search
Back to results

CTLA-4 /PD-L1 Blockade Following Transarterial Chemoembolization (DEB-TACE) in Patients With Intermediate Stage of HCC (Hepatocellular Carcinoma) Using Durvalumab and Tremelimumab

Primary Purpose

Intermediate Stage of Hepatocellular Carcinoma, Hepatocellular Carcinoma

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Durvalumab
Tremelimumab (Cohort A dose)
Tremelimumab (Cohort B dose)
Sponsored by
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intermediate Stage of Hepatocellular Carcinoma focused on measuring HCC, Durvalumab, Tremelimumab, Immunotherapy, PD-L1, Antibodies, Hepatocellular Carcinoma, CTLA-4, DEB-TACE

Eligibility Criteria

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

Inclusion Criteria:

  • Signed informed consent form
  • Age ≥18 years.
  • Newly diagnosed with hepatocellular carcinoma
  • Have measurable disease
  • Have disease that responds to DEB-TACE
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Body weight >30 kg
  • Evidence of clinical or radiographic ascites with a score < 7
  • Patients must have adequate organ function defined by study-specified laboratory tests.
  • Evidence of post-menopausal status or negative pregnancy test
  • Willing and able to comply with study procedures
  • Willing to undergo a liver biopsy

Exclusion Criteria:

  • Anyone involved with the planning and/or conduct of the study.
  • Has participated in another investigational study during the last 6 months.
  • Any concurrent anticancer therapy or received therapy ≤30 days prior to study.
  • Major surgical procedure at the time of study enrollment or within 28 days prior to the first dose of IP.
  • Have a diffuse HCC (Hepatocellular Carcinoma), vascular invasion or extrahepatic tumor.
  • Main portal vein thrombosis present on imaging.
  • History of hepatic encephalopathy within past 12 months or require medications to prevent or control encephalopathy.
  • Ascites within 6 weeks prior to study treatment.
  • Any contraindications for embolization.
  • Has an active infection such as TB, HIV, hepatitis B or C.
  • History of another primary malignancy.
  • History of leptomeningeal carcinomatosis.
  • History of active primary immunodeficiency.
  • Any unresolved toxicities from previous anticancer therapy.
  • Grade ≥2 neuropathy.
  • History of bleeding disorder.
  • History or current use of immunosuppressive medications within 14 days prior to study medications.
  • Has an active known or suspected autoimmune disease.
  • Patients with hypothyroidism.
  • Any active skin conditions.
  • History of allogenic organ transplantation.
  • Significant heart disease.
  • Patients weighing < 30 kg.
  • Patients with celiac disease not controlled by diet alone.
  • Patient with uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Have received a live vaccine within 30 days prior to study drug.
  • Woman who are pregnant or breastfeeding.
  • Known allergy or hypersensitivity to the study drug.
  • Have received durvalumab, tremelimumab, anti-PD-1, anti-PD-L1 or anti-CTLA-4 in a prior study.
  • Unwilling or unable to follow the study schedule for any reason.

Sites / Locations

  • Sidney Kimmel Comprehensive Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Durvalumab in combination with Tremelimumab (Cohort A dose)

Durvalumab in combination with Tremelimumab (Cohort B dose)

Arm Description

Starting at week 2, after initial DEB-TACE treatment, patients will receive Durvalumab in combination with tremelimumab, as specified per protocol (Cohort A dose). Treatment will continue for up to 12 months, while receiving DEB-TACE. Repeat DEB-TACE will be provided Q8W if there is residual tumor that can be targeted.

Starting at week 2, after initial DEB-TACE treatment, patients will receive Durvalumab in combination with tremelimumab as specified per protocol (Cohort B dose). Treatment will continue for up to 12 months, while receiving DEB-TACE. Repeat DEB-TACE will be provided Q8W if there is residual tumor that can be targeted.

Outcomes

Primary Outcome Measures

Objective response rate (ORR) using modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria.
Proportion of participants with reduction in tumor burden as defined by mRECIST criteria.

Secondary Outcome Measures

Progression free survival (PFS)
Number of months until disease progression or death
Tumor response as determined by number of participants with partial (PR) or complete response (CR) as defined by mRECIST criteria
PR is defined as >=30% reduction in size of target lesions, whereas CR is defined as disappearance of all target lesions
Overall Survival (OS)
Number of months until death from any-cause
Number of participants experiencing study drug-related toxicities
Number of participants experiencing drug-related adverse events >= Grade 3 or higher as defined by CTCAE v5.0

Full Information

First Posted
August 15, 2018
Last Updated
September 1, 2023
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
AstraZeneca
search

1. Study Identification

Unique Protocol Identification Number
NCT03638141
Brief Title
CTLA-4 /PD-L1 Blockade Following Transarterial Chemoembolization (DEB-TACE) in Patients With Intermediate Stage of HCC (Hepatocellular Carcinoma) Using Durvalumab and Tremelimumab
Official Title
The Effect of CTLA-4/PD-L1 Blockade Following Drug-eluting Bead Transarterial Chemoembolization (DEB-TACE) in Patients With Intermediate Stage of HCC Using Durvalumab (MEDI4736) and Tremelimumab
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 2, 2019 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
January 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
AstraZeneca

