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HAIC Combined With Camrelizumab and TKI for Unresectable Hepatocellular Carcinoma After TACE Failure

Primary Purpose

Unresectable Hepatocellular Carcinoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Camrelizumab
HAIC
TKI
Sponsored by
Yue Han
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Unresectable Hepatocellular Carcinoma focused on measuring Unresectable, TACE Failure, Hepatocellular Carcinoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Paticipants voluntarily joined the study and signed the informed consent form
  2. Above 18 years old, both male and female
  3. Clinical diagnosis or histopathologically confirmed advanced hepatocellular carcinoma (unresectable)
  4. Child-Pugh score ≤ 7
  5. BCLC B and C
  6. TACE failure: ① Even if chemotherapeutic drugs are changed or the blood supply artery is reassessed, CT/MRI examinations after 2 consecutive TACE treatments 1-3 months show that the target lesions in the liver are compared with the previous TACE count. There are still more than 50% remaining or new lesions; ② extrahepatic metastasis or vascular invasion; ③ postoperative tumor indicators continue to rise (even if there is a short-term decline)
  7. ECOG 0-1
  8. The expected survival is more than 3 months
  9. The function of vital organs is normal (no blood components, cell growth factor drugs are allowed to be used within 14 days before the first medication)
  10. Women of childbearing age need contraception

Exclusion Criteria:

  1. The patient has any active autoimmune disease or a history of autoimmune disease
  2. The patient is using immunosuppressive agents or systemic hormone therapy to achieve the purpose of immunosuppression (dose>10mg/day prednisone or other curative hormones), and continues to use it within 2 weeks before enrollment
  3. Patients who have progressed after receiving second-line or above anti-vascular drug therapy in the past, or patients who have received immunotherapeutic drugs such as PD-1 / PD-L1 monoclonal antibody
  4. Have received HAIC treatment in the past
  5. Severe allergic reaction to other monoclonal antibodies
  6. People with known history of central nervous system metastasis or hepatic encephalopathy
  7. Patients whose liver tumor burden is greater than 50% of the total liver volume, or who have received liver transplantation in the past
  8. Ascites with clinical symptoms, those who need puncture, drainage, or those who have received ascites drainage within the past 3 months, except for those with only a small amount of ascites on imaging but no clinical symptoms
  9. Suffer from high blood pressure and cannot be well controlled by antihypertensive drugs (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg)
  10. Have uncontrolled clinical symptoms or diseases of the heart
  11. Abnormal coagulation function (INR>2.0, PT>16s), have bleeding tendency or are receiving thrombolysis or anticoagulation therapy, and allow preventive use of low-dose aspirin and low-molecular-weight heparin
  12. Have had significant clinically significant bleeding symptoms or have a clear bleeding tendency within 3 months before randomization
  13. Arterial/venous thrombosis events that occurred within 6 months before randomization
  14. Known hereditary or acquired bleeding and thrombotic tendency
  15. Urine routine test showed urine protein ≥ ++ and confirmed 24-hour urine protein content> 1.0 g
  16. Patients who have previously received chemotherapy, hormone therapy, and surgery, after the completion of the treatment (last medication) and less than 4 weeks before the study medication; molecular targeted therapy (including other oral targeted drugs used in clinical trials) is less than 5 drugs from the first study medication Patients whose half-life or adverse events (except alopecia) caused by previous treatment have not recovered to ≤ CTCAE Grade 1
  17. The patient has active infection, fever of unknown origin within 7 days before medication ≥38.5℃
  18. Patients with congenital or acquired immune deficiencies
  19. The patient has suffered from other malignant tumors in the past 3 years or at the same time (except for cured skin basal cell carcinoma and cervical carcinoma in situ)
  20. Patients with bone metastases who received palliative radiotherapy in the 4 weeks before participating in the study >5% of the bone marrow area
  21. Live vaccines may be vaccinated during the study period less than 4 weeks before the study medication

Sites / Locations

  • Cancer Institute and Hospital, Chinese Academy of Medical SciencesRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Camrelizumab+HAIC+TKI*

Arm Description

*For patients who have not received molecular targeted therapy in the past, lenvatinib is recommended; For patients who have received sorafenib or lenvatinib in the past, regorafenib is recommended.

Outcomes

Primary Outcome Measures

Progression-free survival (according to mRECIST)
Time from the first tumor progression or death

Secondary Outcome Measures

Objective response rate (according to mRECIST and RECIST 1.1)
Refers to the proportion of patients whose tumors have shrunk to a certain amount and maintained for a certain period of time (mainly for solid tumors), including complete remission (CR, Complete Response) and partial remission (PR, Partial Response)
Disease control rate (according to mRECIST and RECIST 1.1)
Refers to the proportion of patients whose tumors have shrunk or been stable for a certain period of time (mainly for solid tumors), including complete remission (CR, Complete Response), partial remission (PR, Partial Response) and stable (SD, Stable Disease)

