HAIC Combined With Tislelizumab and Apatinib for Unresectable Intrahepatic Cholangiocarcinoma
Primary Purpose
Intrahepatic Cholangiocarcinoma
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
HAIC Combined with Tislelizumab and Apatinib
Sponsored by
About this trial
This is an interventional treatment trial for Intrahepatic Cholangiocarcinoma focused on measuring Intrahepatic Cholangiocarcinoma, Hepatic Arterial Infusion Chemotherapy, Apatinib, Tislelizumab
Eligibility Criteria
Inclusion Criteria:
- ICC diagnosed by imaging examination (CT or MRI) and pathology;
- ICC patient without any previous tumor treatment
- The tumor was assessed as unresectable by two liver surgeons. Any of the following conditions: (1) Residual liver volume less than 30-40%; (2) Not possible for R0 radical resection; (3) Tumor invades the portal vein, hepatic artery and bile duct, and the normal residual liver cannot be guaranteed blood supply and bile drainage; the tumor involves the hepatic veins and cannot preserve at least one vein.
- At least one assessable intrahepatic lesion;
- ECOG PS score 0-1;
- Child-Pugh class A;
- Life expectancy is at least 3 months;
- Age between 18 and 75 years old;
- Baseline laboratory tests meet the following criteria:
Neutrophils ≥1.5×10^9/L White blood cells ≥3.0×10^9/L Platelets ≥75×10^9/L Hemoglobin ≥80g/L Serum ALT, AST ≤ 3 x upper limit of normal (ULN) Serum creatinine ≤ 1.5 x ULN INR < 1.5, or prothrombin time < ULN+4 seconds Albumin ≥30g/L Total bilirubin ≤ 3 x upper limit of normal (ULN)
Exclusion Criteria:
- Distant metastasis;
- Refused to receive PD-1 inhibitor and apatinib treatment;
- Any of the following conditions within the first 12 months of the study: myocardial infarction, severe/unstable angina, coronary artery bypass grafting, congestive heart failure, cerebrovascular accident (including transient ischemic attack), Pulmonary embolism; ongoing: arrhythmia grade ≥2 according to NCI-CTCAE criteria, QTc prolongation (>450 ms in men, >470 ms in women);
- Renal insufficiency requires peritoneal dialysis or hemodialysis;
- Serious dysfunction of other important organs;
- A second primary malignant tumor was diagnosed in the past;
- Known or new evidence of brain or leptomeningeal lesions;
- Hemophilia or bleeding tendency, who are taking anticoagulation therapy such as coumarin derivatives in therapeutic doses;
- Pregnant or lactating women, all female patients of childbearing potential must undergo a pregnancy test (serum or urine) within 7 days before enrollment, and the result is negative;
- History of previous organ transplantation;
- Known HIV infection;
- Allergy to chemotherapy drugs;
- Patients with other serious acute or chronic physical or psychiatric diseases or abnormal laboratory tests that may increase the risk associated with participating in the study, or may interfere with the interpretation of the study results or the investigators consider unsuitable for enrollment.
Sites / Locations
- Sun Yat-sen University Cancer CenterRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
HAIC Combined with Tislelizumab and Apatinib
Arm Description
Outcomes
Primary Outcome Measures
Objective Response Rate
The objective response rate was calculated according to the RECIST 1.1.
Secondary Outcome Measures
Progression-free survival
defined as the time from the start of enrollment to the time of tumor progression (PD) or death or last follow-up on imaging.
Disease Control Rate
According to the RECIST 1.1 standard, complete remission + partial remission + disease control rate were calculated.
Conversion rate to resection
Defined as the rate of surgical resection among all enrolled patients.
Overall Survival time
Defined as the time from enrollment until death from any cause.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05290116
Brief Title
HAIC Combined With Tislelizumab and Apatinib for Unresectable Intrahepatic Cholangiocarcinoma
Official Title
Hepatic Arterial Infusion Chemotherapy Combined With Tislelizumab and Apatinib in the Treatment of Unresectable Intrahepatic Cholangiocarcinoma: A Prospective, Single-Center, Phase II Study
Study Type
Interventional
2. Study Status
Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 21, 2022 (Actual)
Primary Completion Date
May 1, 2023 (Anticipated)
Study Completion Date
September 1, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Yunfei Yuan
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
Primary liver cancer is the sixth most common cancer worldwide, including hepatocellular carcinoma and intrahepatic cholangiocarcinoma, of which intrahepatic cholangiocarcinoma accounts for 10%-15%. Surgical resection is the only curative method for ICC, but most patients are diagnosed at an advanced stage, and only 15% of patients can undergo surgical resection. In locally advanced ICC patients without distant metastases, although the tumor was initially assessed as unresectable, these patients may have the opportunity for surgical resection after reducing the size tumor lesion and increasing the remnant liver volume through conversion therapy. The current standard first-line treatment for unresectable ICC is gemcitabine combined with cisplatin, with a median overall survival of only 11.7 months and an ORR of 26.1%. In view of the poor effect of the standard chemotherapy regimen, the NCCN guidelines recommend that patients could participate in clinical study. Hepatic arterial infusion chemotherapy can increase the local blood drug concentration and improve the tumor regression rate. By reducing the dose of systemic chemotherapy drugs concentration, the incidence of adverse reactions can be reduced. Hepatic arterial infusion chemotherapy may be a better choice for locally advanced intrahepatic cholangiocarcinoma. PD-1 immunotherapy combined with targeted therapy is expected to improve the prognosis of patients with intrahepatic cholangiocarcinoma. This study investigates the safety and efficacy of hepatic arterial infusion chemotherapy combined with tislelizumab and apatinib in the treatment of unresectable ICC.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intrahepatic Cholangiocarcinoma
Keywords
Intrahepatic Cholangiocarcinoma, Hepatic Arterial Infusion Chemotherapy, Apatinib, Tislelizumab
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
HAIC Combined with Tislelizumab and Apatinib
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
HAIC Combined with Tislelizumab and Apatinib
Intervention Description
Hepatic Arterial Infusion Chemotherapy: FOLFOX6 regimen was infused with chemotherapy drugs: oxaliplatin 130 mg/m2 infusion for 2 hours, folinate calcium 400 mg/m2 infusion for 2 hours, 5-fluorouracil 400 mg/m2 arterial infusion for 10 minutes, 5-fluorouracil 1200 mg/m2 infusion for 23 hours. Every 3 weeks, no more than 4 cycles of HAIC treatment.
