Hepatocellular CarcinomaPhase 2ROWANNCT05063565
TheraSphere With Durvalumab and Tremelimumab for HCC
A Phase 2 study testing TheraSphere Y-90 glass microsphere therapy, Durvalumab (Imfinzi) immunotherapy and Tremelimumab immunotherapy in people with Hepatocellular Carcinoma, run by Boston Scientific Corporation at 35 sites in 5 countries.
Trial summary
The objective of the ROWAN clinical study is to assess the efficacy of local tumor control in HCC patients who receive TheraSphere followed by durvalumab and tremelimumab. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hepatocellular Carcinoma
- What is being tested?
- TheraSphere Y-90 glass microsphere therapy, Durvalumab (Imfinzi) immunotherapy and Tremelimumab immunotherapy
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 100 participants
- Where
- 35 sitesin 5 countries
- Study dates
- 3 Nov 2023to Jun 2027
- Phase
- Phase 2
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Participants must be aged ≥18 years at the time of screening.
- Written informed consent and any locally required authorization (e.g., Health Insurance Portability and accountability Act in the US, European Union (EU) data privacy regulations in the EU) obtained from the patient/legal representative prior to performing any protocol-related procedures, including screening evaluations.
- Life expectancy ≥6 months.
- HCC, diagnosed by radiographic imaging or histology.
- Patient not a candidate for liver resection, thermal ablation, or transplantation at the time of study entry.
- ECOG 0 or 1
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- Measurable disease by mRECIST criteria (e.g. ≥10mm of enhancement).
- Tumor volume ≤35% of whole liver volume (determined by imaging).
- Future liver remnant volume (FLRV) ≥30% of whole liver volume. FRLV is the volume of liver not planned to be treated with TheraSphere and free of HCC.
- Dosimetry criteria for tumor(s) and normal tissue can be determined.
- Patients with previous liver resection or ablation ≥6 months from end of previous treatment to TheraSphere administration.
- Previous transarterial chemoembolization (TACE) is permitted if:
- Previous TACE performed ≥8 months before TheraSphere administration and
- Result of previous TACE was CR and
- Current tumor is not a recurrence of previously treated lesion
- Patients with portal vein thrombosis (PVT) Vp0, Vp1, or Vp2.
- Patients with HBV or HCV infection are to have documented virology status of hepatitis as confirmed by HBV and HCV serology test:
- Patients with HBV infection: HBV DNA load should be ≤2000 IU/mL obtained within 42 days prior to initiation of study treatment, and Anti-HBV treatment (per local standard of care; e.g., entecavir) for a minimum of 14 days prior to study entry and willingness to continue treatment for the length of the study
- Patients with chronic HCV infection are allowed in the study: for untreated patients, AST/ALT should be ≤3xULN and for treated patients, antiviral treatment (per local standard of care) should be stopped for a minimum of 14 days prior to study entry and AST/ALT should be ≤3xULN
- Patients with Human Immunodeficiency Virus (HIV) infection are eligible, provided the HIV infection is well controlled with no current or previous AIDS-related complications and CD4+ T-cell (CD4+) counts ≥ 350 cells/uL
- Negative serum pregnancy test in females of childbearing potential.
- Adequate contraception for the patient and his/her sexual partner.
- Adequate renal and marrow function as defined below:
- Hemoglobin (hgB) ≥9.0 g/dL
- Absolute neutrophil count (ANC) ≥1.5 x 109/L
- Platelet count ≥75 x 109/L
- Measured or calculated creatinine clearance ≥45 mL/min as determined by Cockcroft-Gault (using actual body weight)
- Absolute lymphocyte count ≥0.5 X 109/L
- Adequate liver function, as defined by
- Child-Pugh A
- Albumin-bilirubin (ALBI) score 1 or 2 with upper limit for ALBI score ≤ -2. Patients with confirmed Gilbert's syndrome may not have an evaluable bilirubin value; therefore, ALBI score should not be considered for such patients. Patients with Gilbert's syndrome will be eligible with any bilirubin value, as long as Albumin level is ≥ 34 g/L.
