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A Real-world Study of Immunotherapy Combination Regimens for Treating Liver Cancer in Cold Regions

8. juni 2026 opdateret af: Yingjian Liang, Harbin Medical University
Hepatocellular carcinoma (HCC) is a common global malignancy. In China, the disease burden is substantial: HCC ranks fifth in cancer incidence and third in mortality, with a 5-year relative survival of only 14.4%. In Northeast China's cold regions, metabolic diseases such as hypertension, hyperlipidemia, and diabetes are prevalent and may influence HCC prognosis. Recently, PD-1/PD-L1 inhibitor-based combination regimens (with targeted therapy, chemotherapy, or locoregional treatment) have achieved major breakthroughs, significantly extending overall and progression-free survival. These regimens have become the first-line backbone for unresectable HCC. Investigating their real-world effectiveness and safety is critical for optimizing regional treatment strategies.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This open-label, multicenter, retrospective real-world study aims to enroll 1000 patients with confirmed HCC, intrahepatic cholangiocarcinoma, or mixed cell carcinoma who have long-term residence in Northeast China (annual mean temperature 1.6°C-10°C) and have received immune-based combination therapy. Patient data will be retrospectively collected from January 1, 2020, to December 31, 2025. Based on treatment stage, patients will be assigned to 1 of 4 cohorts: perioperative (neoadjuvant/adjuvant), locoregional therapy, first-line advanced, or later-line advanced. This noninterventional study does not alter routine clinical practice; data are derived from medical records. The primary objective is to evaluate real-world effectiveness and safety of immune-based combinations. The primary endpoint is overall survival (OS). Secondary endpoints include objective response rate (rwORR), progression-free survival (rwPFS), disease control rate (rwDCR), duration of response (rwDOR), and safety (AE, SAE, irAE rates). The findings aim to provide real-world evidence for immunotherapy in HCC across Northeast China.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

1000

Kontakter og lokationer

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

Studiesteder

    • Heilongjiang
      • Harbin, Heilongjiang, Kina, 150081
        • Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin, Heilongjiang Province, China

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

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Patients with a clinically confirmed diagnosis of primary hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (iCCA), or combined hepatocellular-cholangiocarcinoma (cHCC-CCA), with measurable tumor lesions.

Beskrivelse

Inclusion Criteria

  1. Patients with a clinically confirmed diagnosis of primary hepatocellular carcinoma, intrahepatic cholangiocarcinoma, or combined hepatocellular-cholangiocarcinoma, with measurable tumor lesions.
  2. Patients who have long-term residence in the cold regions of Northeast China, specifically in provinces with an annual mean temperature between 1.6°C and 10°C: Heilongjiang Province, Jilin Province, and selected cities in Liaoning Province.
  3. Patients who have received an immune-based therapy regimen.
  4. Patients with complete clinical data who meet the enrollment criteria, retrospectively collected from January 1, 2020, to December 31, 2025.

Exclusion Criteria

  1. Patients with concurrent other malignancies.
  2. Patients who are confirmed pregnant or breastfeeding.
  3. Any other conditions that, in the investigator's judgment, make the patient unsuitable for participation in this study.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Perioperative Therapy Cohort
Patients receiving immune-based combination therapy as neoadjuvant or adjuvant treatment.

Immunotherapy:

PD-1 inhibitors (e.g., pembrolizumab, nivolumab, camrelizumab, sintilimab) and other immune checkpoint inhibitors; PD-L1 inhibitors (e.g., atezolizumab, durvalumab, adebrelimab) and other immune checkpoint inhibitors.

Targeted therapy:

Lenvatinib, donafenib, sorafenib, apatinib, bevacizumab, and other targeted therapy agents.

Chemotherapy:

Oxaliplatin-based and other systemic chemotherapy regimens.

Locoregional therapy:

Transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), radiofrequency ablation (RFA), microwave ablation (MWA), percutaneous ethanol injection (PEI), cryoablation, external beam radiotherapy (EBRT), and internal radiotherapy.

Other regimens selected/recommended by investigators:

Including but not limited to traditional Chinese medicine preparations and other antitumor therapies.

Treatment options include immunotherapy alone, immunotherapy combined with targeted therapy, or immunotherapy combined with locoregional thera

Locoregional Therapy Combined Cohort
Patients receiving immune-based combination therapy combined with locoregional therapies such as ablation, TACE, HAIC, or radiotherapy.

Immunotherapy:

PD-1 inhibitors (e.g., pembrolizumab, nivolumab, camrelizumab, sintilimab) and other immune checkpoint inhibitors; PD-L1 inhibitors (e.g., atezolizumab, durvalumab, adebrelimab) and other immune checkpoint inhibitors.

Targeted therapy:

Lenvatinib, donafenib, sorafenib, apatinib, bevacizumab, and other targeted therapy agents.

Chemotherapy:

Oxaliplatin-based and other systemic chemotherapy regimens.

Locoregional therapy:

Transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), radiofrequency ablation (RFA), microwave ablation (MWA), percutaneous ethanol injection (PEI), cryoablation, external beam radiotherapy (EBRT), and internal radiotherapy.

