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Epalrestat Combined With HAIC, Donafenib and Tislelizumab as First-line Treatment for Patients With Unresectable HCC and Diabetes

1. juni 2026 opdateret af: Haibo Shao

A Multicenter, Prospective, Single-arm Clinical Study Evaluating the Efficacy and Safety of Epalrestat Combined With Hepatic Arterial Chemotherapy Infusion (HAIC), Donafenib and Tislelizumab as First-line Treatment for Patients With Unresectable Hepatocellular Carcinoma and Diabetes

The purpose of this study is to evaluate the comprehensive therapeutic efficacy and safety profile of the epalrestat combined with hepatic artery infusion chemotherapy (HAIC), donafenib and tislelizumab quadruple regimen in patients with unresectable hepatocellular carcinoma (HCC) and diabetes.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

32

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Kina
    • Liaoning
      • Shenyang, Liaoning, Kina, 110000
        • The First Hospital of China Medical University
        • Kontakt:
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  1. Diabetes mellitus combined with unresectable advanced HCC (BCLC stage C);
  2. Patients who have the need for treatment, prevention and improvement of diabetic neuropathy;
  3. Liver function at Child-Pugh grade A or B (≤ 7 points), ECOG PS 0-1;
  4. Age 18-80 years old. Confirmed as unrectable HCC through pathological or imaging diagnosis;

Exclusion Criteria:

  1. Severe liver dysfunction: Child-Pugh C grade (≥ 8 points) or active hepatic encephalopathy Illness;
  2. Extensive extrahepatic metastases (e.g., lung, bone, or peritoneum metastases);
  3. Severe cardiovascular diseases: Uncontrolled heart failure, recent myocardial infarction;
  4. Renal failure: Creatinine clearance rate < 30 mL/min;
  5. Thrombocytopenia (less than 50×10⁹/L) or coagulation dysfunction (INR greater than 1.5);
  6. Active infection (such as uncontrolled hepatitis B virus replication with HBV-DNA > 2000 IU/mL);
  7. ECOG PS ≥ 2 or extremely poor overall condition;
  8. Diabetic patients with acute ketoacidosis or during the period of severe infection;
  9. Pregnant and lactating women;
  10. Known history of other malignancy.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Epalrestat plus HAIC, donafenib and tislelizumab
Epalrestat 50mg tid, donafenib 0.2g bid, tislelizumab 200mg per 21days, HAIC (FOLFOX or RALOX) per 21days
Medicin: Epalrestat
For the first 6 patients in the safety lead-in period, the starting dose of epalrestat was 50 mg, three times per day. If dose-limiting toxicity (DLT) occurred in the first 6 patients, the dose for the second round of 6 patients in the safety lead-in period would be adjusted to 50 mg, twice per day. If DLT occurred in the second round of 6 patients, the dose for the third round of 6 patients in the safety lead-in period would be adjusted to 50 mg, once per day.
Medicin: Donafenib + Tislelizumab
donafenib 0.2g BID, tislelizumab 200mg/21days
Procedure: HAIC
Include FOLFOX and RALOX.
Andre navne:
  • hepatic artery infusion chemotherapy

