Adebrelimab plus capecitabine versus capecitabine monotherapy for adjuvant treatment of high-risk resected cholangiocarcinoma (ACHIEVE): protocol for a phase II, multicentre, randomised controlled trial

BMJ Open Gastroenterol. 2025 Jul 30;12(1):e001892. doi: 10.1136/bmjgast-2025-001892.

Abstract

Introduction: Cholangiocarcinoma (CCA) carries a high risk of recurrence even after curative resection. Capecitabine is standard adjuvant therapy, but recurrence rates remain significant, particularly in high-risk patients. Immunotherapy has shown promise in advanced CCA, prompting investigation into its role in earlier settings.

Methods and analysis: This multicentre, randomised, open-label phase II trial will compare adjuvant adebrelimab plus capecitabine versus capecitabine alone in patients with high-risk resected CCA. The study is being conducted at four tertiary hospitals in Jiangsu Province, China. Eligible patients will be randomised 1:1. The primary endpoint is 1-year recurrence-free survival rate (1y-RFS rate). Secondary endpoints are overall survival, RFS and safety. Exploratory endpoints are circulating tumour DNA (ctDNA)-based MRD assessment.

Ethics and dissemination: The study is approved by the Institutional Review Board of Jiangsu Provincial People's Hospital (2024-SR571). Informed consent will be obtained from all participants. The findings will be published in peer-reviewed journals and presented at scientific conferences.

Trial registration number: NCT06607276.

Keywords: ADJUVANT TREATMENT; CHOLANGIOCARCINOMA; GASTROINTESTINAL CANCER.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized* / administration & dosage
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols* / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Bile Duct Neoplasms* / drug therapy
  • Bile Duct Neoplasms* / mortality
  • Bile Duct Neoplasms* / pathology
  • Bile Duct Neoplasms* / surgery
  • Capecitabine* / administration & dosage
  • Capecitabine* / adverse effects
  • Capecitabine* / therapeutic use
  • Chemotherapy, Adjuvant / methods
  • China
  • Cholangiocarcinoma* / drug therapy
  • Cholangiocarcinoma* / mortality
  • Cholangiocarcinoma* / pathology
  • Cholangiocarcinoma* / surgery
  • Clinical Trials, Phase II as Topic
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / prevention & control
  • Randomized Controlled Trials as Topic

Substances

  • Capecitabine
  • Antibodies, Monoclonal, Humanized
  • Antimetabolites, Antineoplastic

Associated data

  • ClinicalTrials.gov/NCT06607276