- AST and ALT <3 x ULN.
- Body weight >30 kg and BMI ≥18 kg/m2.
Who cannot join
- Any contraindication to angiography or selective visceral catheterization.
- Cone Beam CT (CBCT) or Technetium-99m macroaggregated Albumin (99mTc-MAA) hepatic arterial perfusion scintigraphy shows any deposition to the gastrointestinal tract that may not be corrected by angiographic techniques.
- 99mTc-MAA hepatic arterial perfusion scintigraphy shows poor tumor and/or portal vein thrombosis (PVT) targeting that would lead to a dose that does not meet the liver dosing criteria.
- Shunting of blood to the lungs that could result in delivery of >30 Gy to the lungs in a single treatment or >50 Gy cumulative dose to the lungs in case of multiple TheraSphere treatments, as seen on 99mTc-MAA hepatic arterial perfusion scintigraphy.
- Vp3, Vp4, hepatic vein invasion, or inferior vena cava (IVC) invasion
- Extrahepatic metastases (patients with extrahepatic spread [EHS]):
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- EHS is any extrahepatic lesion that, according to clinical symptoms, histology, or imaging data, is highly suspicious of being metastases.
- For patients with bone pain/neurological symptoms (deficit, seizure or else) at baseline and suspected of metastases at screening, a bone scan/brain MRI is recommended prior to study entry.
- Extrahepatic non-target non-measurable lesions (<1 cm per RECIST 1.1) are acceptable if considered not suspicious by the investigator.
- Any previous systemic HCC treatment
- Prior exposure to immune mediated therapy for other disease, such as other anti-PD- 1, anti-PDL-1, anti-PDL-2, anti-CTLA-4, antibodies, etc.
- Previous liver radiation (external beam radiation therapy (EBRT) or peptide receptor radionuclide therapy (PRRT)).
- Concurrent treatment for HCC or treatment in the last 4 weeks in another clinical study, unless it is an observational study (non-interventional) or during a non-interventional follow-up stage of an interventional study, or prior inclusion in this study
- Hepatic encephalopathy present at study entry and/or episodes of encephalopathy (Grade ≥ 2) within 6 months prior to study inclusion.
- HCC with infiltrative disease that is not evaluable by mRECIST.
- Pulmonary insufficiency (defined by an arterial oxygen pressure (PaO2) of <60 mmHg, or oxygen saturation (SaO2) of <90% (Roussos \& Koutsoukou, 2003) or clinically evident chronic obstructive pulmonary disease (COPD)).
- Medical history of radiation pneumonitis or recent pneumonitis, regardless of causality
- History of any organ allograft, including bone marrow allo and autograft.
- History of active primary/acquired immunodeficiency, that makes patients unsuitable for additional immunotherapy in this study (per investigator and as detailed in exclusion criterion #18).
- Active or prior documented autoimmune or inflammatory disorders (including but not limited to, inflammatory bowel disease [e.g. ulcerative colitis or Crohn's disease], systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc]). The following are exceptions to this criterion:
- Patients with vitiligo or alopecia
- Patients with hypothyroidism (e.g. following Hashimoto's syndrome) stable on hormone replacement therapy
- Any chronic skin condition that does not require systemic therapy.
- Patients without active disease in the last 5 years may be included but only after consultation with the Sponsor Study physician.
- Patients with celiac disease controlled by diet alone.
- Current or prior use of immunosuppressive medication within 14 days before the first dose of durvalumab. The following are exceptions to this criterion:
- Intranasal, inhaled, topical steroids, or local steroid injections (e.g. intra-articular injection)
- Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent.
- Steroids as premedication for hypersensitivity reactions (e.g. CT scan premedication).
- History of gastrointestinal bleeding within 42 days prior to study inclusion, active GI bleeding and any bleeding diathesis or coagulopathy that is not correctable by usual therapy or hemostatic agents (e.g. closure device). Patients with known varices that have not bled or which have been clinically addressed can enter the study. No endoscopic exploration is required before study inclusion.
