- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07623265
Improving the Use of Immunotherapy to Treat Liver Cancer (IO-MARC)
Optimizing and Improving Immunotherapy for Hepatocellular Carcinoma: the IO-MARC Study
This project targets patients with a form of primary liver cancer, specifically "hepatocellular carcinoma". This disease often develops in the context of a chronically diseased liver, caused by viral infections, excessive alcohol consumption, or fatty liver. Primarily due to the rise of the latter risk factor, liver cancer is one of the few cancer types whose incidence continues to increase globally, year after year. As a result, liver cancer has become the third most common cause of cancer-related deaths worldwide. There exists a significant challenge in reducing the disease on all fronts: prevention, diagnosis, and treatment.
This research aims to personalize the treatment of liver cancer patients, tailoring it to the individual. More specifically, this research seeks to identify patients with immunotherapy-sensitive liver cancer by biomarkers before treatment begins. Determining whether a tumor is immunotherapy-sensitive is internationally recognized as one of the most important challenges within this condition. Based on a combination of existing laboratory techniques on tumor tissue and/or blood, the investigators seek to predict the likelihood of this treatment's success before initiating it. With this knowledge, the investigators could recommend alternative treatments to patients with tumors that are unresponsive. This way, they would also avoid exposure to the side effects of an ineffective therapy.
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
Multicentric, low-interventional with retrospective and prospective components. No investigational medicinal product (IMP) is involved.
Patient management is standard of care. Prospective tissue collection is done at the time of standard of care diagnostic biopsies or surgical procedures. Blood collection is performed at the time of routine lab evaluations. No additional study visits, venipunctures or other procedures are expected. Three hundred patients will be included in the following three cohorts:
- Cohort 1 - 120 patients: archival tumor tissue of 120 patients previously treated with systemic therapies for hepatocellular carcinoma in the last 5 years will be collected.
- Cohort 2 - 90 patients: prospective tumor tissue and blood samples of 90 patients with advanced HCC and candidate for systemic therapy will be collected.
- Cohort 3 - 90 patients: prospective tumor tissue and blood samples of 90 patients with early HCC and candidate for local treatment will be collected.
Objectives:
- Aim 1: Spatial orientation of cell types of interest in the tumor microenvironment (TME) of HCC using a variety of techniques: multiplex immune histochemistry, spatial proteomics and spatial transcriptomics. Samples from early versus advanced HCC will be used.
- Aim 2: Identification of shared T-cell receptor sequences between PBMCs and tumor tissue using RNA and TCR sequencing. Exploration of the degree of TCR sharing in early and advanced HCC.
- Aim 3: Collecting starting material for TWISTAR, aiming to identify tumor antigens in HCC using a transcriptome-wide screen for T cell antigens.
Our analysis will be powered to identify a difference in progression-free survival between the biomarker positive and negative population with a hazard ratio of 0.6 with a power of 75% and an alpha of 0.05, provided that about 30% of samples are biomarker positive. The historical samples of patients treated with a TKI will serve as a control group to detect an interaction with the biomarker and the treatment effect.
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Jeroen Dekervel, MD
- Telefonní číslo: 016344225
- E-mail: jeroen.dekervel@uzleuven.be
Studijní záloha kontaktů
- Jméno: Frederik Peeters, MD
- E-mail: frederik.1.peeters@uzleuven.be
Studijní místa
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Antwerp, Belgie
- Nábor
- UZA
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Kontakt:
- Timon Van Damme, MD, PhD
- E-mail: Timon.vandamme@uza.be
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Vrchní vyšetřovatel:
- Timon Van Damme, MD, PhD
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Hasselt, Belgie
- Nábor
- Jessa Ziekenhuis
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Kontakt:
- Elisabeth Stragier, MD
- E-mail: Elisabeth.stragier@jessazh.be
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Vrchní vyšetřovatel:
- Elisabeth Stragier, MD
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Kortrijk, Belgie
- Nábor
- AZ Groeninge
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Kontakt:
- Alexander Vanden Bulcke, MD
- E-mail: Alexander.vandenbulcke@azgroeninge.be
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Vrchní vyšetřovatel:
- Alexander Vandenbulcke, MD
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Roeselare, Belgie
- Nábor
- AZ Delta
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Kontakt:
- Sofie De Meulder, MD
- E-mail: sofie.demeulder@azdelta.be
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Vrchní vyšetřovatel:
- Sofie De Meulder, MD
-
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
General inclusion Criteria:
- Male or female, age > 18 years