Other regimens selected/recommended by investigators:

Including but not limited to traditional Chinese medicine preparations and other antitumor therapies.

Treatment options include immunotherapy alone, immunotherapy combined with targeted therapy, or immunotherapy combined with locoregional thera

First-Line Advanced Cohort
Patients with advanced HCC who have received no prior systemic therapy and receive immune-based combination as first-line treatment.

Immunotherapy:

PD-1 inhibitors (e.g., pembrolizumab, nivolumab, camrelizumab, sintilimab) and other immune checkpoint inhibitors; PD-L1 inhibitors (e.g., atezolizumab, durvalumab, adebrelimab) and other immune checkpoint inhibitors.

Targeted therapy:

Lenvatinib, donafenib, sorafenib, apatinib, bevacizumab, and other targeted therapy agents.

Chemotherapy:

Oxaliplatin-based and other systemic chemotherapy regimens.

Locoregional therapy:

Transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), radiofrequency ablation (RFA), microwave ablation (MWA), percutaneous ethanol injection (PEI), cryoablation, external beam radiotherapy (EBRT), and internal radiotherapy.

Other regimens selected/recommended by investigators:

Including but not limited to traditional Chinese medicine preparations and other antitumor therapies.

Treatment options include immunotherapy alone, immunotherapy combined with targeted therapy, or immunotherapy combined with locoregional thera

Later-Line Advanced Cohort
Patients with advanced HCC who have progressed after at least one prior systemic therapy and receive immune-based combination as subsequent treatment.

Immunotherapy:

PD-1 inhibitors (e.g., pembrolizumab, nivolumab, camrelizumab, sintilimab) and other immune checkpoint inhibitors; PD-L1 inhibitors (e.g., atezolizumab, durvalumab, adebrelimab) and other immune checkpoint inhibitors.

Targeted therapy:

Lenvatinib, donafenib, sorafenib, apatinib, bevacizumab, and other targeted therapy agents.

Chemotherapy:

Oxaliplatin-based and other systemic chemotherapy regimens.

Locoregional therapy:

Transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), radiofrequency ablation (RFA), microwave ablation (MWA), percutaneous ethanol injection (PEI), cryoablation, external beam radiotherapy (EBRT), and internal radiotherapy.

Other regimens selected/recommended by investigators:

Including but not limited to traditional Chinese medicine preparations and other antitumor therapies.

Treatment options include immunotherapy alone, immunotherapy combined with targeted therapy, or immunotherapy combined with locoregional thera

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Overall Survival
Tidsramme: From start of treatment to death or last follow-up, assessed up to 36 months.
Time from initiation of immune-based combination therapy to death from any cause
From start of treatment to death or last follow-up, assessed up to 36 months.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Real-World Progression-Free Survival (rwPFS)
Tidsramme: From start of treatment to progression or death, assessed up to 36 months.
Time from treatment initiation to first documented disease progression or death, based on real-world clinical assessment.
From start of treatment to progression or death, assessed up to 36 months.
Real-World Objective Response Rate (rwORR)
Tidsramme: From start of treatment to end of treatment, assessed up to 36 months.
Proportion of patients with best overall response of complete response (CR) or partial response (PR) based on real-world clinical assessment.
From start of treatment to end of treatment, assessed up to 36 months.
Real-World Best Overall Response (rwBOR)
Tidsramme: From start of treatment to end of treatment, assessed up to 36 months.
Best tumor response recorded during treatment, including CR, PR, SD, PD, or NE based on real-world clinical assessment.
From start of treatment to end of treatment, assessed up to 36 months.
Real-World Disease Control Rate (rwDCR)
Tidsramme: From start of treatment to end of treatment, assessed up to 36 months
Proportion of patients with best overall response of CR, PR, or stable disease (SD) based on real-world clinical assessment.
From start of treatment to end of treatment, assessed up to 36 months
Real-World Duration of Response (rwDOR)
Tidsramme: From first response to progression or death, assessed up to 36 months.
Time from first documented CR or PR to disease progression or death, assessed in patients who achieved objective response.
From first response to progression or death, assessed up to 36 months.
AE Incidence
Tidsramme: From first dose to 90 days after last dose of immunotherapy or 30 days after last dose of antiangiogenic agents, whichever is later.
Incidence and severity of adverse events (AEs), serious adverse events (SAEs), and immune-related adverse events (irAEs), graded by NCI-CTCAE v6.0.
From first dose to 90 days after last dose of immunotherapy or 30 days after last dose of antiangiogenic agents, whichever is later.

Samarbejdspartnere og efterforskere

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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 (Faktiske)

13. maj 2026

Primær færdiggørelse (Anslået)

13. maj 2028

Studieafslutning (Anslået)

13. maj 2029

Datoer for studieregistrering

Først indsendt

8. juni 2026

Først indsendt, der opfyldte QC-kriterier

8. juni 2026

Først opslået (Faktiske)

12. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. juni 2026

Sidst verificeret

1. juni 2026

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