eligibility_summary
Adults 18–75 with unresectable left‑sided, stage IV colorectal cancer, RAS/BRAF wild type, PS 0–2, life expectancy >3 months, no prior systemic chemo or cetuximab, adequate liver/kidney/bone marrow, ≥4‑week washout from prior chemo/targeted therapy, willing to consent/comply. Exclude severe heart/liver/kidney dysfunction, other malignancies, pregnancy/lactation, active infections, drug allergy, current trial participation, or other unsuitability.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase 2, parallel-arm trial in stage IV unresectable, left-sided RAS/BRAF–wild-type colorectal cancer. Experimental: thalidomide + cetuximab + FOLFOX or FOLFIRI, Control: cetuximab + FOLFOX/FOLFIRI. Thalidomide (IMiD, oral small molecule) has anti-angiogenic and immunomodulatory activity: suppresses TNF-α and pro-inflammatory cytokines, inhibits VEGF/bFGF-driven neovascularization, and modulates T/NK cells. Cetuximab (chimeric IgG1 anti-EGFR monoclonal antibody) blocks EGFR ligand binding and downstream RAS/RAF/MEK/ERK and PI3K/AKT signaling, also mediates ADCC. FOLFOX/FOLFIRI are cytotoxic regimens: 5-FU (thymidylate synthase inhibitor) + leucovorin (enhancer) with oxaliplatin (platinum DNA crosslinker) or irinotecan (topoisomerase I inhibitor). Targets/pathways: EGFR on tumor cells, MAPK/PI3K cascades, tumor vasculature/angiogenesis, cytokine milieu (e.g., TNF-α), immune effector cells (NK), and DNA replication in proliferating cancer cells.