- Diagnosis or suspected diagnosis of hepatocellular carcinoma based on imaging
Specific inclusion criteria cohort 1 (retrospective/prospective data may be applicable):
- Pathologically confirmed HCC
- Treated with systemic treatment [tyrosine kinase inhibitor (TKI) or immunotherapy (ICI)] in the last 7 years and follow-up data (at least one imaging on treatment) available until 01/01/2025
- Biopsy obtained between 01/01/2018 until 01/01/2025
- Left-over tissue from previous diagnostic biopsies or resection specimens available
- Time between biopsy and initiation of systemic treatment < 1 year
- Ability to sign informed consent for secondary use of archival tissue and data collection for study-specific research for patients who are alive
Specific inclusion criteria cohort 2 (aHCC & prospective):
- Suspicion of hepatocellular carcinoma (imaging criteria or recurrent disease of previously treated HCC)
- Indication for tumor biopsy per standard of care
- Eligible for systemic treatment (any) after pathological confirmation of HCC
- Ability to sign informed consent for primary use of tissue and blood samples and data collection for study-specific research
Specific inclusion criteria cohort 3 (eHCC & prospective):
- Suspicion of hepatocellular carcinoma (imaging criteria or recurrent disease of previously treated HCC)
- Indication for local treatment (resection or ablation)
Ability to sign informed consent for primary use of tissue and blood samples and for data collection for study-specific research
Due to the observational nature of this study, participation in other (interventional) clinical trials is permitted, if biological materials can be collected per protocol.
General exclusion criteria:
- Poor liver function and/or performance status which prohibits active treatment
- Pathologically proven other malignancies of the liver, including primary cholangiocarcinoma or liver metastases
- Treatment plan other than systemic treatment or local treatment (resection or ablation), such as TACE, TARE, liver transplantation
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Základní věda
- Přidělení: Nerandomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
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Žádný zásah: Cohort 1
Cohort 1 (observational):
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|
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Jiný: Cohort 2
Cohort 2 (advanced HCC):
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Prospective collection of additional blood and tissue samples for study-specific analyses at specific timepoints, at the same time as routine procedures.
|
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Jiný: Cohort 3
|
Prospective collection of additional blood and tissue samples for study-specific analyses at specific timepoints, at the same time as routine procedures.
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Spatial orientation
Časové okno: Through study completion, an average of 6 months
|
Spatial orientation of cell types of interest in the tumour microenvironment (TME) of HCC using a variety of techniques: multiplex IHC, spatial proteomics and spatial transcriptomics.
Samples from early (cohort 3) and advanced HCC (cohort 2) will be used.
|
Through study completion, an average of 6 months
|
|
TCR sharing
Časové okno: Through study completion, an average of 6 months
|
Identification of shared TCR sequences between PBMCs and tumor tissue using RNA and TCR sequencing.
Exploration of the degree of TCR sharing in early and advanced HCC.
|
Through study completion, an average of 6 months
|
|
Antigen identification
Časové okno: Through study completion, an average of 6 months
|
The investigators will use tumor tissue and PBMC to construct an antigenic landscape of advanced HCC.
To achieve this goal the investigators will use a unique technique called Transcriptome-Wide Screening for T cell Antigen Research (TWISTAR).
|
Through study completion, an average of 6 months
|
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Biomarker validation
Časové okno: 12 months after tissue acquisition
|
This study will be used to validate two candidate predictive biomarkers (CD45RA effector-memory CD8 T-cells/PDL1-expressing CXCL10+ macrophages) AND TCR sharing between tumor and blood in relation to response to immunotherapy in HCC. The investigators will compare the biomarker positive and biomarker negative groups in terms of progression-free survival and overall survival (Kaplan-Meier time-to-event) in the context of known prognostic clinical variables (multivariable cox proportional hazards model). |
12 months after tissue acquisition
|
Spolupracovníci a vyšetřovatelé
Spolupracovníci
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Novotvary podle místa
- Novotvary
- Novotvary podle histologického typu
- Novotvary trávicího systému
- Nemoci trávicího systému
- Onemocnění jater
- Novotvary, žlázové a epiteliální
- Adenokarcinom
- Novotvary jater
- Karcinom
- Karcinom, Hepatocelulární
- Vyšetřovací techniky
- Manipulace se vzorkem
- Klinické laboratorní techniky
- Diagnostické techniky a postupy
- Diagnóza
- Vpichy
- Chirurgické postupy, operativní
- Imunologické techniky
- Imunologické testy
- Sběr vzorků krve
- Testování histokompatibility
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