- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05908786
A Study Evaluating The Efficacy and Safety of Neoadjuvant Immunotherapy Combinations in Patients With Surgically Resectable Hepatocellular Carcinoma
April 18, 2024 updated by: Hoffmann-La Roche
A Phase Ib/II, Open-Label, Multicenter, Randomized Platform Study Evaluating The Efficacy and Safety of Neoadjuvant Immunotherapy Combinations in Patients With Surgically Resectable Hepatocellular Carcinoma (MORPHEUS-NEO HCC)
This is a Phase Ib/II, open-label, multicenter, randomized platform study to evaluate neoadjuvant immunotherapy combinations in participants with resectable HCC.
The study is designed with the flexibility to open new treatment arms as new agents become available, close existing treatment arms that demonstrate minimal clinical activity or unacceptable toxicity, or modify the participant population.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
150
Phase
- Phase 2
- 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 Contact
- Name: Reference Study ID Number: GO44457 https://forpatients.roche.com/
- Phone Number: 888-662-6728 (U.S. and Canada)
- Email: global.rochegenentechtrials@roche.com
Study Locations
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Dijon, France, 21079
- Recruiting
- Centre Georges Francois Leclerc (CGFL)
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Rennes, France, 35042
- Recruiting
- Centre Eugene Marquis (CEM)
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Villejuif, France, 94805
- Recruiting
- Gustave Roussy
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Villejuif, France, 94800
- Recruiting
- Assistance Publique-Hopitaux de Paris
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Gyeonggi-do, Korea, Republic of, 13496
- Recruiting
- CHA Bundang Medical Center
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Seoul, Korea, Republic of, 05505
- Recruiting
- Asan Medical Center
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Seoul, Korea, Republic of, 06351
- Recruiting
- Samsung Medical Center
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Seoul, Korea, Republic of, 03722
- Recruiting
- Severance Hospital, Yonsei University Health System
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Auckland, New Zealand, 1023
- Recruiting
- Auckland District Health Board (ADHB); Auckland City Hospital (ACH)
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Madrid, Spain, 28040
- Recruiting
- Hospital Universitario Fundacion Jimenez Diaz.
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Cantabria
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Santander, Cantabria, Spain, 39008
- Recruiting
- Hospital Universitario Marques de Valdecilla
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Navarra
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Pamplona, Navarra, Spain, 31620
- Recruiting
- Clinica Universidad de Navarra
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Tainan, Taiwan, 70457
- Recruiting
- National Cheng Kung University Hospital
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Taipei City, Taiwan, 112
- Recruiting
- Taipei Veterans General Hospital
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Zhongzheng Dist., Taiwan, 10002
- Recruiting
- National Taiwan University Hospital (NTUH) - Cancer Research Center
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London, United Kingdom
- Recruiting
- Imperial College London - Imperial Centre for Translational and Experimental Medicine (ICTEM)
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California
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Los Angeles, California, United States, 90033
- Recruiting
- University of Southern California (USC); Norris Comprehensive Cancer Center
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Santa Monica, California, United States, 90404-2023
- Recruiting
- University of California Los Angeles (UCLA) - Cancer Care - Santa Monica
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Colorado
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New Haven, Colorado, United States, 06519-1110
- Recruiting
- Yale School of Medicine - Smilow Cancer Hospital - Yale-New Haven Hospital Location
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District of Columbia
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Washington, District of Columbia, United States, 20007
- Recruiting
- Georgetown University Medical Center
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Michigan
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Detroit, Michigan, United States, 48201-2013
- Recruiting
- Barbara Ann Karmanos Cancer Institute - Karmanos Cancer Center - Main Campus
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New York
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Bronx, New York, United States, 10461
- Recruiting
- Montefiore Einstein Cancer Center
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New York, New York, United States, 10032
- Recruiting
- Columbia University Medical Center; Herbert Irving Pavilion Location
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104-4206
- Recruiting
- University of Pennsylvania - Abramson Cancer Center
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Texas
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Dallas, Texas, United States, 75390-8813
- Recruiting
- UT Southwestern Medical Center
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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
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Diagnosis of HCC confirmed either histologically or clinically according to AASLD criteria for patients with cirrhosis. For participants without cirrhosis, histological confirmation is mandatory.
