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Sintilimab Combined With Bevacizumab Biosimilar for Potentially Resectable Intermediate HCC

Primary Purpose

Hepatocellular Carcinoma

Status
Unknown status
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Sintilimab
Bevacizumab Biosimilar
Sponsored by
Fudan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Able to provide informed consent and willing to sign an approved consent form
  2. Age 18-75, male and female
  3. Potentially resectable Intermediate (CNLC-IIa and IIb) HCC with diagnosis confirmed by histology/cytology or clinically
  4. No prior therapy for HCC
  5. Child-Pugh: A
  6. ECOG PS: 0-1
  7. Expected survival ≥6 months
  8. Measurable disease per RECIST1.1
  9. Major organ functions meet the following requirements:

    no blood transfusion, no use of hematopoietic stimulators (including g-csf, gm-csf, EPO and TPO) and infusion of human albumin preparations within 14 days prior to screening: neutrophil absolute count ≥1.0×10^9/L;Platelet count ≥ 75×10^9/L;Hemoglobin ≥ 9 g/dL;Serum albumin ≥ 2.8 g/dL;Total serum bilirubin ≤2.0× upper limit of normal range (ULN);Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 5 × ULN;Serum creatinine (Cr) ≤1.5×ULN or Cr clearance ≥30 mL/min (calculated by Cockcroft-Gault formula);International standardized ratio (INR) ≤1.5×ULN;

  10. Women of childbearing age must undergo a blood pregnancy test within the first 3 days of randomization with negative results and agree to use a reliable and effective method of contraception during the trial and within 120 days of the last trial drug administration. Male patients whose partners are women of childbearing age must agree to use a reliable and effective method of contraception during the trial and within 120 days of the last trial drug administration.

Exclusion Criteria:

  1. known as cholangiocarcinoma (ICC) or mixed hepatocellular carcinoma, sarcomatoid hepatocellular carcinoma, and hepatic fibrolamellar carcinoma.
  2. History of organ transplantation or hepatic encephalopathy
  3. Tumor accumulation range exceeds 70% of liver volume
  4. Pleural fluid, ascites, and pericardial effusion with clinical symptoms requiring drainage
  5. Any history of kidney disease or nephrotic syndrome
  6. History of gastrointestinal (GI) perforation and/or fistula in the past 6 months;Severe (G3) varicose veins are known to be present on endoscopy within 3 months before the first dose ; history of thrombosis, bleeding diathesis, coagulopathy or significant vascular disease
  7. Prior life-threatening blood loss or grade 3/4 gastrointestinal bleeding requiring blood infusion, endoscopic or surgical intervention within 3 months
  8. Arterial and venous thromboembolic events in the past 6 months, including myocardial infarction, unstable angina, cerebrovascular accident or transient ischemic attack, pulmonary embolism, deep vein thrombosis or any other serious thromboembolism history.
  9. Severe bleeding tendency or coagulopathy, or are receiving thrombolytic therapy
  10. Long-term use of vitamin K antagonists (such as warfarin) or low-dose low-molecular-weight heparin (such as enoxaparin 40 mg/day) or heparin
  11. Uncontrollable hypertension, systolic blood pressure> 140 mmHg or diastolic blood pressure> 90 mmHg after optimal medical treatment, history of hypertensive crisis or hypertensive encephalopathy
  12. Symptomatic congestive heart failure (New York Heart Association Grade II-IV), symptomatic or poorly controlled arrhythmia, history of congenital long QT syndrome or QTc> 500ms corrected during screening
  13. History of abdominal or tracheoesophageal fistula, gastrointestinal (GI) perforation, or intra-abdominal abscess within 6 months of initiation of study treatment
  14. Had major surgical procedure within 4 weeks of initiation of study treatment
  15. Past and current history of pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, drug-related pneumonia, severely impaired lung function and other lung diseases
  16. Had acute or chronic active hepatitis B or C infection. Hepatitis C virus (HCV) RNA>103 copies/ml; hepatitis B surface antigen (HbsAg) and anti-HCV antibody are positive at the same time; hepatitis B virus (HBV) DNA positive but has received antiviral treatment is allowed.
  17. Had active tuberculosis (TB)
  18. Had human immunodeficiency virus (HIV) infection (HIV 1/2 antibody positive), known syphilis infection
  19. Had severe infections that are active or poorly clinically controlled.
  20. Had active autoimmune disease
  21. Have used immunosuppressive drugs within 4 weeks before the first dose
  22. Received live attenuated vaccines within 4 weeks before the first dose or plan to receive live attenuated vaccines during the study period
  23. Received Chinese medicine with anti-tumor indications, or received drugs with immunomodulatory effect within 2 weeks before the first administration
  24. Received any anti-PD-1 antibody, anti-PD-L1/L2 antibody, anti-CTLA4 antibody, or other immunotherapy
  25. Allergic to Sintilizumab, Bevacizumab preparations and excipients, or had severe allergic reactions to other monoclonal antibodies in the past
  26. Received treatment from other clinical trials within 4 weeks before the first dose
  27. Female patients who are pregnant or breastfeeding

