- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05225116
Safety and Efficacy of Lenvatinib and Anti-PD1 Antibody Combined With Radiotherapy Neoadjuvant Treatment for Resectable Hepatocellular Carcinoma With PVTT
February 6, 2023 updated by: Beijing Tsinghua Chang Gung Hospital
Safety and Efficacy of Lenvatinib and Anti-PD1 Antibody Combined With Radiotherapy Neoadjuvant Treatment for Resectable Hepatocellular Carcinoma With PVTT,Prospective, Multicenter, Single-arm Study
Patients with hepatocellular carcinoma with PVTT can benefit from surgical resection and radiotherapy.
As the rapid development of systematic treatment in hepatocellular carcinoma, ICIs neoadjuvant therapy is being actively explored .But there is no evidence to prove the safety and efficacy of lenvatinib and anti-PD1 antibody combined with radiotherapy neoadjuvant treatment for resectable hepatocellular carcinoma with PVTT.
This study intends to supplement the evidence of benefit in such patients.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Anticipated)
20
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Beijing
-
Beijing, Beijing, China, 102218
- Recruiting
- Beijing Tsinghua Changgung Hospital
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 70 years (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Aged 18-70, with no gender limitation;
- HCC patients who strictly met the clinical diagnostic criteria of The Code for The Diagnosis and Treatment of Primary Liver Cancer (2019 edition) or were confirmed by histopathological or cytological examination;
- BCLC stage C, no distant metastasis;
- Patients with PVTT of type VP1-2-3-4 according to Japanese VP Classification;
- The primary tumor can be resected (the remaining liver has complete vascular structure and sufficient liver volume, in line with the decision-making system of safe liver resection)
- ECOG score 0-1;
- Child-Pugh score ≤7;
- If the patient is HBV antigen positive, HBV DNA < 500 IU/ mL, conventional antiviral treatment;
The major organs meeting the following criteria:
- Adequate bone marrow function, defined as: Absolute neutrophil count (ANC ≥ or equal to 1.5 X 10 ^ 9 per liter (/ L)) Hemoglobin (Hb ≥ 8.5 g/dL) Platelet count ≥ 75×10 ^ 9 / L.
- Adequate liver function, defined as: Albumin > 2.8 g/dL Bilirubin is 3.0 mg/dL or less Aspartate aminotransferase (AST), alkaline phosphatase (ALP) and alanine aminotransferase (ALT) are less than or equal to 5 ULN.
- Adequate coagulation function, defined as an international standardized ratio ( (INR) of 2.3 or less.
- Adequate renal function was defined as creatinine clearance greater than 40 mL/min (mL/min), calculated according to the Cockcroft and Gault formulas.
- Adequate pancreatic function, defined as amylase and lipase. = 1.5 x ULN.
- Adequate control of blood pressure (BP) with up to 3 antihypertensive drugs, defined as BP-lt at screening time; = 150/90 mmHg (mmHg), and there was no change in antihypertensive therapy 1 week prior to cycle 1 / day 1.
- Patients are expected to survive longer than 3 months.
- No pregnancy or pregnancy plan.
- Subjects voluntarily joined the study and signed informed consent with good compliance and follow-up.
Exclusion Criteria:
- Extrahepatic metastasis of primary hepatocellular carcinoma;
- Diffuse liver cancer;
- Patients who had previously received targeted drugs or immune checkpoint inhibitors;
- allergic to Lenvatinib or PD-1 inhibitor ingredients;
- Patients with grade II or higher myocardial ischemia or myocardial infarction and poorly controlled arrhythmias (including QTc interval ≥470 ms); Patients with grade III ~ IV cardiac insufficiency according to NYHA standard, or left ventricular ejection fraction (LVEF) < 50% as indicated by color doppler echocardiography;
- abnormal coagulation function (INR > 1.5 or prothrombin time (PT) > ULN+4 seconds or APTT > 1.5ULN), with bleeding tendency or receiving thrombolytic or anticoagulant therapy;
- pregnant or breast-feeding women; Fertile patients unwilling or unable to take effective contraceptive measures;
- have a history of mental illness or abuse of psychotropic drugs;
- patients with co-HIV infection;
- a history of liver resection, liver transplantation, interventional therapy, and other malignant tumors;
- patients with active infection;
- contraindications to radiotherapy;
- Patients with poor compliance such as floating population;
- participants in clinical trials of other experimental drugs or devices within 4 weeks;
- those considered unsuitable for inclusion by the researcher.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Sintilimab+Lenvatinib+Radiotherapy
|
Sintilimab will be at a dose of 200mg,Q3W
On the first day of the trial, Lenvatinib will be taken orally once daily (8mg/day ≤ 60kg or 12mg/day ≥60kg).
Radiotherapy will be completed within two weeks at a dose of 300cGy× 10 fraction
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety(CTCAE v5.0)
Time Frame: up to 5 years
|
Number of patients who reported incidence of grade ≥3 treatment related adverse events.
|
up to 5 years
|
Number of patients who complete pre-op treatment and proceed to surgery
Time Frame: up to 5 years
|
Number of patients who complete pre-op treatment and proceed to surgery
|
up to 5 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Major Pathological Response(MPR)
Time Frame: Within 3 months after surgery
|
Survival tumor ≤10% during surgery
|
Within 3 months after surgery
|
Objective Response Rate(ORR)
Time Frame: within 1 week before surgery
|
Efficacy included objective response (includes complete and partial response) according to modified RECIST 1.1 for HCC
|
within 1 week before surgery
|
Imaging-pathology Concordance Rate
Time Frame: Within 3 months after surgery
|
Imaging-pathology Concordance Rate
|
Within 3 months after surgery
|
PVTT regression rate
Time Frame: Within 3 months after surgery
|
The fading rate of PVTT
|
Within 3 months after surgery
|
Median Overall survival(mOS)
Time Frame: up to 5 years
|
mOS is defined as the median difference (in months) between the date of study enrollment to the date death due to any cause
|
up to 5 years
|
Recurrence free survival(RFS)
Time Frame: 1 year after surgery
|
From radical resection to the date of the first documented tumor into recurrence or death from any cause, whichever occurred first
|
1 year after surgery
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
January 8, 2023
Primary Completion (ANTICIPATED)
December 5, 2025
Study Completion (ANTICIPATED)
December 5, 2025
Study Registration Dates
First Submitted
January 23, 2022
First Submitted That Met QC Criteria
January 26, 2022
First Posted (ACTUAL)
February 4, 2022
Study Record Updates
Last Update Posted (ACTUAL)
February 8, 2023
Last Update Submitted That Met QC Criteria
February 6, 2023
Last Verified
January 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Adenocarcinoma
- Neoplasms, Glandular and Epithelial
- Digestive System Neoplasms
- Liver Diseases
- Liver Neoplasms
- Carcinoma
- Carcinoma, Hepatocellular
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Protein Kinase Inhibitors
- Lenvatinib
Other Study ID Numbers
- 21323-0-03
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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