Tislelizumab and Apatinib treatment: start at 0-3 days after the end of hepatic arterial infusion chemotherapy: Tislelizumab 200 mg, ivdrip, Q3W; Apatinib 250 mg, po, QD.
Primary Outcome Measure Information:
Title
Objective Response Rate
Description
The objective response rate was calculated according to the RECIST 1.1.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Progression-free survival
Description
defined as the time from the start of enrollment to the time of tumor progression (PD) or death or last follow-up on imaging.
Time Frame
12 months
Title
Disease Control Rate
Description
According to the RECIST 1.1 standard, complete remission + partial remission + disease control rate were calculated.
Time Frame
12 months
Title
Conversion rate to resection
Description
Defined as the rate of surgical resection among all enrolled patients.
Time Frame
12 months
Title
Overall Survival time
Description
Defined as the time from enrollment until death from any cause.
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
ICC diagnosed by imaging examination (CT or MRI) and pathology;
ICC patient without any previous tumor treatment
The tumor was assessed as unresectable by two liver surgeons. Any of the following conditions: (1) Residual liver volume less than 30-40%; (2) Not possible for R0 radical resection; (3) Tumor invades the portal vein, hepatic artery and bile duct, and the normal residual liver cannot be guaranteed blood supply and bile drainage; the tumor involves the hepatic veins and cannot preserve at least one vein.
At least one assessable intrahepatic lesion;
ECOG PS score 0-1;
Child-Pugh class A;
Life expectancy is at least 3 months;
Age between 18 and 75 years old;
Baseline laboratory tests meet the following criteria:
Neutrophils ≥1.5×10^9/L White blood cells ≥3.0×10^9/L Platelets ≥75×10^9/L Hemoglobin ≥80g/L Serum ALT, AST ≤ 3 x upper limit of normal (ULN) Serum creatinine ≤ 1.5 x ULN INR < 1.5, or prothrombin time < ULN+4 seconds Albumin ≥30g/L Total bilirubin ≤ 3 x upper limit of normal (ULN)
Exclusion Criteria:
Distant metastasis;
Refused to receive PD-1 inhibitor and apatinib treatment;
Any of the following conditions within the first 12 months of the study: myocardial infarction, severe/unstable angina, coronary artery bypass grafting, congestive heart failure, cerebrovascular accident (including transient ischemic attack), Pulmonary embolism; ongoing: arrhythmia grade ≥2 according to NCI-CTCAE criteria, QTc prolongation (>450 ms in men, >470 ms in women);
Renal insufficiency requires peritoneal dialysis or hemodialysis;
Serious dysfunction of other important organs;
A second primary malignant tumor was diagnosed in the past;
Known or new evidence of brain or leptomeningeal lesions;
Hemophilia or bleeding tendency, who are taking anticoagulation therapy such as coumarin derivatives in therapeutic doses;
Pregnant or lactating women, all female patients of childbearing potential must undergo a pregnancy test (serum or urine) within 7 days before enrollment, and the result is negative;
History of previous organ transplantation;
Known HIV infection;
Allergy to chemotherapy drugs;
Patients with other serious acute or chronic physical or psychiatric diseases or abnormal laboratory tests that may increase the risk associated with participating in the study, or may interfere with the interpretation of the study results or the investigators consider unsuitable for enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yunfei Yuan
Phone
+862087343118
Email
yuanyf@mail.sysu.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Wei He
Phone
+8615521248313
Email
hewei@sysucc.org.cn
Facility Information:
Facility Name
Sun Yat-sen University Cancer Center
City
GuangZhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yunfei Yuan
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
HAIC Combined With Tislelizumab and Apatinib for Unresectable Intrahepatic Cholangiocarcinoma
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