- Presence of biliary stent or sphincterotomy within one year prior to study inclusion.
- History of malignancy, other than HCC, within three years, except the condition is one of the following:
- Adequately treated carcinoma in situ of the cervix, early squamous cell carcinoma or basal cell carcinoma of the skin, localized prostate cancer, breast ductal carcinoma in situ, or low-grade endometrial carcinoma with no myometrial invasion
- Localized prostate cancer under active surveillance.
- Other cancer when there is a negligible risk of recurrence or progression or death (5-year OS rate > 90%).
- Major surgical procedure (as defined by the Investigator) within 42 days prior to study inclusion.
- A history of severe allergy or intolerance to contrast agents, narcotics, sedatives or atropine that cannot be managed medically.
- Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients that cannot be managed medically.
- Active infection including tuberculosis (clinical evaluation that includes clinical history, physical examination and radiographic findings, and tuberculosis testing in line with local practice), HBV and HVC co-infection, HBV and Hep D co-infection, human immunodeficiency virus (HIV 1/2 antibodies) plus HCV or HBV co-infection.
- Receipt of live attenuated vaccine within 30 days prior to the first dose of durvalumab and/or tremelimumab. Note: patients, if enrolled, should not receive live vaccine whilst receiving durvalumab and/or tremelimumab and up to 30 days after the last dose of durvalumab and/or tremelimumab.
- Female patients who are pregnant or breastfeeding and who do not want to stop breastfeeding. Male or female patients of reproductive potential who are not willing to employ any effective birth control method from screening and for at least 90 days after TheraSphere administration, 90 days after the last dose of durvalumab, and 6 months after the last dose of tremelimumab.
- Unstable chronic disease or evidence of any disease or condition that would place the patient at undue risk and preclude safe use of TheraSphere, durvalumab and tremelimumab treatment as deemed by the site principal investigator.
- Patients who are not able to follow the TheraSphere, durvalumab or tremelimumab treatment requirements.
- For France Patients Only
- Persons deprived of their liberty by a judicial or administrative decision, persons subject to psychiatric care under articles L. 3212-1 and L. 3213-1 who are not covered by the provisions of Article L. 1121-8 and persons admitted to a health or social establishment for purposes other than research, including:
- Pregnant, parturient, breast-feeding women (see also inclusion criterion 16 and exclusion criterion 27)
- Minors (see also inclusion criterion 1)
- Persons receiving psychiatric treatment (see also exclusion criteria 28)
- Persons admitted to a health or social establishment for purposes other than research
- Person of full age under curatorship
- Adult subject to a mandate for future protection, a family authorization, or a guardianship measure
- Person not affiliated or not beneficiary of a social security scheme
Trial locations and contacts
35 sites in 5 countries.
35 sites in 5 countries
United States12 sites
Rush University Medical Center
Chicago, Illinois, 60612
University of Chicago Hospital
Chicago, Illinois, 60637
Mayo Clinic
Jacksonville, Florida, 32224
University of Minnesota
Minneapolis, Minnesota, 55455
Ochsner Clinic Foundation
New Orleans, Louisiana, 70121
Columbia University Irving Medical Center
New York, New York, 10032
Intermountain Health
Salt Lake City, Utah, 84157
University of California San Diego
San Diego, California, 92093
University of California San Francisco
San Francisco, California, 94143
Washington University (Barnes-Jewish Hospital)
St Louis, Missouri, 63101
Georgetown University
Washington D.C., District of Columbia, 20007
MedStar Washington Hospital Center
Washington D.C., District of Columbia, 20010
France10 sites
CHU de Bordeaux - Hôpital Haut-Lévêque
Clermont-Ferrand
Hôpital Beaujon
Clichy, Hauts De Seine, 92110
