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

14 de setembro de 2026 atualizado por: 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.

Visão geral do estudo

Status

Ainda não está recrutando

Descrição detalhada

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)

Tipo de estudo

Intervencional

Inscrição (Estimado)

40

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: N / D
  • Modelo Intervencional: Atribuição de grupo único
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.
Outros nomes:
  • Partial TACE

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
1-year progression-free survival (PFS) by mRECIST
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
1-year overall survival (OS)
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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

Outras medidas de resultado

Medida de resultado
Descrição da medida
Prazo
Depth of response (maximum percentage reduction from baseline in the sum of viable target lesion diameters)
Prazo: 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
Prazo: 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
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

30 de setembro de 2026

Conclusão Primária (Estimado)

31 de maio de 2029

Conclusão do estudo (Estimado)

31 de maio de 2029

Datas de inscrição no estudo

Enviado pela primeira vez

25 de julho de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

14 de setembro de 2026

Primeira postagem (Real)

18 de setembro de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

18 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

14 de setembro de 2026

Última verificação

1 de julho de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 202600872A3
  • LHYY001 (Número de outro subsídio/financiamento: Lin Huang Yueh-Ying Medical Foundation)

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

produto fabricado e exportado dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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