Development of a Risk Prediction Model for Immune-Targeted Therapy-Related Diarrhea in Patients With Hepatocellular Carcinoma Based on TCM Constitutional Types: A Prospective Cohort Study
Immune checkpoint inhibitors combined with anti-angiogenic targeted agents have become the first-line standard therapeutic regimen for advanced hepatocellular carcinoma (HCC). Nevertheless, the high incidence rate of therapy-related diarrhea severely impairs patients' quality of life and treatment adherence, and may even result in treatment discontinuation. Current studies mostly focus on symptomatic intervention after diarrhea onset, while few tools are available for upfront risk screening prior to treatment initiation. According to the theory of traditional Chinese medicine (TCM) constitutional types, individuals with different constitutions exhibit discrepant disease susceptibility and drug responses. Based on a prospective cohort design, this study aims to explore the correlation between TCM constitutional types and immune-targeted therapy-related diarrhea in HCC patients, and further construct a risk prediction model integrated with both western medical and TCM indicators.
This study is designed as a multicenter prospective observational cohort study. A total of 350 primary HCC patients receiving combined immunotherapy and targeted therapy at the Affiliated Hospital of Chengde Medical University from January 2027 to December 2028 will be enrolled into the model development cohort. Another 150 patients from Chengde Central Hospital and Chengde Hospital of Traditional Chinese Medicine between January 2029 and January 2030 will be recruited as the external validation cohort. Baseline data will be collected before treatment, including sociodemographic and general clinical information, tumor and treatment-related data, laboratory test results, TCM constitutional assessment, nutritional risk screening, physical function and psychological status evaluation. All participants will be followed up regularly for one year to record the occurrence of diarrhea.
Samples in the development cohort will be randomly divided into a training set and an internal validation set at a stratified ratio of 7:3. Lasso regression will be applied to screen predictive factors, and multivariate Logistic regression will be adopted to establish a nomogram prediction model. Receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA) will be used to assess the discrimination, calibration and clinical net benefit of the established model, respectively. The independent multicenter data of the external validation cohort will adopt consistent variable criteria, outcome definitions and the prediction model from the development cohort to evaluate the cross-center generalizability, stability and clinical applicability of the model for comprehensive efficacy verification.
The study protocol has been approved by the Medical Ethics Committee of the Affiliated Hospital of Chengde Medical University. Written informed consent will be obtained from all subjects before enrollment. The research findings will be disseminated via academic journal publications, web-based assessment tools and clinical promotion. The established TCM constitution risk screening tool can be directly applied to routine admission assessment in the hepatology department.
Studieoversigt
Status
Status
Betingelser
Betingelser
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Liyang Liu
- Telefonnummer: 18232242016
- E-mail: 519151381@qq.com
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- Pathologically or radiologically confirmed primary hepatocellular carcinoma (HCC);
- Scheduled to receive combined immune checkpoint inhibitor (ICI) and anti-angiogenic targeted therapy;
- Aged ≥ 18 years, able to complete questionnaire assessment independently;
- Normal hearing, speaking, reading and writing ability; Voluntary participation and signed written informed consent.
Exclusion Criteria:
- Pre-existing underlying intestinal diseases such as chronic diarrhea, inflammatory bowel disease (IBD), or intestinal metastasis before enrollment;
- History of long-term laxative use;
- Cognitive dysfunction or mental illness that prevents cooperation with questionnaire assessment;
- Severe multiple organ failure that precludes completion of full follow-up.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Incidence of diarrhea associated with combined immunotherapy and targeted therapy for liver cancer
Tidsramme: one year
|
one year
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- CYFYLL2026030
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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