Tato stránka byla automaticky přeložena a přesnost překladu není zaručena. Podívejte se prosím na anglická verze pro zdrojový text.

Improving the Use of Immunotherapy to Treat Liver Cancer (IO-MARC)

27. května 2026 aktualizováno: Universitaire Ziekenhuizen KU Leuven

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

Nábor

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

Intervenční

Zápis (Odhadovaný)

300

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní záloha kontaktů

Studijní místa

      • Antwerp, Belgie
        • Nábor
        • UZA
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Timon Van Damme, MD, PhD
      • Hasselt, Belgie
      • Kortrijk, Belgie
      • Roeselare, Belgie

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý
  • Starší dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

  • General inclusion Criteria:

    1. Male or female, age > 18 years
    2. Diagnosis or suspected diagnosis of hepatocellular carcinoma based on imaging
  • Specific inclusion criteria cohort 1 (retrospective/prospective data may be applicable):

    1. Pathologically confirmed HCC
    2. 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
    3. Biopsy obtained between 01/01/2018 until 01/01/2025
    4. Left-over tissue from previous diagnostic biopsies or resection specimens available
    5. Time between biopsy and initiation of systemic treatment < 1 year
    6. 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):

    1. Suspicion of hepatocellular carcinoma (imaging criteria or recurrent disease of previously treated HCC)
    2. Indication for tumor biopsy per standard of care
    3. Eligible for systemic treatment (any) after pathological confirmation of HCC
    4. 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):

    1. Suspicion of hepatocellular carcinoma (imaging criteria or recurrent disease of previously treated HCC)
    2. Indication for local treatment (resection or ablation)
    3. 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:

    1. Poor liver function and/or performance status which prohibits active treatment
    2. Pathologically proven other malignancies of the liver, including primary cholangiocarcinoma or liver metastases
    3. Treatment plan other than systemic treatment or local treatment (resection or ablation), such as TACE, TARE, liver transplantation

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

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
Žádný zásah: Cohort 1

Cohort 1 (observational):

  • Collection of leftover archival tumour tissue of patients with advanced HCC treated with systemic therapies.
  • No blood collection.
  • Retrospective and prospective collection of data.
Jiný: Cohort 2

Cohort 2 (advanced HCC):

  • Prospective collection of tumour tissue at the time of standard of care biopsy from advanced HCC patients prior to initiation of a systemic treatment (max 2 needle biopsy cylinders).
  • Additional collection of leftover archival tissue from previous biopsies or resection specimens is possible.
  • Prospective collection of blood samples at two timepoints (prior to start of systemic treatment and prior to the 2nd therapy cycle). Maximum 30ml of blood per timepoint (3x10ml EDTA tubes).
  • Retrospective and prospective collection of data.
Prospective collection of additional blood and tissue samples for study-specific analyses at specific timepoints, at the same time as routine procedures.
Jiný: Cohort 3
  • Prospective collection of tumour tissue at the time of standard of care biopsy (max 2 needle biopsy cylinders) or surgical treatment (resection or ablation; 2 surgical biopsies or a piece of the resection specimen) from early HCC patients.
  • Additional collection of leftover archival tissue from previous biopsies or resection specimens is possible.
  • Prospective collection of blood samples at one timepoint (prior to resection or ablation). Maximum 30ml of blood per timepoint (3x10ml EDTA tubes).
  • Retrospective and prospective collection of data.
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
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

Zde najdete lidi a organizace zapojené do této studie.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

4. března 2025

Primární dokončení (Odhadovaný)

1. ledna 2029

Dokončení studie (Odhadovaný)

1. ledna 2032

Termíny zápisu do studia

První předloženo

6. února 2025

První předloženo, které splnilo kritéria kontroly kvality

27. května 2026

První zveřejněno (Aktuální)

3. června 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

3. června 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

27. května 2026

Naposledy ověřeno

1. května 2026

Více informací

Termíny související s touto studií

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

Klinické studie na Hepatocelulární karcinom (HCC)

Předplatit