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PEARL Trial: Partial TACE Enhancing Anti-tumor Response With Lenvatinib in Unresectable HCC (Pearl)

14. september 2026 opdateret af: Chang Gung Memorial Hospital
This is a single-arm, open-label, phase II clinical trial. Patients with unresectable hepatocellular carcinoma (HCC) who are eligible for lenvatinib treatment will receive partial transarterial chemoembolization (TACE) targeting up to two liver segments containing the largest tumor volume or lesions at risk of rupture, in combination with standard lenvatinib therapy. The partial TACE approach is designed as a liver-function-sparing technique that limits ischemic territory while preserving hepatic reserve.

Studieoversigt

Detaljeret beskrivelse

Primary objective:

-1-year progression-free survival (PFS) by mRECIST

Secondary objectives:

  • 1-year overall survival (OS)
  • Objective response rate (ORR) and disease control rate (DCR) per RECIST v1.1 and mRECIST
  • Incidence of hepatic decompensation within 30 days after treatment (defined as: bilirubin > 3 mg/dL, new or worsened ascites, or hepatic encephalopathy)
  • Duration of response (DOR)

Exploratory Endpoints:

  • Depth of response (DpR)
  • Immune profile changes from baseline (assessed by multiparametric flow cytometry and single-cell RNA sequencing)

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

40

Fase

  • Fase 2

Kontakter og lokationer

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

Studiekontakt

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:

Diagnosis of HCC confirmed by histology/cytology or typical imaging features, unsuitable for surgical resection or liver transplantation

  • Age ≥ 20 years at the time of signing informed consent
  • ECOG performance status 0-1
  • BCLC stage B or C (without main portal vein thrombosis)
  • Child-Pugh score 5-7 (Class A or B7) within 28 days of registration
  • Adequate bone marrow, liver, and renal function
  • Blood pressure adequately controlled
  • Ability to understand and sign written informed consent

Exclusion Criteria:

Prior systemic therapy for HCC

  • Main portal vein thrombosis
  • Prior locoregional therapy within 4 weeks
  • Uncontrolled hypertension
  • Clinically significant cardiovascular disease within 6 months
  • Pregnancy or breastfeeding

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: Partial TACE Enhancing Anti-tumor Response with Lenvatinib in unresectable HCC

Lenvatinib: Oral administration at 12 mg once daily (body weight ≥ 60 kg) or 8 mg once daily (body weight < 60 kg). Treatment continues until disease progression, unacceptable toxicity, or patient withdrawal.

Partial TACE:

Performed within 4 weeks after starting lenvatinib.

Oral lenvatinib 12 mg once daily for body weight 60 kg or greater, or 8 mg once daily for body weight less than 60 kg. Treatment continues until disease progression, unacceptable toxicity, or patient withdrawal.
Transarterial chemoembolization targeting up to two liver segments containing the largest tumor volume or lesions at risk of rupture, performed within 4 weeks after starting lenvatinib. This liver-function-sparing approach limits the ischemic territory in order to preserve hepatic reserve.
Andre navne:
  • Partial TACE

