Efficacy and Safety of Multimodal Ablation Combined With PD-1 Monoclonal Antibody, Lenvatinib and TACE in the Treatment of Unresectable Primary Hepatocellular Carcinoma: A Single-Arm, Single-Center Clinical Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: zhiping Yan, M.D
- Phone Number: +86 13122806500
- Email: yan.zhiping@zs-hospital.sh.cn
Study Locations
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Shanghai Municipality
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Shanghai, Shanghai Municipality, China, 200032
- Recruiting
- Zhongshan Hospital, Fudan University
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Contact:
- Minjie Yang
- Phone Number: +86 02164041990
- Email: yang.mingjie@zs-hospital.sh.cn
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18-80 years, regardless of gender.
- Clinically or pathologically confirmed HCC.
- CNLC stage IIb-IIIa, deemed unresectable after multidisciplinary evaluation.
- Having radiologically evaluable, untreated target lesions for ablation, with the largest diameter of the target tumor >5 cm.
- Patients who have not undergone systemic chemotherapy, targeted therapy, or immunotherapy for hepatocellular carcinoma, or those who have been evaluated as SD (stable disease) or PD (progressive disease) after treatment..
- ECOG PS 0-1 and an expected survival >3 months.
- Child-Pugh score ≤7.
Exclusion Criteria:
- Child-Pugh class C liver dysfunction.
- Tumor thrombus in the main portal vein or hepatic vein.
- Extensive metastatic disease with an expected survival <3 months.
- Severe dysfunction of major organs (liver, kidney, heart, lung, or brain).
- History of esophageal/gastric variceal bleeding within the past month.
- History of other malignancies.
- Last anti-tumor therapy (e.g., radiotherapy, systemic chemotherapy, or local treatment) within <1 month.
- Active infection; HBV co-infection (HBV DNA ≥2000 IU/mL or ≥10⁴ copies/mL unless reduced by one log after antiviral therapy); HCV co-infection requiring guideline-directed antiviral treatment; HIV infection; or biliary tract inflammation.
- History of organ transplantation or hepatic encephalopathy.
- Uncorrectable coagulation disorders.
- Refractory massive ascites, pleural effusion, or cachexia.
- Pregnancy, impaired consciousness, or inability to comply with treatment.
- High tumor burden (sum of the largest liver lesion diameter and number of liver lesions >12).
- Any other condition deemed unsuitable by investigators that may affect study participation.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Treatment Group
The patient will receive induction therapy with tislelizumab and lenvatinib within 14 days after enrollment.
Subsequently, within 2-7 days (the exact timing will be determined based on clinical circumstances), they will undergo Multimodal Thermal Therapy (MTT).
Following the MTT procedure, on-demand TACE treatment will be administered.
Starting from day 7 post-MTT (with the exact timing adjusted according to clinical conditions), the patient will resume tislelizumab and lenvatinib therapy until disease progression, occurrence of intolerable toxicity, or withdrawal of consent.
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The high-burden tumor is identified as the target lesion for treatment.
A pre-treatment biopsy of the target lesion is performed to obtain tumor tissue.
Multimodal ablation therapy of the target lesion is conducted under CT guidance.
The treatment procedure follows the tumor ablation protocol using the multimodal therapy radiofrequency temperature-controlled mode.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Objective response rate (ORR) according to RECIST 1.1 and mRECIST
Time Frame: Follow-up for 12 months, with evaluations conducted at 2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 12 months postoperatively.
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Refers to the proportion of patients whose tumors shrink to a certain extent and maintain that response for a specified period, including cases of Complete Response (CR) and Partial Response (PR).
Tumor objective response is assessed using RECIST 1.1 and mRECIST criteria.
At baseline, subjects must have measurable tumor lesions.
According to the efficacy evaluation criteria, the outcomes are classified as Complete Response (CR), Partial Response (PR), Stable Disease (SD), or Progressive Disease (PD).
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Follow-up for 12 months, with evaluations conducted at 2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 12 months postoperatively.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression-Free Survival(PFS)
Time Frame: Follow-up for 12 months,with assessments conducted every 3 months.
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It refers to the time from the date of enrollment to the date of the first recorded disease progression(PD)or death,whichever occurs first.
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Follow-up for 12 months,with assessments conducted every 3 months.
|
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Overall Survival(OS)
Time Frame: Follow-up for 12 months,with assessments conducted every 3 months.
|
Overall Survival(OS)refers to the time from the date of enrollment to the date of death due to any cause.
|
Follow-up for 12 months,with assessments conducted every 3 months.
|
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Safety and Tolerability
Time Frame: Follow-up for 12 months, with evaluations conducted at 2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 12 months postoperatively.
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Safety:Refers to the extent to which a drug does not cause unacceptable harm or side effects when applied in the human body.Tolerability:Refers to the degree to which patients accept the side effects that occur after treatment,reflecting their ability to endure the side effects of the medication.All adverse events will be recorded and assessed for severity based on the NCI-CTC AE 5.0 grading criteria.During the follow-up period,all subjects will be continuously monitored,and the occurrence,duration,severity,and treatment-relatedness of adverse events will be documented.
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Follow-up for 12 months, with evaluations conducted at 2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 12 months postoperatively.
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- MTT-B2024
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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