A Study of Liposomal Irinotecan Plus 5-FU/LV HAIC With Lenvatinib and a PD-1 Inhibitor in Advanced ICC

NCT07432568 | Not Yet Recruiting Phase 2

• 1 other identifier: CSPC-DNY-BTC-TJ03
• Study Type: interventional
• Target: 30
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a prospective, single-center, single-arm clinical study. It aims to evaluate the efficacy and safety of a new combination therapy as a first-line treatment for patients with advanced intrahepatic cholangiocarcinoma (ICC) who cannot be treated with surgery. The combined therapy includes hepatic arterial infusion chemotherapy (HAIC) with Liposomal Irinotecan, 5-Fluorouracil, and Leucovorin, along with the oral targeted drug Lenvatinib and an intravenous PD-1 inhibitor (an immunotherapy). A total of 30 participants will be enrolled. The main goal of the study is to measure the Objective Response Rate (ORR), which is the percentage of patients whose cancer shrinks or disappears after treatment.

Conditions

Intrahepatic Cholangiocarcinoma

Keywords

Hepatic Arterial Infusion Chemotherapy(HAIC), Liposomal Irinotecan, 5-Fluorouracil, Leucovorin, Lenvatinib, PD-1 Inhibitor, Immunotherapy, Targeted Therapy

Outcome Measures

Primary Outcomes (1)

• Objective Response Rate (ORR)

  Every 2 cycles (each cycle is 21 days ) during the treatment period

Secondary Outcomes (4)

• Progression-Free Survival (PFS)

  From date of first dose until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 60 months

• Overall Survival (OS)

  From date of first dose until the date of death from any cause, assessed up to 60 months

• Disease Control Rate (DCR)

  From date of first dose until the date of first documented progression or the end of treatment, whichever came first, assessed up to 24 months

• Conversion Resection Rate

  From date of first dose until the date of radical surgery, assessed up to 24 months

Study Arms (1)

Combination Therapy Group

EXPERIMENTAL

All participants receive the combined regimen of hepatic arterial infusion chemotherapy (HAIC) with Liposomal Irinotecan, 5-Fluorouracil, and Leucovorin, plus oral Lenvatinib and an intravenous PD-1 inhibitor as first-line treatment.

Other: Hepatic Arterial Infusion Chemotherapy (HAIC) with Liposomal Irinotecan, 5-Fluorouracil, Leucovorin; Drug: Lenvatinib; Drug: PD-1 Inhibitor

Interventions

Hepatic Arterial Infusion Chemotherapy (HAIC) with Liposomal Irinotecan, 5-Fluorouracil, Leucovorin OTHER

Liposomal Irinotecan (70 mg/m²) infused over 90 minutes, followed by Leucovorin (400 mg/m²) infused over 2 hours, and then 5-Fluorouracil (2400 mg/m²) infused over 24 hours via hepatic arterial infusion on Day 1 of each 21-day cycle. The number of treatment cycles (2 to 6) is determined by the investigator based on tumor response and tolerability after the initial 2 cycles.

Combination Therapy Group

Lenvatinib DRUG

Lenvatinib is administered orally at a dose of 8 mg once daily, continuously throughout each 21-day cycle.

Combination Therapy Group

PD-1 Inhibitor DRUG

A PD-1 inhibitor (specific agent chosen at the investigator's discretion) is administered via intravenous infusion on Day 1 of each 21-day cycle, approximately 24 hours prior to the initiation of HAIC.

