NCT04229355

Brief Summary

Transarterial chemoembolization (TACE) based on drug-eluting beads (DEB-TACE) is widely used for unresectable hepatocellular carcinoma (HCC). However, the long-term survival is still low after DEB-TACE treatment. In recent years, lenvatinib and anti-PD-1 have exhibited potential therapeutic effects for advanced HCC. And sorafenib is the standard drug for advanced HCC. Combining targeted drugs or immunotherapies with DEB-TACE may provide synergistic effects and facilitate the development of personalized medicine. Therefore, this prospective study aims to investigate the safety and efficacy of DEB-TACE plus sorafenib or lenvatinib or PD-1 Inhibitor for unresectable HCC.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
90

participants targeted

Target at below P25 for phase_3 hepatocellular-carcinoma

Timeline
Completed

Started Feb 2021

Shorter than P25 for phase_3 hepatocellular-carcinoma

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 12, 2020

Completed
6 days until next milestone

First Posted

Study publicly available on registry

January 18, 2020

Completed
1 year until next milestone

Study Start

First participant enrolled

February 2, 2021

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 30, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 30, 2022

Completed
Last Updated

February 9, 2021

Status Verified

February 1, 2021

Enrollment Period

1.9 years

First QC Date

January 12, 2020

Last Update Submit

February 7, 2021

Conditions

Outcome Measures

Primary Outcomes (1)

  • Progression-free survival

    Primary endpoint is progression-free survival (PFS).

    one month

Secondary Outcomes (1)

  • Overall survival

    one month

Study Arms (3)

DEB-TACE plus Sorafenib

EXPERIMENTAL

Patients with unresectable hepatocellular carcinoma (HCC) in this group will receive drug-eluting bead transarterial chemoembolization (DEB-TACE).And then, they will receive sorafenib (400 mg/d, po, bid) one week after DEB-TACE therapy. The second DEB-TACE will be performed after one month later the first DEB-TACE. Lenvatinib will be taken orally for six months, untill tumor progression, or intolerable adverse reactions.

Drug: DEB-TACE plus Sorafenib

DEB-TACE plus Lenvatinib

EXPERIMENTAL

Patients with unresectable hepatocellular carcinoma (HCC) in this group will receive drug-eluting bead transarterial chemoembolization (DEB-TACE).And then, they will receive lenvatinib (8 mg/d, po, qd) one week after DEB-TACE therapy. The second DEB-TACE will be performed after one month later the first DEB-TACE. Lenvatinib will be taken orally for six months, untill tumor progression, or intolerable adverse reactions.

Drug: DEB-TACE plus Lenvatinib

DEB-TACE plus PD-1 inhibitor

ACTIVE COMPARATOR

Patients with unresectable hepatocellular carcinoma (HCC) in this group will receive drug-eluting bead transarterial chemoembolization (DEB-TACE).And then, they will receive PD-1 inhibitor (200 mg, iv, 3 weeks) one week after DEB-TACE therapy. The second DEB-TACE will be performed after one month later the first DEB-TACE. PD-1 inhibitor will be taken for six months, untill tumor progression, or intolerable adverse reactions.

Drug: DEB-TACE plus PD-1 inhibitor

Interventions

Drug-eluting bead transarterial chemoembolization plus sorafenib (400 mg/d, po, bid)

DEB-TACE plus Sorafenib

Drug-eluting bead transarterial chemoembolization plus lenvatinib (8 mg/d, po, qd)

DEB-TACE plus Lenvatinib

Drug-eluting bead transarterial chemoembolization plus PD-1 inhibitor

DEB-TACE plus PD-1 inhibitor

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18 - 75 years
  • Patients with unresectable primary hepatocellular carcinoma.
  • With Child-Pugh A liver function.

