Ivosidenib Plus mFOLFOXIRI and Celecoxib for BRAF-targeted Therapy-refractory BRAF V600E-mutant Colorectal Cancer Patients

This study is a prospective, investigator-initiated, single-arm, phase II trial to evaluate the efficacy and safety of ivonescimab (AK112) combined with FOLFOXIRI and celecoxib in patients with BRAF-mutated advanced/metastatic colorectal cancer who have developed resistance to prior chemotherapy and BRAF inhibitors . The inclusion criteria: histologically confirmed BRAF V600E-mutated advanced or metastatic colorectal cancer; documented resistance/progression after at least one line of standard chemotherapy ( FOLFOX/FOLFIRI-based) and BRAF inhibitor-based targeted therapy; measurable disease per RECIST 1.1; ECOG performance status 0-1; adequate organ function; no active brain metastases or other uncontrolled comorbidities (specific criteria can be supplemented as needed). Patients received ivonescimab combined with mFOLFOXIRI (modified FOLFOXIRI regimen) and celecoxib for up to 6-8 cycles or until progression/toxicity, followed by maintenance therapy of continued ivonescimab with 5-FU/leucovorin and celecoxib. All patients will be evaluated every four cycles of treatment using imaging CT/MRI. The primary objective is to assess the objective response rate (ORR) per RECIST 1.1, with secondary endpoints including progression-free survival (PFS), disease control rate (DCR), safety profile, and exploratory biomarkers .