Combination Therapy Group

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged 18 to 75 years.
• Histologically or cytologically confirmed unresectable, locally advanced, or metastatic intrahepatic cholangiocarcinoma (ICC).
• Liver function: Child-Pugh class A (score 5-6) or good class B (score ≤7).
• At least one measurable lesion as defined by RECIST 1.1 criteria.
• ECOG performance status of 0 or 1.
• Life expectancy greater than 12 months.
• No prior systemic therapy for unresectable locally advanced or metastatic ICC. Prior adjuvant or neoadjuvant chemotherapy is allowed if completed \>6 months before recurrence.
• Adequate bone marrow function: Absolute Neutrophil Count (ANC) ≥1.5×10⁹/L, Hemoglobin ≥90 g/L, Platelet count (PLT) ≥100×10⁹/L, White Blood Cell count (WBC) ≥3.0×10⁹/L.
• Adequate renal function: Serum creatinine (Cr) ≤1.5 × ULN or Creatinine Clearance (CCr) ≥60 mL/min (calculated by Cockcroft-Gault formula).
• Adequate coagulation function: Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), and International Normalized Ratio (INR) ≤1.5 × ULN.
• No active or suspected infection.
• Not pregnant or lactating. Female and male participants of childbearing potential must use effective contraception during the study and for 6 months after the last dose.
• Good compliance, ability to understand the study procedures, and provision of signed informed consent.

You may not qualify if:

• History of other malignancies within the past 5 years (except cured carcinoma in situ or basal cell skin cancer).
• Significant clinical bleeding symptoms or tendency within 3 months prior to treatment (e.g., \>30 mL bleeding, hematemesis, melena, hematochezia), hemoptysis (\>5 mL of fresh blood within 4 weeks). Venous/thrombotic events within the past 6 months (e.g., cerebrovascular accident, deep vein thrombosis, pulmonary embolism). Requirement for long-term anticoagulation (e.g., warfarin, heparin) or antiplatelet therapy (Aspirin ≥300 mg/day or Clopidogrel ≥75 mg/day).
• Extensive distant metastasis (e.g., peritoneal metastasis, multiple bone/brain metastases).
• Use of strong CYP3A4 inducers within 3 weeks prior to first dose, or use of strong CYP3A4 inhibitors or strong UGT1A1 inhibitors within 3 weeks prior to first dose.
• Major organ surgery within 4 weeks prior to treatment (excluding needle biopsy, central venous catheter placement, port implantation, biliary stenting, percutaneous transhepatic biliary drainage, cholecystostomy) or planned elective surgery.
• Active cardiac disease within 6 months prior to treatment, including myocardial infarction, severe/unstable angina. Left ventricular ejection fraction (LVEF) \<50% by echocardiogram, or poorly controlled arrhythmia.
• Congenital or acquired immunodeficiency (e.g., HIV infection), or active hepatitis (abnormal liver enzymes; for Hepatitis B: HBV DNA ≥1000 IU/mL; for Hepatitis C: HCV RNA ≥1000 IU/mL). Chronic HBV carriers with HBV DNA \<2000 IU/ml can be enrolled if they receive concurrent antiviral therapy during the trial.
• Any other disease, metabolic disorder, physical examination finding, or laboratory abnormality that, in the investigator's judgment, contraindicates the use of the study drug, may affect result interpretation, or places the patient at high risk.
• Bowel obstruction (except incomplete obstruction manageable with enteral nutrition) or patients at risk of bowel perforation (e.g., acute diverticulitis, abdominal abscess, history of abdominal cancer).
• Pregnant or lactating female participants.

Sponsors & Collaborators

• Tianjin Medical University Cancer Institute and Hospital: lead

MeSH Terms

Conditions

Cholangiocarcinoma

Interventions

Fluorouracil; Leucovorin; lenvatinib; Immune Checkpoint Inhibitors

Condition Hierarchy (Ancestors)

Adenocarcinoma; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms

Intervention Hierarchy (Ancestors)

Uracil; Pyrimidinones; Pyrimidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Formyltetrahydrofolates; Tetrahydrofolates; Folic Acid; Pterins; Pteridines; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Coenzymes; Enzymes and Coenzymes; Molecular Mechanisms of Pharmacological Action; Pharmacologic Actions; Chemical Actions and Uses; Antineoplastic Agents, Immunological; Antineoplastic Agents; Therapeutic Uses

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 2, 2026
• First Posted: February 25, 2026
• Study Start: March 9, 2026
• Primary Completion (Estimated): June 9, 2032
• Study Completion (Estimated): August 9, 2032
• Last Updated: February 25, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will share