A Study Evaluating the Efficacy and Safety of Multiple Immunotherapy-Based Treatment Combinations in Patients With Advanced Liver Cancers (Morpheus-Liver)
Advanced Liver Cancers
About this trial
This is an interventional treatment trial for Advanced Liver Cancers
Eligibility Criteria
Inclusion Criteria:
Stage 1
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 within 7 days prior to randomization
- Locally advanced or metastatic and/or unresectable hepatocellular carcinoma (HCC) with diagnosis confirmed by histology/cytology or clinically by American Association for the Study of
- Liver Diseases criteria in cirrhotic patients
- Child-Pugh class A within 7 days prior to randomization
- Disease that is not amenable to curative surgical and/or locoregional therapies
- No prior systemic treatment for HCC
- Life expectancy >= 3 months
- Availability of a representative tumor specimen that is suitable for determination of PD-L1 and/or additional biomarker status via central testing
Stage 1 and Stage 2
- Measurable disease according to Response Evaluation Criteria in Solid Tumors v1.1
- Adequate hematologic and end-organ function within 7 days prior to initiation of study treatment
- Documented virology status of hepatitis, as confirmed by screening tests for hepatitis B virus - (HBV) and hepatitis C virus (HCV)
- Negative HIV test at screening
- For women of childbearing potential: agreement to remain abstinent or use contraception and for men: agreement to remain abstinent or use contraception, and agreement to refrain from donating sperm
Stage 2
- ECOG Performance Status of 0, 1, or 2
- Ability to initiate Stage 2 treatment within 3 months after experiencing unacceptable toxicity not related to atezolizumab or RO7247669 or loss of clinical benefit as determined by the investigator while receiving Stage 1 treatment
- Availability of a tumor specimen from a biopsy performed upon discontinuation of Stage 1 (if deemed clinically feasible)
Exclusion Criteria:
Stage 1
- Prior treatment with CD137 agonists or immune checkpoint inhibitors
- Treatment with investigational therapy within 28 days prior to initiation of study
- Treatment with locoregional therapy to liver within 28 days prior to initiation of study, or non-recovery from side effects of any such procedure
- Untreated or incompletely treated esophageal and/or gastric varices with bleeding or at high risk for bleeding
- Prior bleeding event due to esophageal and/or gastric varices within 6 months prior to initiation of study
- AEs from prior anti-cancer therapy that have not resolved to Grade <= 1 or better, with the exception of alopecia of any grade
- Inadequately controlled hypertension
- History of hypertensive crisis or hypertensive encephalopathy
- Significant vascular disease
- History of hemoptysis within 1 month prior to initiation of study
- Evidence of bleeding diathesis or significant coagulopathy
- Current or recent use of asprin (>325 mg/day) or treatment with clopidogrel, dipyramidole, ticlopidine, or cilostazol
- Current or recent use of full-dose oral or parenteral anticoagulants or thrombolytic agents for therapeutic (as opposed to prophylactic) purpose
- Core biopsy or other minor surgical procedure within 3 days prior to initiation of study
- History of abdominal or tracheoesophageal fistula, GI perforation, or intra-abdominal abscess, intestinal obstruction and/or clinical signs/symptoms of GI obstruction
- Evidence of abdominal free air not explained by paracentesis or recent surgery
- Serious, non-healing/dehiscing wound, active ulcer, or untreated bone fracture
- Grade >=2 proteinuria
- Metastatic disease involving major airways/blood vessels, or centrally located mediastinal tumor masses of large volume
- History of intra-abdominal inflammatory process
- Radiotherapy within 28 days or abdominal/pelvic radiotherapy within 60 days prior to initiation of study with the exception of palliative radiotherapy to bone lesions within 7 days prior to initiation of study
- Major surgery, open biopsy, or significant traumatic injury within 28 days prior to initiation of study; or abdominal surgery, abdominal interventions or significant abdominal traumatic injury within 60 days prior to initiation of study; or anticipation of need for major surgery during study or non-recovery from side effects of any such procedure
- Chronic daily treatment with NSAID
- Eligible only for control arm
Stage 1 and 2
- Fibrolamellar or sarcomatoid HCC, or mixed cholangiocarcinoma and HCC
- History of hepatic encephalopathy
- Moderate or severe ascites
- HBV and HCV coinfection
- Symptomatic, untreated, or actively progressing CNS metastases
- History of leptomeningeal disease
- Uncontrolled tumor-related pain
- Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
- Uncontrolled or symptomatic hypercalcemia
- Active or history of autoimmune disease or immune deficiency
- History of IPF, organizing pneumonia, drug-induced or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest CT scan
- Active TB
- Significant CV disease within 3 months prior to initiation of study, unstable arrhythmia, or unstable angina
- Major surgery, other than for diagnosis, within 4 weeks prior to initiation of study, or anticipated major surgery during study
- History of malignancy other than HCC within 5 years prior to screening
- Severe infection within 4 weeks prior to initiation of study
- Treatment with therapeutic oral or IV antibiotics within 2 weeks prior to initiation of study
- Prior allogeneic stem cell or solid organ transplantation
- Treatment with a live, attenuated vaccine within 4 weeks prior to initiation of study, or anticipation of need for such a vaccine during atezolizumab treatment or within 5 months after the final dose of atezolizumab
- History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins
- Known allergy or hypersensitivity to any of the study drugs or any of their excipients Treatment with systemic immunostimulatory, immunosuppressive agents within 4 weeks or 5 drug-elimination half-lives (whichever is longer) prior to initiation of study
- Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study
- Patients entering Stage 2: immunotherapy-related adverse events that have not resolved to Grade 1 or better or to baseline at time of consent
Sites / Locations
- UC Irvine Medical CenterRecruiting
- City of HopeRecruiting
- University of California San DiegoRecruiting
- UC Irvine Medical CenterRecruiting
- University of California San Francisco Cancer Center; PharmacyRecruiting
- UCLA Center for East; West MedicineRecruiting
- Smilow Cancer Hospital at Yale New HavenRecruiting
- Georgetown University Medical CenterRecruiting
- Sarah Cannon Research InstituteRecruiting
- The University of Texas Southwestern Medical Center at DallasRecruiting
- Beijing Cancer Hospital; Pharmacy roomRecruiting
- Zhongshan Hospital Fudan UniversityRecruiting
- Centre Georges Francois Leclerc; Oncologie 3Recruiting
- CHU Hôpitaux de MarseilleRecruiting
- Centre Eugène MarquisRecruiting
- Gustave RoussyRecruiting
- Rambam Medical CenterRecruiting
- Hadassah University Medical CenterRecruiting
- Rabin Medical Center-Beilinson Campus; Davidof InstituteRecruiting
- Sourasky Medical CentreRecruiting
- Seoul National University HospitalRecruiting
- Asan Medical CenterRecruiting
- Samsung Medical CenterRecruiting
- Auckland City HospitalRecruiting
- National Cheng Kung University HospitalRecruiting
- National Taiwan University HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Arm 8
Active Comparator
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Stage 1: Atezolizumab + Bevacizumab
Stage 1: Atezolizumab + Bevacizumab + Tiragolumab
Stage 1: Atezolizumab + Bevacizumab + Tocilizumab
Stage 1: Atezolizumab + Bevacizumab + TPST-1120
Stage 1: RO7247669 2100 mg Q2W + Bevacizumab
Stage 1: RO7247669 600 mg Q3W + Bevacizumab
Stage 1: RO7247669 1200 mg Q3W + Bevacizumab
Stage 1: Atezolizumab + Bevacizumab + ADG126
Participants will receive atezolizumab plus bevacizumab until unacceptable toxicity or loss of clinical benefit, as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Participants will receive atezolizumab plus bevacizumab plus tiragolumab until unacceptable toxicity or loss of clinical benefit, as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Participants will receive atezolizumab plus bevacizumab plus tocilizumab until unacceptable toxicity or loss of clinical benefit, as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Participants will receive atezolizumab plus bevacizumab plus TPST-1120 until unacceptable toxicity or loss of clinical benefit, as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Participants will receive RO7247669 plus bevacizumab until unacceptable toxicity or loss of clinical benefit, as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Participants will receive RO7247669 plus bevacizumab until unacceptable toxicity or loss of clinical benefit, as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Participants will receive RO7247669 plus bevacizumab until unacceptable toxicity or loss of clinical benefit, as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.
Participants will receive atezolizumab plus bevacizumab plus ADG126 until unacceptable toxicity or loss of clinical benefit as determined by the investigator after an integrated assessment of radiographic and biochemical data, local biopsy results (if available), and clinical status.