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
1-year progression-free survival (PFS) by mRECIST
Tidsramme: 1 year after start of study treatment
Percentage of participants alive and free of disease progression at 1 year. Progression-free survival is measured from the start date of study treatment to the date of first documented disease progression according to modified RECIST (mRECIST) or death from any cause, whichever occurs first.
1 year after start of study treatment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
1-year overall survival (OS)
Tidsramme: 1 year after start of study treatment
Percentage of participants alive at 1 year. Overall survival is measured from the start date of study treatment to the date of death from any cause.
1 year after start of study treatment
Objective response rate (ORR) by mRECIST
Tidsramme: Up to 12 months after start of study treatment
Percentage of participants with a best overall response of confirmed complete response or partial response, as assessed by modified RECIST (mRECIST). Tumor response is assessed by CT or MRI every 12 weeks from the start of study treatment; a first objective response is confirmed by a second imaging assessment 4 weeks later.
Up to 12 months after start of study treatment
Objective response rate (ORR) by RECIST v1.1
Tidsramme: Up to 12 months after start of study treatment
Percentage of participants with a best overall response of confirmed complete response or partial response, as assessed by RECIST version 1.1. Tumor response is assessed by CT or MRI every 12 weeks from the start of study treatment; a first objective response is confirmed by a second imaging assessment 4 weeks later.
Up to 12 months after start of study treatment
Disease control rate (DCR) by mRECIST
Tidsramme: Up to 12 months after start of study treatment
Percentage of participants with a best overall response of confirmed complete response, partial response, or stable disease, as assessed by modified RECIST (mRECIST). Tumor response is assessed by CT or MRI every 12 weeks from the start of study treatment.
Up to 12 months after start of study treatment
Disease control rate (DCR) by RECIST v1.1
Tidsramme: Up to 12 months after start of study treatment
Percentage of participants with a best overall response of confirmed complete response, partial response, or stable disease, as assessed by RECIST version 1.1. Tumor response is assessed by CT or MRI every 12 weeks from the start of study treatment.
Up to 12 months after start of study treatment
Duration of response (DOR) by mRECIST
Tidsramme: Up to 12 months after start of study treatment
Time from the date of first documented objective response (complete or partial response) to the date of first documented disease progression, as assessed by modified RECIST (mRECIST). Reported in months.
Up to 12 months after start of study treatment
Incidence of hepatic decompensation
Tidsramme: Within 30 days after treatment
Percentage of participants with hepatic decompensation within 30 days after treatment. Hepatic decompensation is defined as any of the following: total bilirubin greater than 3 mg/dL, new or worsened ascites, or hepatic encephalopathy.
Within 30 days after treatment
Incidence of treatment-emergent adverse events
Tidsramme: From first dose of study treatment up to 30 days after the last dose
Number of participants with treatment-emergent adverse events and serious adverse events, graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
From first dose of study treatment up to 30 days after the last dose

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Depth of response (maximum percentage reduction from baseline in the sum of viable target lesion diameters)
Tidsramme: Up to 12 months after start of study treatment
Maximum percentage reduction from baseline in the sum of viable target lesion diameters, as assessed by modified RECIST (mRECIST). Reported as percentage change from baseline.
Up to 12 months after start of study treatment
Change from baseline in immune cell subset frequencies assessed by multiparametric flow cytometry
Tidsramme: Baseline, within 24 hours before TACE, within 48 hours after TACE, Week 12, and Week 24
Change from baseline in the frequencies of peripheral blood immune cell subsets measured by multiparametric flow cytometry, including CD4+ and CD8+ T cells, regulatory T cells, natural killer cells, mucosal-associated invariant T cells, and myeloid populations, together with the activation and exhaustion markers PD-1, TIM-3, HLA-DR, and CD38. Reported as percentage of live cells.
Baseline, within 24 hours before TACE, within 48 hours after TACE, Week 12, and Week 24
Change from baseline in immune cell composition assessed by single-cell RNA sequencing
Tidsramme: Baseline, within 24 hours before TACE, within 48 hours after TACE, Week 12, and Week 24
Change from baseline in immune cell composition measured by single-cell RNA sequencing of peripheral blood mononuclear cells and tissue samples, reported as percentage of sequenced cells assigned to each annotated immune cell cluster.
Baseline, within 24 hours before TACE, within 48 hours after TACE, Week 12, and Week 24

Samarbejdspartnere og efterforskere

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

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)

30. september 2026

Primær færdiggørelse (Anslået)

31. maj 2029

Studieafslutning (Anslået)

31. maj 2029

Datoer for studieregistrering

Først indsendt

25. juli 2026

Først indsendt, der opfyldte QC-kriterier

14. september 2026

Først opslået (Faktiske)

18. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

18. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

14. september 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 202600872A3
  • LHYY001 (Andet bevillings-/finansieringsnummer: Lin Huang Yueh-Ying Medical Foundation)

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