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Sintilimab+Bevacizumab

    Arm Description

    Outcomes

    Primary Outcome Measures

    Adverse Events (AEs)
    Defined as the proportion of patients with AE, treatment-related AE (TRAE), immune-related AE (irAE), serious adverse event (SAE), assessed by NCI CTCAE v5.0; Surgical safety including Intraoperative blood loss,PHLF assessed by ISGLS(2012),Postoperative complications evaluated by modified Clavien-Dindo system
    Events Free Survival (EFS) Assessed by RECIST1.1
    Defined as the time from enrollment to disease progression, recurrence or death (whichever occurs first)

    Secondary Outcome Measures

    resection rate (R0 resection rate)
    Defined as the proportion of patients undergoing radical resection to the total subjects (R0 resection rate)
    Pathological response rate
    Defined as the proportion of patients who had pathological response.
    Objective response rate (ORR) assessed by RECIST1.1
    Defined as the proportion of patients who had a best overall tumor response rating of complete response (CR) or partial response (PR).
    Recurrence-free survival (RFS) of patients who accepted surgery
    Defined as the time from the date of surgery to the date of disease recurrence or death whichever occur first, assessed up to 2 years post-treatment
    Progression free survival (PFS) assessed by RECIST1.1 of patients who didn't accept surgery
    Defined as the time from initiation of treatment until the first occurrence of disease progression or death from any cause, whichever occurs first.
    Overall survival (OS) of the patients who accepted surgery
    Defined as the time from the date of treatment start to the date of death or to the date of last follow-up for patients alive.
    Overall survival (OS) of the patients who didn't accepted surgery
    Defined as the time from the date of treatment start to the date of death or to the date of last follow-up for patients alive.
    Overall survival (OS)
    Defined as the time from the date of treatment start to the date of death or to the date of last follow-up for patients alive

    Full Information

    First Posted
    April 8, 2021
    Last Updated
    April 11, 2021
    Sponsor
    Fudan University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04843943
    Brief Title
    Sintilimab Combined With Bevacizumab Biosimilar for Potentially Resectable Intermediate HCC
    Official Title
    An Exploratory Study of Sintilimab in Combination With Bevacizumab Biosimilar in Patients With Potentially Resectable Intermediate HCC
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2021
    Overall Recruitment Status
    Unknown status
    Study Start Date
    May 1, 2021 (Anticipated)
    Primary Completion Date
    May 1, 2022 (Anticipated)
    Study Completion Date
    May 1, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Fudan University

    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
    This is a Phase Ib study to evaluate the safety and efficacy of sintilimab combined with bevacizumab biosimilar in patients with potentially resectable intermediate hepatocellular carcinoma (HCC).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Hepatocellular Carcinoma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    30 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Sintilimab+Bevacizumab
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    Sintilimab
    Intervention Description
    Sintilimab: 200mg IV Q3W D1
    Intervention Type
    Drug
    Intervention Name(s)
    Bevacizumab Biosimilar
    Intervention Description
    Bevacizumab biosimilar: 15mg/kg, IV, Q3W, D1
    Primary Outcome Measure Information:
    Title
    Adverse Events (AEs)
    Description
    Defined as the proportion of patients with AE, treatment-related AE (TRAE), immune-related AE (irAE), serious adverse event (SAE), assessed by NCI CTCAE v5.0; Surgical safety including Intraoperative blood loss,PHLF assessed by ISGLS(2012),Postoperative complications evaluated by modified Clavien-Dindo system
    Time Frame
    Up to 2 years
    Title
    Events Free Survival (EFS) Assessed by RECIST1.1
    Description
    Defined as the time from enrollment to disease progression, recurrence or death (whichever occurs first)
    Time Frame
    Up to 2 years
    Secondary Outcome Measure Information:
    Title
    resection rate (R0 resection rate)
    Description
    Defined as the proportion of patients undergoing radical resection to the total subjects (R0 resection rate)
    Time Frame
    Up to 2 years
    Title
    Pathological response rate
    Description
    Defined as the proportion of patients who had pathological response.
    Time Frame
    Up to 2 years
    Title
    Objective response rate (ORR) assessed by RECIST1.1
    Description
    Defined as the proportion of patients who had a best overall tumor response rating of complete response (CR) or partial response (PR).
    Time Frame
    Up to 2 years
    Title
    Recurrence-free survival (RFS) of patients who accepted surgery
    Description
    Defined as the time from the date of surgery to the date of disease recurrence or death whichever occur first, assessed up to 2 years post-treatment
    Time Frame
    Up to 2 years
    Title
    Progression free survival (PFS) assessed by RECIST1.1 of patients who didn't accept surgery
    Description
    Defined as the time from initiation of treatment until the first occurrence of disease progression or death from any cause, whichever occurs first.
    Time Frame
    Up to 2 years
    Title
    Overall survival (OS) of the patients who accepted surgery
    Description
    Defined as the time from the date of treatment start to the date of death or to the date of last follow-up for patients alive.
    Time Frame
    Up to 2 years
    Title
    Overall survival (OS) of the patients who didn't accepted surgery
    Description
    Defined as the time from the date of treatment start to the date of death or to the date of last follow-up for patients alive.
    Time Frame
    Up to 2 years
    Title
    Overall survival (OS)
    Description
    Defined as the time from the date of treatment start to the date of death or to the date of last follow-up for patients alive
    Time Frame
    Up to 2 years