Full Information

First Posted
October 26, 2021
Last Updated
November 22, 2021
Sponsor
Yue Han
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05135364
Brief Title
HAIC Combined With Camrelizumab and TKI for Unresectable Hepatocellular Carcinoma After TACE Failure
Official Title
Hepatic Artery Infusion Chemotherapy (HAIC) Combined With Camrelizumab and Tyrosine Kinase Inhibitor for Unresectable Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization (TACE) Failure: a Single-arm and Open-label Prospective Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Recruiting
Study Start Date
November 5, 2021 (Actual)
Primary Completion Date
October 5, 2022 (Anticipated)
Study Completion Date
December 5, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Yue Han
Collaborators
Jiangsu HengRui Medicine Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The efficacy and safety of HAIC combined with tyrosine kinase inhibitor and immunotherapy have been proved by the clinical research. In this single-arm, open-label, prospective study, for those patients with unresectable primary HCC, in the case of failure of TACE treatment, the combination of HAIC, TKI and immunotherapy is expected to bring new breakthroughs.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Unresectable Hepatocellular Carcinoma
Keywords
Unresectable, TACE Failure, Hepatocellular Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
48 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Camrelizumab+HAIC+TKI*
Arm Type
Experimental
Arm Description
*For patients who have not received molecular targeted therapy in the past, lenvatinib is recommended; For patients who have received sorafenib or lenvatinib in the past, regorafenib is recommended.
Intervention Type
Drug
Intervention Name(s)
Camrelizumab
Intervention Description
Each infusion is 30 min (not less than 20 min, not more than 60 min), once every 3 weeks
Intervention Type
Drug
Intervention Name(s)
HAIC
Intervention Description
A chemotherapy regimen perfused through the tumor supplying artery, d1-2 administration, perfused every 4 weeks
Intervention Type
Drug
Intervention Name(s)
TKI
Intervention Description
Lenvatinib or Regorafenib
Primary Outcome Measure Information:
Title
Progression-free survival (according to mRECIST)
Description
Time from the first tumor progression or death
Time Frame
Up to two years
Secondary Outcome Measure Information:
Title
Objective response rate (according to mRECIST and RECIST 1.1)
Description
Refers to the proportion of patients whose tumors have shrunk to a certain amount and maintained for a certain period of time (mainly for solid tumors), including complete remission (CR, Complete Response) and partial remission (PR, Partial Response)
Time Frame
Up to two years
Title
Disease control rate (according to mRECIST and RECIST 1.1)
Description
Refers to the proportion of patients whose tumors have shrunk or been stable for a certain period of time (mainly for solid tumors), including complete remission (CR, Complete Response), partial remission (PR, Partial Response) and stable (SD, Stable Disease)
Time Frame
Up to two years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Paticipants voluntarily joined the study and signed the informed consent form Above 18 years old, both male and female Clinical diagnosis or histopathologically confirmed advanced hepatocellular carcinoma (unresectable) Child-Pugh score ≤ 7 BCLC B and C TACE failure: ① Even if chemotherapeutic drugs are changed or the blood supply artery is reassessed, CT/MRI examinations after 2 consecutive TACE treatments 1-3 months show that the target lesions in the liver are compared with the previous TACE count. There are still more than 50% remaining or new lesions; ② extrahepatic metastasis or vascular invasion; ③ postoperative tumor indicators continue to rise (even if there is a short-term decline) ECOG 0-1 The expected survival is more than 3 months The function of vital organs is normal (no blood components, cell growth factor drugs are allowed to be used within 14 days before the first medication) Women of childbearing age need contraception Exclusion Criteria: The patient has any active autoimmune disease or a history of autoimmune disease The patient is using immunosuppressive agents or systemic hormone therapy to achieve the purpose of immunosuppression (dose>10mg/day prednisone or other curative hormones), and continues to use it within 2 weeks before enrollment Patients who have progressed after receiving second-line or above anti-vascular drug therapy in the past, or patients who have received immunotherapeutic drugs such as PD-1 / PD-L1 monoclonal antibody Have received HAIC treatment in the past Severe allergic reaction to other monoclonal antibodies People with known history of central nervous system metastasis or hepatic encephalopathy Patients whose liver tumor burden is greater than 50% of the total liver volume, or who have received liver transplantation in the past Ascites with clinical symptoms, those who need puncture, drainage, or those who have received ascites drainage within the past 3 months, except for those with only a small amount of ascites on imaging but no clinical symptoms Suffer from high blood pressure and cannot be well controlled by antihypertensive drugs (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) Have uncontrolled clinical symptoms or diseases of the heart Abnormal coagulation function (INR>2.0, PT>16s), have bleeding tendency or are receiving thrombolysis or anticoagulation therapy, and allow preventive use of low-dose aspirin and low-molecular-weight heparin Have had significant clinically significant bleeding symptoms or have a clear bleeding tendency within 3 months before randomization Arterial/venous thrombosis events that occurred within 6 months before randomization Known hereditary or acquired bleeding and thrombotic tendency Urine routine test showed urine protein ≥ ++ and confirmed 24-hour urine protein content> 1.0 g Patients who have previously received chemotherapy, hormone therapy, and surgery, after the completion of the treatment (last medication) and less than 4 weeks before the study medication; molecular targeted therapy (including other oral targeted drugs used in clinical trials) is less than 5 drugs from the first study medication Patients whose half-life or adverse events (except alopecia) caused by previous treatment have not recovered to ≤ CTCAE Grade 1 The patient has active infection, fever of unknown origin within 7 days before medication ≥38.5℃ Patients with congenital or acquired immune deficiencies The patient has suffered from other malignant tumors in the past 3 years or at the same time (except for cured skin basal cell carcinoma and cervical carcinoma in situ) Patients with bone metastases who received palliative radiotherapy in the 4 weeks before participating in the study >5% of the bone marrow area Live vaccines may be vaccinated during the study period less than 4 weeks before the study medication
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
yue Han, phD
Phone
13511021629
Email
doctorhan@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
yue Han, phD
Organizational Affiliation
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
City
Beijing
State/Province
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
yue Han, phD
Email
doctorhan@163.com

12. IPD Sharing Statement

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HAIC Combined With Camrelizumab and TKI for Unresectable Hepatocellular Carcinoma After TACE Failure

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