- HCC that is amenable to R0 surgical resection with curative intent in the opinion of the surgeons and oncologists or hepatologists involved in the care of the participant. Patients presenting with resectable HCC within or beyond Milan criteria (without extrahepatic spread or macrovascular invasion) are eligible.
- Measurable disease (at least one target lesion) according to RECIST v1.1 as determined by the investigator
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 within 7 days prior to randomization
- Child-Pugh Class A within 7 days prior to randomization
- Negative HIV test at screening
- No prior locoregional or systemic treatment for HCC
- Adequate hematologic and end-organ function
- Documented virology status of hepatitis
- For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception
- For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception, and agreement to refrain from donating sperm
General Exclusion Criteria:
- Presence of extrahepatic disease or macrovascular invasion
- Known fibrolamellar HCC, sarcomatoid HCC, mixed cholangiocarcinoma and HCC, or other rare variants of HCC
- History of hepatic encephalopathy if clinically significant within one year prior to initiation of study treatment
- Moderate or severe ascites
- Active co-infection with HBV and HCV
- Known active co-infection with HBV and hepatitis D viral infection
- Prior treatment with CD137 agonists or immune checkpoint inhibitors, including anti-CTLA-4, anti-PD-1, and anti-PD-L1 therapeutic antibodies
- Treatment with investigational therapy within 28 days prior to initiation of study treatment
- Untreated or incompletely treated esophageal and/or gastric varices with bleeding or that are at high risk for bleeding
- A prior bleeding event due to esophageal and/or gastric varices within 6 months prior to initiation of study treatment
- Inadequately controlled hypertension
- History of hypertensive crisis or hypertensive encephalopathy
- Significant vascular disease within 6 months prior to initiation of study treatment
- History of hemoptysis within 1 month prior to initiation of study treatment
- Evidence of bleeding diathesis or significant coagulopathy
- Current or recent (<= 10 days prior to initiation of study treatment) use of full-dose oral or parenteral anticoagulants or thrombolytic agents for therapeutic purposes
- History of abdominal or tracheoesophageal fistula, GI perforation or intra-abdominal abscesses within 6 months prior to initiation of study treatment
- History of intestinal obstruction and/or clinical sign or symptoms of GI obstruction
- Serious, non-healing or dehiscing wound, active ulcer, or untreated bone fracture
- Grade >= proteinuria
- Major surgical procedure, open biopsy, or significant traumatic injury, or abdominal surgery, interventions or traumatic injuries, or anticipation of need of major surgical procedure other than potentially curative liver resection
- Chronic daily treatment with a non-steroidal anti-inflammatory drug (NSAID)
- Serious infection requiring oral or IV antibiotics and/or hospitalization
- Active tuberculosis
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: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Atezo + Bev
Participants in the atezolizumab plus bevacizumab (Atezo + Bev) arm will receive up to three cycles of treatment until surgery or unacceptable toxicity, whichever occurs first.
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Atezolizumab will be administered at a dose of 1200 mg by IV infusion on Day 1.
Other Names:
Bevacizumab will be administered at a dose of 15 mg/kg by IV infusion on Day 1.
Other Names:
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Experimental: Atezo + Bev +Tira
Participants in the atezolizumab plus bevacizumab plus tiragolumab (Atezo + Bev +Tira) arm will receive up to three cycles of treatment until surgery or unacceptable toxicity, whichever occurs first.
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Atezolizumab will be administered at a dose of 1200 mg by IV infusion on Day 1.
Other Names:
Bevacizumab will be administered at a dose of 15 mg/kg by IV infusion on Day 1.
Other Names:
Tiragolumab will be administered at a dose of 600 mg by IV infusion on Day 1.
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Experimental: Tobe + Bev
Participants in the Tobemstomig + Bev arm will receive up to three cycles of treatment until surgery or unacceptable toxicity, whichever occurs first.
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Bevacizumab will be administered at a dose of 15 mg/kg by IV infusion on Day 1.
Other Names:
Tobemstomig will be administered at a dose of 600 mg by IV infusion on Day 1
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Major Pathologic Response (MPR) Rate
Time Frame: At the time of surgery
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MPR rate is defined as the proportion of participants with =<10% residual viable tumor in the tumor bed at the time of surgery, as assessed by central pathological review.
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At the time of surgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Relapse-Free Survival (RFS)
Time Frame: Surgery to the first documented recurrence of disease (up to approximately 2 years)
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RFS is defined as the time from surgery to the first documented recurrence of disease (intrahepatic or extrahepatic) according to EASL and/or RECIST v1.1, or death from any cause.
