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The CRC Blueprint

My scientific approach to my own cancer – shared with you.

Clinical trials

Neoadjuvant Treatment of Fulzerasib Plus Cetuximab N01 in KRAS G12C Mutated Locally Advanced Colorectal Cancer With or Without Resectable Metastases

Recruiting nowPhase 2

What this trial is trying to do

The researchers are testing whether fulzerasib, which blocks the KRAS G12C protein, works better when paired with cetuximab, an antibody that blocks EGFR signalling. Given before surgery, the chemotherapy-free combination is intended to shrink KRAS G12C-mutated colorectal cancers, including some with removable metastases.

The idea is that avoiding chemotherapy and bevacizumab around surgery could make perioperative treatment safer, while the two targeted drugs may control the cancer well enough to support surgery or, in some complete clinical responders, careful observation instead. The main measure is the proportion of people whose tumours completely disappear on examination or scans before surgery (pathological or clinical complete response), with disease-free survival and quality of life also measured.

Worth knowing: This is a small, single-arm phase 2 trial with no comparison group, and its primary endpoint is tumour response rather than overall survival.

Written from the trial's own registry entry to explain what the researchers are testing and why. Nothing here is a result — this trial has not reported one — and it is not a view on whether the treatment works or on whether it would suit you.

The trial at a glance
Registry number NCT07581912
Recruitment Recruiting now
Phase Phase 2
Design open label
Taking part 40 people (planned)
Who can join aged 18 Years to 85 Years
Run by Zhejiang University
Started
Main results expected
Record last updated

What is being tested

  • Drug fulzerasib; cetuximab N01

What it is measuring

overall response rate

This is the trial's main question — the one it is designed and sized to answer. Anything else it reports is a secondary finding, and secondary findings are far more likely to be chance.

Phase 2. Tests whether the treatment works well enough to be worth a larger trial. Usually too small to prove it changes survival.

How the researchers describe it

Background:KRAS mutations are the most common genetic alterations in colorectal cancer (CRC), associated with aggressive tumor biology and poor prognosis. For metastatic CRC harboring KRAS mutations, first-line standard treatment is chemotherapy plus bevacizumab. However, its anti-angiogenic effects contraindicate perioperative use. KRAS G12C, the first druggable KRAS target, accounts for ~3% of CRC KRAS mutations. KRAS G12C inhibitor monotherapy shows efficacy in post-standard-therapy metastatic CRC, while combination with RAS-MAPK pathway blockade demonstrates superior efficacy. Based on promising frontline data combining KRAS G12C inhibitors with anti-EGFR antibodies in metastatic CRC, we evaluate neoadjuvant fulzerasib plus cetuximab N01 in locally advanced KRAS G12C-mutated CRC, with or without resectable metastases.

Methods:Single-arm, multicenter, phase II trial (N=40). Eligibility: age 18-80 years, ECOG 0-1, histologically confirmed colorectal adenocarcinoma (stages T4N0-2M0, T3N2M0, T0-4N0-2M1a [resectable metastases confirmed by multidisciplinary discussion]), KRAS G12C mutation, NRAS/BRAF wild-type, pMMR/MSS. Neoadjuvant therapy: fulzerasib (qd, po, d1-28) plus cetuximab N01 (500 mg/m², IV, q2w) for 2 months. Safety assessments (CBC, liver/renal function, QoL) every 2 weeks; CEA monthly. Tumor response assessed by CT chest/abdomen and rectal MRI at 2 months.

Written by the trial’s sponsor, quoted from its ClinicalTrials.gov record.

What this trial is looking for

Genotype

  • RAS wild-type
  • (K/N)RAS mutated
Disease

  • Metastatic
  • Locally advanced

Read automatically from the criteria below, to make the list searchable. It is a summary of what the text mentions, not a decision about whether you qualify — and where the two disagree, the criteria are right and this is wrong.

Who the trial is looking for

Inclusion Criteria

  • The subjects voluntarily joined this study, signed an informed consent form, and showed good compliance;
  • Age: 18-80 years old, PS score 0-1;
  • Colorectal adenocarcinoma diagnosed by histopathology, preoperative staging: T4N0-2M0, T3N2M0, T0-4N0-2M1a (with metastatic lesions present, requiring MDT evaluation as resectable); PMMR/MSS, KRAS G12C mutation, and both NRAS and BRAF wild-type
  • Locally advanced colorectal cancer requires initial diagnosis of patients who have not received systematic treatment in the past. Patients with resectable metastatic lesions are required to have not received targeted therapy in the past, and new metastases after adjuvant therapy can be included in this study.
  • The main organ functions well and meets the following criteria:

1. Blood routine examination criteria (corrected for no blood transfusion or use of hematopoietic stimulating factor drugs within 7 days before screening): hemoglobin (HGB) ≥ 90g/L (if chronic anemia is caused by chronic blood loss from the tumor and the researcher evaluates the stability of vital signs, it can be included in the group); absolute neutrophil count (NEUT) ≥ 1.5 × 109/L; platelet count (PLT) ≥ 75 × 109/L;

2.

This is an extract. Whether you qualify is decided by the trial team against the full criteria, not by reading this page. Read the full eligibility criteria

Where it is running

Running at 1 site. Listed in: China.

Individual hospitals, and whether each is currently open, are listed on the registry record. Sites open and close throughout a trial.

Worth asking your oncology team

Being listed here is not a recommendation, and no one page can tell you whether a trial is right for you. These are the questions it raises.

  • Is this trial open at a hospital I could realistically travel to?
  • Given my stage, my previous treatment and my tumour's molecular profile, would I be eligible?
  • What would I be giving up by joining — is the comparison arm the treatment I would otherwise be having?
  • What is already known about the safety of what is being tested?

The source

Registry record NCT07581912, registered by Zhejiang University on ClinicalTrials.gov, a public database run by the US National Library of Medicine. The details on this page come from that record and are only ever as current as the sponsor has kept it.

This is a listing of a registered clinical trial, reproduced for information. It is not a recommendation, this site has no connection to the trial or its sponsor, and being listed here says nothing about whether the treatment works. Talk to your own oncology team before pursuing any trial.

This article summarises published research for general information. It is not medical advice, and it is not a substitute for a conversation with your own oncology team, who know your case. Do not start, stop, or change any treatment or supplement on the basis of what you read here.


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