You may not qualify if:

  • Patients received targeted drugs, anti-PD1, or anti-PD-L1 treatment.
  • Patients with recurrent hepatocellular carcinoma.
  • Patient compliance is poor.
  • The blood supply of tumor lesions is absolutely poor or arterial-venous shunt that TACE can not be performed.
  • Known history of human immunodeficiency virus (HIV) infection.
  • Known Central Nervous System tumors including metastatic brain disease.
  • Patients with clinically significant gastrointestinal bleeding within 30 days prior to study entry.
  • History of organ allograft.
  • Known or suspected allergy to the investigational agent or any agent given in association with this trial.
  • Any condition that is unstable or which could jeopardize the safety of the patient and his/her compliance in the study.
  • Pregnant or breast-feeding patients. Women of childbearing potential must have a negative pregnancy test performed within seven days prior to the start of study drug. Both men and women enrolled in this trial must use adequate barrier birth control measures during the course of the trial.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Guangxi Medical University Cancer Hospital

Nanning, Guangxi, 530021, China

RECRUITING

Related Publications (5)

  • Kudo M, Finn RS, Qin S, Han KH, Ikeda K, Piscaglia F, Baron A, Park JW, Han G, Jassem J, Blanc JF, Vogel A, Komov D, Evans TRJ, Lopez C, Dutcus C, Guo M, Saito K, Kraljevic S, Tamai T, Ren M, Cheng AL. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet. 2018 Mar 24;391(10126):1163-1173. doi: 10.1016/S0140-6736(18)30207-1.

    PMID: 29433850BACKGROUND
  • Hatanaka T, Kakizaki S, Nagashima T, Namikawa M, Tojima H, Shimada Y, Takizawa D, Naganuma A, Arai H, Sato K, Harimoto N, Shirabe K, Uraoka T. Analyses of objective response rate, progression-free survival, and adverse events in hepatocellular carcinoma patients treated with lenvatinib: A multicenter retrospective study. Hepatol Res. 2020 Mar;50(3):382-395. doi: 10.1111/hepr.13460. Epub 2019 Dec 10.

    PMID: 31760660BACKGROUND
  • Kim JJ, McFarlane T, Tully S, Wong WWL. Lenvatinib Versus Sorafenib as First-Line Treatment of Unresectable Hepatocellular Carcinoma: A Cost-Utility Analysis. Oncologist. 2019 Nov 20:theoncologist.2019-0501. doi: 10.1634/theoncologist.2019-0501. Online ahead of print.

    PMID: 31748341BACKGROUND
  • Feng Z, Rong P, Wang W. Meta-analysis of the efficacy and safety of PD-1/PD-L1 inhibitors administered alone or in combination with anti-VEGF agents in advanced hepatocellular carcinoma. Gut. 2020 Oct;69(10):1904-1906. doi: 10.1136/gutjnl-2019-320116. Epub 2019 Dec 18. No abstract available.

    PMID: 31852768BACKGROUND
  • Xie ZB, Wang XB, Peng YC, Zhu SL, Ma L, Xiang BD, Gong WF, Chen J, You XM, Jiang JH, Li LQ, Zhong JH. Systematic review comparing the safety and efficacy of conventional and drug-eluting bead transarterial chemoembolization for inoperable hepatocellular carcinoma. Hepatol Res. 2015 Jan;45(2):190-200. doi: 10.1111/hepr.12450. Epub 2014 Dec 24.

    PMID: 25388603BACKGROUND

MeSH Terms

Conditions

Carcinoma, Hepatocellular

Interventions

SorafeniblenvatinibImmune Checkpoint Inhibitors

Condition Hierarchy (Ancestors)

AdenocarcinomaCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeNeoplasmsLiver NeoplasmsDigestive System NeoplasmsNeoplasms by SiteDigestive System DiseasesLiver Diseases

Intervention Hierarchy (Ancestors)

Phenylurea CompoundsUreaAmidesOrganic ChemicalsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsNiacinamideNicotinic AcidsAcids, HeterocyclicHeterocyclic CompoundsPyridinesHeterocyclic Compounds, 1-RingMolecular Mechanisms of Pharmacological ActionPharmacologic ActionsChemical Actions and UsesAntineoplastic Agents, ImmunologicalAntineoplastic AgentsTherapeutic Uses

Study Officials

  • Le-Qun Li, PhD

    Guangxi Medical University Cancer Hospital

    STUDY CHAIR

Central Study Contacts

Fei-Xiang Wu, PhD

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
NON RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
Outcomes assessor will be blinded about patients' allocation.
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

January 12, 2020

First Posted

January 18, 2020

Study Start

February 2, 2021

Primary Completion

December 30, 2022

Study Completion

December 30, 2022

Last Updated

February 9, 2021

Record last verified: 2021-02

Locations