Safety and Feasibility of CIK Cell Therapy in HCC After Tumor Resection
Safety and Feasibility of Autologous Cytokine Induced Killer (CIK) Cells Infusion as an Adjuvant Therapy in Post Resection Hepatocellular Carcinoma (HCC) Patients
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and a leading cause of cancer-related mortality worldwide. Even after curative-intent surgical resection, disease recurrence occurs in approximately 60-70% of patients within five years, and no adjuvant systemic therapy has demonstrated a consistent recurrence-free survival or overall survival benefit in this setting. Cytokine-induced killer (CIK) cells are ex vivo-expanded autologous immune effector cells with a heterogeneous phenotype dominated by CD3⁺CD56⁺ cells, combining T-cell and NK-cell features and exhibiting MHC-unrestricted cytotoxicity against tumor cells. Phase II/III trials and subsequent meta-analyses conducted predominantly in East Asian populations have reported improved recurrence-free and overall survival with adjuvant CIK therapy following HCC resection, without a corresponding increase in severe (Grade ≥3) adverse events, and the South Korean Ministry of Food and Drug Safety approved a CIK-based product (Immuncell-LC) on this basis in 2022. No clinical data exist to date for an Iranian population, which differs from East Asian cohorts in HCC etiology (notably HBV prevalence and metabolic-associated steatotic liver disease burden) and genetic background.
This is a single-center, open-label, single-arm, phase I safety and feasibility study conducted at the Liver Transplant and Surgery Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, in collaboration with Royan Institute. Full eligibility criteria are listed in the Eligibility section of this record.
For each patient, peripheral blood mononuclear cells (PBMCs) are isolated and expanded ex vivo under Good Manufacturing Practice (GMP) conditions for 14-21 days using IFN-γ, anti-CD3 antibody, and IL-2 to generate the autologous CIK cell product. Prior to release, each batch undergoes quality control testing for viability, CD3⁺CD56⁺ phenotype, antitumor cytotoxicity, sterility, and endotoxin level against pre-specified thresholds (≥85% viability, ≥60% CD3⁺CD56⁺, ≥30% cytotoxicity, endotoxin ≤5 EU/kg, negative microbial/mycoplasma testing); only batches meeting these criteria are released for infusion.
Each patient receives six intravenous infusions of autologous CIK cells administered as a slow infusion over approximately 60 minutes under sterile conditions: three weekly infusions (weeks 0, 1, and 2) followed by three biweekly infusions (weeks 4, 6, and 8). Vital signs are monitored before, during, and for two hours after each infusion. No routine premedication is given; mild fever is managed with acetaminophen. Adverse event monitoring and grading methodology are detailed under Outcome Measures. Over the 6-month follow-up period, scheduled assessments also include laboratory testing (including AFP, PIVKA-II, liver function and coagulation panels), peripheral blood lymphocyte immunophenotyping (CD56⁺CD16⁺CD3-, CD3⁺CD8⁺, CD3⁺CD56⁺CD16⁺, CD3⁺CD4⁺ populations at month 6 versus baseline), and contrast-enhanced MRI at months 3 and 6. Given the phase I descriptive design and small sample size, statistical analysis is planned to be descriptive rather than inferential.
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Vroege fase 1
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Massoud Vosough, MD, Ph.D.
- Telefoonnummer: 98 21 2251 8388
- E-mail: masvos@yahoo.com
Studie Locaties
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Tehran Province
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Tehran, Tehran Province, Iran
- Liver Transplant and Surgery Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences
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Contact:
- Mohsen Nassiri-Toosi, MD
- Telefoonnummer: +98 21 6119 2996
- E-mail: nasirimohsen@gmail.com
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Age between 18 and 80 years
- Documented HCC at BCLC stage 0-A, having undergone surgical tumor resection
- Single tumor or ≤3 nodules, each ≤3 cm
- Child-Pugh score A-B
- ECOG performance status 0-1
- Confirmed cancer-free status one month after surgery
- Written informed consent
- Leukocyte count > 3 × 10⁹/L
- Absolute neutrophil count (ANC) ≥ 1,000/µL
- Hemoglobin ≥ 8.5 g/dL
- Platelet count > 50 × 10⁹/L
- BUN and serum creatinine ≤ 1.5 × upper limit of normal No extrahepatic abdominal disease spread, confirmed by abdominal CT/MRI
Exclusion Criteria:
- Active infection or uncontrolled viremia (particularly HBV, HCV, or HIV)
- Any cell therapy or immunotherapy in the past 6 months, or current participation in another clinical study
- Another malignancy (prior or concurrent) differing from HCC in primary site or histology
- Clinically significant cardiovascular disease (e.g., heart failure, serious arrhythmia, symptomatic coronary artery disease)
- History of organ transplantation
- Primary or secondary immunodeficiency, or active autoimmune disease
- Severe allergic disorder or history of anaphylaxis
- Pregnancy or breastfeeding at study entry
- Women of childbearing potential intending to become pregnant
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
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Experimenteel: CIK Cell Adjuvant Therapy
Patients with HCC who have undergone curative surgical resection receive six intravenous infusions of autologous CIK cells (three weekly, three biweekly) in addition to standard postoperative care.
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PBMCs are collected from the patient, expanded ex vivo for 14-21 days under GMP conditions administered as 6 intravenous infusions (weeks 0, 1, 2, then weeks 4, 6, 8) following release testing for sterility, viability, and phenotype.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Incidence and severity of adverse events following CIK cell infusion
Tijdsspanne: From first infusion through 6 months post-treatment (assessed at weeks 1-10 and months 3 and 6)
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Frequency, type, severity, and relatedness of adverse events (AEs) and serious adverse events (SAEs), graded per CTCAE v5.0.
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From first infusion through 6 months post-treatment (assessed at weeks 1-10 and months 3 and 6)
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Recurrence-Free Survival (RFS)
Tijdsspanne: From date of enrollment until first documented intrahepatic or extrahepatic tumor recurrence, or death from any cause, whichever occurs first, assessed up to 6 months
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Time from study enrollment to first tumor recurrence (intrahepatic or extrahepatic) or death from any cause, whichever occurs first.
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From date of enrollment until first documented intrahepatic or extrahepatic tumor recurrence, or death from any cause, whichever occurs first, assessed up to 6 months
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Overall Survival (OS)
Tijdsspanne: From date of enrollment until death from any cause, assessed up to 6 months
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Time from study enrollment to death from any cause.
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From date of enrollment until death from any cause, assessed up to 6 months
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Medewerkers en onderzoekers
Sponsor
Sponsor
Medewerkers
Medewerkers
Onderzoekers
Onderzoekers
- Studie directeur: Massoud Vosough, MD, Ph.D., Royan Institute
- Hoofdonderzoeker: Mohsen Nassiri-Toosi, MD, Liver Transplant Research Center, Tehran University of Medical Sciences
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata per site
- Neoplasmata
- Neoplasmata per histologisch type
- Neoplasmata van het spijsverteringsstelsel
- Ziekten van het spijsverteringsstelsel
- Lever Ziekten
- Neoplasmata, glandulair en epitheel
- Adenocarcinoom
- Lever neoplasmata
- Carcinoom
- Carcinoom, hepatocellulair
- Onderzoekstechnieken
- Klinische laboratoriumtechnieken
- Diagnostische technieken en procedures
- Diagnose
- Cytologische technieken
- Cel fysiologische fenomenen
- Cellen
Andere studie-ID-nummers
Andere studie-ID-nummers
- 404000269
- IRCT20201229049871N1 (Register-ID: Iranian Registry of Clinical Trials (IRCT))
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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