    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: Able to provide informed consent and willing to sign an approved consent form Age 18-75, male and female Potentially resectable Intermediate (CNLC-IIa and IIb) HCC with diagnosis confirmed by histology/cytology or clinically No prior therapy for HCC Child-Pugh: A ECOG PS: 0-1 Expected survival ≥6 months Measurable disease per RECIST1.1 Major organ functions meet the following requirements: no blood transfusion, no use of hematopoietic stimulators (including g-csf, gm-csf, EPO and TPO) and infusion of human albumin preparations within 14 days prior to screening: neutrophil absolute count ≥1.0×10^9/L;Platelet count ≥ 75×10^9/L;Hemoglobin ≥ 9 g/dL;Serum albumin ≥ 2.8 g/dL;Total serum bilirubin ≤2.0× upper limit of normal range (ULN);Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 5 × ULN;Serum creatinine (Cr) ≤1.5×ULN or Cr clearance ≥30 mL/min (calculated by Cockcroft-Gault formula);International standardized ratio (INR) ≤1.5×ULN; Women of childbearing age must undergo a blood pregnancy test within the first 3 days of randomization with negative results and agree to use a reliable and effective method of contraception during the trial and within 120 days of the last trial drug administration. Male patients whose partners are women of childbearing age must agree to use a reliable and effective method of contraception during the trial and within 120 days of the last trial drug administration. Exclusion Criteria: known as cholangiocarcinoma (ICC) or mixed hepatocellular carcinoma, sarcomatoid hepatocellular carcinoma, and hepatic fibrolamellar carcinoma. History of organ transplantation or hepatic encephalopathy Tumor accumulation range exceeds 70% of liver volume Pleural fluid, ascites, and pericardial effusion with clinical symptoms requiring drainage Any history of kidney disease or nephrotic syndrome History of gastrointestinal (GI) perforation and/or fistula in the past 6 months;Severe (G3) varicose veins are known to be present on endoscopy within 3 months before the first dose ; history of thrombosis, bleeding diathesis, coagulopathy or significant vascular disease Prior life-threatening blood loss or grade 3/4 gastrointestinal bleeding requiring blood infusion, endoscopic or surgical intervention within 3 months Arterial and venous thromboembolic events in the past 6 months, including myocardial infarction, unstable angina, cerebrovascular accident or transient ischemic attack, pulmonary embolism, deep vein thrombosis or any other serious thromboembolism history. Severe bleeding tendency or coagulopathy, or are receiving thrombolytic therapy Long-term use of vitamin K antagonists (such as warfarin) or low-dose low-molecular-weight heparin (such as enoxaparin 40 mg/day) or heparin Uncontrollable hypertension, systolic blood pressure> 140 mmHg or diastolic blood pressure> 90 mmHg after optimal medical treatment, history of hypertensive crisis or hypertensive encephalopathy Symptomatic congestive heart failure (New York Heart Association Grade II-IV), symptomatic or poorly controlled arrhythmia, history of congenital long QT syndrome or QTc> 500ms corrected during screening History of abdominal or tracheoesophageal fistula, gastrointestinal (GI) perforation, or intra-abdominal abscess within 6 months of initiation of study treatment Had major surgical procedure within 4 weeks of initiation of study treatment Past and current history of pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, drug-related pneumonia, severely impaired lung function and other lung diseases Had acute or chronic active hepatitis B or C infection. Hepatitis C virus (HCV) RNA>103 copies/ml; hepatitis B surface antigen (HbsAg) and anti-HCV antibody are positive at the same time; hepatitis B virus (HBV) DNA positive but has received antiviral treatment is allowed. Had active tuberculosis (TB) Had human immunodeficiency virus (HIV) infection (HIV 1/2 antibody positive), known syphilis infection Had severe infections that are active or poorly clinically controlled. Had active autoimmune disease Have used immunosuppressive drugs within 4 weeks before the first dose Received live attenuated vaccines within 4 weeks before the first dose or plan to receive live attenuated vaccines during the study period Received Chinese medicine with anti-tumor indications, or received drugs with immunomodulatory effect within 2 weeks before the first administration Received any anti-PD-1 antibody, anti-PD-L1/L2 antibody, anti-CTLA4 antibody, or other immunotherapy Allergic to Sintilizumab, Bevacizumab preparations and excipients, or had severe allergic reactions to other monoclonal antibodies in the past Received treatment from other clinical trials within 4 weeks before the first dose Female patients who are pregnant or breastfeeding
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Huichuan Sun
    Phone
    13701922065
    Email
    sun.huichuan@zs-hospital.sh.cn

    12. IPD Sharing Statement

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    Sintilimab Combined With Bevacizumab Biosimilar for Potentially Resectable Intermediate HCC

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