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Surgery to the first documented recurrence of disease (up to approximately 2 years)
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Overall Survival (OS)
Time Frame: Randomization to death from any cause (up to approximately 3 years)
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OS is defined as the time from randomization to death from any cause.
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Randomization to death from any cause (up to approximately 3 years)
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Proportion of Participants Downstaged to Within Milan Criteria
Time Frame: Prior to surgery
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Proportion of participants downstaged to within Milan criteria (for participants beyond criteria at randomization).
Within Milan criteria is defined as single tumor <= 5 cm or 2 - 3 nodules all <= 3 cm.
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Prior to surgery
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R0 Resection Rate
Time Frame: At the time of surgery
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R0 resection rate (proportion of resected participants obtaining an R0 resection).
R0 resection is defined as a microscopically margin-negative resection, in which no tumor (gross or microscopic) remains in the primary tumor bed.
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At the time of surgery
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Percentage of Participants With Adverse Events
Time Frame: Up to approximately 3 years after first participant enrolled
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Up to approximately 3 years after first participant enrolled
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Proportion of Participants With Delayed or Canceled Surgery Due to Treatment-Related Adverse Events
Time Frame: >28 days from surgical restaging visit, anticipated up to 56 days
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Proportion of participants with delayed or canceled surgery due to treatment-related adverse events (defined as > 28 days from surgical restaging visit).
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>28 days from surgical restaging visit, anticipated up to 56 days
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Post-Operative Surgical Complication Rates According to The Clavien-Dindo Surgical Classification
Time Frame: Surgery to treatment completion/discontinuation (up to approximately 2 years)
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Post-operative surgical complication rates according to the Clavien-Dindo surgical classification.
Clinically relevant complications are defined as Clavien-Dindo Grade >= IIIa.
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Surgery to treatment completion/discontinuation (up to approximately 2 years)
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Pathologic Complete Response (pCR) Rate
Time Frame: At the time of surgery
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pCR rate is defined as the proportion of participants with an absence of residual tumor at the time of surgery, as assessed by central pathological review.
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At the time of surgery
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Event-Free Survival (EFS)
Time Frame: Randomization up to approximately 3 years
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EFS is defined as the time from randomization to any of the following events (whichever occurs first): disease progression that precludes surgery, as assessed by the investigator according RECIST v1.1; local regional, or distant disease recurrence as measured by EASL and/or RECIST v1.1; or death from any cause.
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Randomization up to approximately 3 years
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OS Rate at 24 Months
Time Frame: Randomization up to 24 months
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OS rate at 24 months is defined as the proportion of participants who have not experience death from any cause at 24 months after randomization.
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Randomization up to 24 months
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OS Rate at 36 Months
Time Frame: Randomization up to 36 months
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OS rate at 36 months is defined as the proportion of participants who have not experience death from any cause at 36 months after randomization.
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Randomization up to 36 months
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Objective Response Rate (ORR)
Time Frame: Prior to surgery
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ORR is defined as the proportion of participants with a radiographic Complete Response (CR) or Partial Response (PR) prior to surgery, as determined by the investigator according to RECIST v1.1 and HCC mRECIST.
Responses will be assessed and determined according to RECIST v1.1 and HCC mRECIST but are not required to be confirmed by subsequent imaging assessments.
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Prior to surgery
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Post-Operative Mortality
Time Frame: Within 90 days after surgery
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Post-operative mortality is defined as death within 90 days after surgery
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Within 90 days after surgery
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Director: Clinical Trials, Hoffmann-La Roche
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)
December 5, 2023
Primary Completion (Estimated)
September 30, 2025
Study Completion (Estimated)
September 30, 2028
Study Registration Dates
First Submitted
June 7, 2023
First Submitted That Met QC Criteria
June 15, 2023
First Posted (Actual)
June 18, 2023
Study Record Updates
Last Update Posted (Actual)
April 19, 2024
Last Update Submitted That Met QC Criteria
April 18, 2024
Last Verified
April 1, 2024
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
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Immune Checkpoint Inhibitors
- Bevacizumab
- Atezolizumab
Other Study ID Numbers
- GO44457
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.vivli.org).
Further details on Roche's criteria for eligible studies are available here ( https://vivli.org/ourmember/roche/).
For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
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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