dybvhuji Barcelona Spain

Want to learn more about this study or check if you can participate? Contact us.

Trial status

Country Status Recruitment Start
France France
Recruiting
31.10.2025
Italy Italy
Recruiting
31.10.2025
Spain Spain
Recruiting
31.10.2025

Trial locations

ONO-4578 is an investigational medication being studied for the treatment of colorectal cancer. It is being tested in combination with other medications as a first-line treatment for specific types of advanced colorectal cancer.

Opdivo (nivolumab) is an immunotherapy medication that helps the body’s immune system attack cancer cells. It works by blocking a protein that prevents the immune system from attacking cancer cells.

mFOLFOX6 is a combination chemotherapy regimen that includes several medications working together to fight cancer cells. It is commonly used as a standard treatment for colorectal cancer.

Bevacizumab is a targeted therapy that works by blocking the formation of new blood vessels that feed tumors. This helps prevent tumor growth by cutting off their blood supply.

Investigated diseases:

PD-L1 Positive Advanced Colorectal Cancer – A type of bowel cancer that has spread beyond its original location and shows specific protein markers called PD-L1 on the surface of cancer cells. The disease begins in the large intestine (colon) or rectum and develops from small growths called polyps that become cancerous over time. As it advances, the cancer grows through the layers of the intestinal wall and can spread to nearby lymph nodes and other organs. The presence of PD-L1 proteins on cancer cells makes this particular type distinct from other forms of colorectal cancer. The disease typically develops gradually, often starting with no symptoms and progressing to changes in bowel habits, abdominal discomfort, and unexplained weight loss.

Trial ID:
2024-519590-19-00
Protocol code:
ONO-4578-10
Trial Phase:
Therapeutic exploratory (Phase II)

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