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to determine the safety and efficacy of immunotherapy durvalumab and tremelimumab combined with DEB-TACE in patients with Hepatocellular Carcinoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intermediate Stage of Hepatocellular Carcinoma, Hepatocellular Carcinoma
Keywords
HCC, Durvalumab, Tremelimumab, Immunotherapy, PD-L1, Antibodies, Hepatocellular Carcinoma, CTLA-4, DEB-TACE

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Durvalumab in combination with Tremelimumab (Cohort A dose)
Arm Type
Experimental
Arm Description
Starting at week 2, after initial DEB-TACE treatment, patients will receive Durvalumab in combination with tremelimumab, as specified per protocol (Cohort A dose). Treatment will continue for up to 12 months, while receiving DEB-TACE. Repeat DEB-TACE will be provided Q8W if there is residual tumor that can be targeted.
Arm Title
Durvalumab in combination with Tremelimumab (Cohort B dose)
Arm Type
Experimental
Arm Description
Starting at week 2, after initial DEB-TACE treatment, patients will receive Durvalumab in combination with tremelimumab as specified per protocol (Cohort B dose). Treatment will continue for up to 12 months, while receiving DEB-TACE. Repeat DEB-TACE will be provided Q8W if there is residual tumor that can be targeted.
Intervention Type
Drug
Intervention Name(s)
Durvalumab
Other Intervention Name(s)
MEDI4736
Intervention Description
Durvalumab IV
Intervention Type
Drug
Intervention Name(s)
Tremelimumab (Cohort A dose)
Other Intervention Name(s)
CP-675,206
Intervention Description
Tremelimumab IV
Intervention Type
Drug
Intervention Name(s)
Tremelimumab (Cohort B dose)
Other Intervention Name(s)
CP-675,206
Intervention Description
Tremelimumab IV
Primary Outcome Measure Information:
Title
Objective response rate (ORR) using modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria.
Description
Proportion of participants with reduction in tumor burden as defined by mRECIST criteria.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Progression free survival (PFS)
Description
Number of months until disease progression or death
Time Frame
2 years
Title
Tumor response as determined by number of participants with partial (PR) or complete response (CR) as defined by mRECIST criteria
Description
PR is defined as >=30% reduction in size of target lesions, whereas CR is defined as disappearance of all target lesions
Time Frame
2 years
Title
Overall Survival (OS)
Description
Number of months until death from any-cause
Time Frame
2 years
Title
Number of participants experiencing study drug-related toxicities
Description
Number of participants experiencing drug-related adverse events >= Grade 3 or higher as defined by CTCAE v5.0
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent form Age ≥18 years. Newly diagnosed with hepatocellular carcinoma Have measurable disease Have disease that responds to DEB-TACE Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 Body weight >30 kg Evidence of clinical or radiographic ascites with a score < 7 Patients must have adequate organ function defined by study-specified laboratory tests. Evidence of post-menopausal status or negative pregnancy test Willing and able to comply with study procedures Willing to undergo a liver biopsy Exclusion Criteria: Anyone involved with the planning and/or conduct of the study. Has participated in another investigational study during the last 6 months. Any concurrent anticancer therapy or received therapy ≤30 days prior to study. Major surgical procedure at the time of study enrollment or within 28 days prior to the first dose of IP. Have a diffuse HCC (Hepatocellular Carcinoma), vascular invasion or extrahepatic tumor. Main portal vein thrombosis present on imaging. History of hepatic encephalopathy within past 12 months or require medications to prevent or control encephalopathy. Ascites within 6 weeks prior to study treatment. Any contraindications for embolization. Has an active infection such as TB, HIV, hepatitis B or C. History of another primary malignancy. History of leptomeningeal carcinomatosis. History of active primary immunodeficiency. Any unresolved toxicities from previous anticancer therapy. Grade ≥2 neuropathy. History of bleeding disorder. History or current use of immunosuppressive medications within 14 days prior to study medications. Has an active known or suspected autoimmune disease. Patients with hypothyroidism. Any active skin conditions. History of allogenic organ transplantation. Significant heart disease. Patients weighing < 30 kg. Patients with celiac disease not controlled by diet alone. Patient with uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Have received a live vaccine within 30 days prior to study drug. Woman who are pregnant or breastfeeding. Known allergy or hypersensitivity to the study drug. Have received durvalumab, tremelimumab, anti-PD-1, anti-PD-L1 or anti-CTLA-4 in a prior study. Unwilling or unable to follow the study schedule for any reason.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Colleen Apostal, RN
Phone
410-614-3644
Email
GIClinicalTrials@jhmi.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Joann Santmyer, RN
Phone
410-614-3644
Email
GIClinicalTrials@jhmi.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ana De Jesus-Acosta, MD
Organizational Affiliation
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sidney Kimmel Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Trish Brothers, RN
Phone
410-614-3644
Email
GIClinicalTrials@jhmi.edu
First Name & Middle Initial & Last Name & Degree
Brad Wilt, RN
Phone
410-614-1816
Email
bwilt1@jhmi.edu
First Name & Middle Initial & Last Name & Degree
Ana DeJesus, MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

CTLA-4 /PD-L1 Blockade Following Transarterial Chemoembolization (DEB-TACE) in Patients With Intermediate Stage of HCC (Hepatocellular Carcinoma) Using Durvalumab and Tremelimumab

We'll reach out to this number within 24 hrs