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
12-month Event-free survival (EFS) Rate
Tidsramme: From treatment to the first occurrence of a predefined event (progression of disease, death for any reason, terminate the treatment due to intolerable AEs), assessed up to 2 years.
The proportion of patients who have remained event-free from the start of treatment until the 12-month time point.(Predefined events include: progression of disease, death for any reason, terminate the treatment due to intolerable AEs.)
From treatment to the first occurrence of a predefined event (progression of disease, death for any reason, terminate the treatment due to intolerable AEs), assessed up to 2 years.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Objektiv svarprocent (ORR) pr. RESCIST 1.1
Tidsramme: Op til cirka 2 år
ORR er defineret som andelen af ​​patienter med et dokumenteret fuldstændigt respons (CR) eller delvist respons (PR) pr. RECIST 1.1.
Op til cirka 2 år
Bivirkninger (AE) i henhold til almindelige terminologikriterier for bivirkninger (CTCAE) 5.0
Tidsramme: Op til cirka 2 år
Procentdelen og graden af ​​patienter, der oplever mindst én AE, uanset om den anses for at være relateret til behandlingen, ifølge CTCAE version 5.0.
Op til cirka 2 år
ORR pr. mRECIST
Tidsramme: Op til cirka 2 år
ORR er defineret som andelen af ​​patienter med dokumenteret CR eller PR pr. mRECIST.
Op til cirka 2 år
Event-free survival (EFS)
Tidsramme: From treatment to the first occurrence of a predefined event (progression of disease, death for any reason, terminate the treatment due to intolerable AEs), assessed up to 2 years.
Defined as the time from treatment to the first occurrence of a predefined event (progression of disease, death for any reason, terminate the treatment due to intolerable AEs).
From treatment to the first occurrence of a predefined event (progression of disease, death for any reason, terminate the treatment due to intolerable AEs), assessed up to 2 years.
Overall survival (OS)
Tidsramme: Up to approximately 2 years
The OS is defined as the time from the enrollment to death due to any cause.
Up to approximately 2 years
Progression free survival(PFS) (Overall)
Tidsramme: From enrollment to progressive disease (according to mRECIST) or death due to any cause, up to 2 years.
The PFS is defined as the time from the enrollment to the first documented progressive disease (according to mRECIST) or death due to any cause, whichever occurs first.
From enrollment to progressive disease (according to mRECIST) or death due to any cause, up to 2 years.
Progression free survival(PFS) of intra-hepatic lesions
Tidsramme: From the enrollment to the first documented progressive disease of intra-hepatic lesions or death due to any cause, up to 2 years.
The PFS is defined as the time from the enrollment to the first documented progressive disease of intra-hepatic lesions or death due to any cause, whichever occurs first.
From the enrollment to the first documented progressive disease of intra-hepatic lesions or death due to any cause, up to 2 years.
Progression free survival(PFS) of extra-hepatic lesions
Tidsramme: From the enrollment to the first documented appearance of extra-hepatic lesions or death due to any cause, up to 2 years.
The PFS is defined as the time from the enrollment to the first documented appearance of extra-hepatic lesions or death due to any cause, whichever occurs first.
From the enrollment to the first documented appearance of extra-hepatic lesions or death due to any cause, up to 2 years.
PVTT response rate per mRECIST
Tidsramme: Up to approximately 2 years

The PVTT response rate is defined as the proportion of patients with a documented CR or PR of PVTT.

According to the Vp classification:

CR: PVTT disappears or the portal vein becomes completely unobstructed. PR: Decrease in VP classification. SD: Without PR and PD. PD: Increase in VP classification.
Up to approximately 2 years
Disease control rate(DCR) per RESCIST 1.1
Tidsramme: Up to approximately 2 years
The DCR is defined as the proportion of patients with a documented complete response(CR), partial response(PR) or stable disease(SD) per RECIST 1.1.
Up to approximately 2 years
DCR per mRECIST
Tidsramme: Up to approximately 2 years
The DCR is defined as the proportion of patients with a documented complete response(CR), partial response(PR) or stable disease(SD) per mRECIST.
Up to approximately 2 years

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Haibo Shao

Samarbejdspartnere

First Hospital of China Medical University
The Affiliated Hospital of Yanbian University
Liaoning Cancer Hospital & Institute
Harbin Medical University Third Affiliated Hospital
The General Hospital of Northern Theater Command

Efterforskere

  • Ledende efterforsker: Haibo Shao, First Hospital of China Medical University
  • Ledende efterforsker: Tao Han, First Hospital of China Medical University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juni 2026

Primær færdiggørelse (Anslået)

1. februar 2029

Studieafslutning (Anslået)

1. februar 2029

Datoer for studieregistrering

Først indsendt

22. april 2026

Først indsendt, der opfyldte QC-kriterier

22. april 2026

Først opslået (Faktiske)

30. april 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

3. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. juni 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • kelunshen【2025】2025-861-2

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Consent and privacy: Participants usually only agreed to data use in the original study. Sharing IPD may violate that agreement. And we want to protect our academic credit and avoid misuse of the data.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

produkt fremstillet i og eksporteret fra U.S.A.

Ja

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Kliniske forsøg med Epalrestat

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Betingelser

Sjældne sygdomme

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Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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