Chu Henri Mondor
Créteil, 94010
CHU Grenoble
Grenoble, Isere, 38043
Chru De Lille
Lille, 59037
CHU Montpellier
Montpellier, 34295
CHU Angers - Hôpital Hôtel Dieu
Nantes, 49033
CHU Nantes
Rennes, Cedex, 35042
CRLCC Eugene Marquis
Rennes
Hopital Paul Brousse
Villejuif, 94800
Spain8 sites
Hospital Clinic de Barcelona
Barcelona, Catalonia, 08036
Hospital Gregorio Maranon
Madrid
Hospital Universitario Virgen de las Nieves
Madrid
Hospital. Ramon Y Cajal
Madrid
Hospital Universitario Central de Asturias
Oviedo, Principality of Asturias, 33006
Clinica Universidad de Navarra
Pamplona, Navarre, 31008
Hospital Universitari
Valencia, 46026
Clinico de Valladolid
Valladolid, 47012
Italy3 sites
National Cancer Institute of Milan, Italy
Milan, 20133
IRCCS - Regina Elena Cancer Institute
Roma
Azienda Sanitaria Universitaria Integrata Friuli Centrale (ASU FC)
Udine
Switzerland2 sites
University Hospital of Bern
Bern, 3010
University Hospital Geneva (HUG)
Geneva, 1211
About this study
Official title: An Open-Label, Prospective, Multi-Center Clinical Trial to Evaluate the Efficacy and Safety of TheraSphere™ Followed by Durvalumab (Imfinzi®) With Tremelimumab (Imjudo®) for Hepatocellular Carcinoma (HCC)
The objective of the ROWAN clinical study is to assess the efficacy of local tumor control in HCC patients who receive TheraSphere followed by durvalumab and tremelimumab.
Read the detailed description
A global open-label, prospective, multi-center Phase II trial designed to assess the safety and efficacy of TheraSphere administered before initiation of Durvalumab with Tremelimumab in HCC patients who are not a candidate for resection, thermal ablation or liver transplant at the time of study entry.
- Conditions
- Hepatocellular Carcinoma
- Being tested
- TheraSphere Y-90 glass microsphere therapy, Durvalumab (Imfinzi) immunotherapy, Tremelimumab immunotherapy
- Keywords
- Carcinoma, Carcinoma, Hepatocellular, Neoplasms, Glandular and Epithelial, Neoplasms by Histologic Type, Neoplasms, Adenocarcinoma, Liver Neoplasms, Digestive System Neoplasms, Neoplasms by Site, Digestive System Diseases, Liver Diseases
- Medical subject headings
- Carcinoma, Hepatocellular, Carcinoma, Neoplasms, Glandular and Epithelial, Neoplasms by Histologic Type, Neoplasms, Adenocarcinoma, Liver Neoplasms, Digestive System Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TheraSphere Y-90 glass microsphere therapyDevice
TheraSphere Y-90 glass microsphere therapy administered through the hepatic artery at index procedure.
Durvalumab (Imfinzi) immunotherapyDrug
1500 mg, every 4 weeks that continues for a maximum duration of 18 months or until confirmed progression (by site assessment), unacceptable toxicity, study withdrawal, or study early termination by the sponsor. Treatment beyond confirmed radiographic progression is permitted per patient consent if the following criteria are met:
- Absence of clinical symptoms or signs indicating clinically significant disease progression
- No decline in performance status
- Absence of rapid disease progression or threat to vital organs or critical anatomical sites (i.e. new CNS metastasis, respiratory failure due to tumor compression, spinal cord compression) requiring urgent alternative medical intervention
- No other treatment discontinuation criteria are met
Tremelimumab immunotherapyDrug
300 mg, single administration
| Study group | Role | What they receive |
|---|---|---|
| TheraSphere followed by Durvalumab and Tremelimumab | Experimental | TheraSphere followed by Tremelimumab plus Durvalumab administered once, then repeated administration of Durvalumab monthly up 18 months. Receives: Device: TheraSphere Y-90 glass microsphere therapy; Drug: Durvalumab (Imfinzi) immunotherapy; Drug: Tremelimumab immunotherapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Objective Response Rate (ORR)
Complete response and partial response evaluated by mRECIST.
Measured: Start of Treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated)
Secondary outcomes (36)
Number of immune mediated AEs and SAEs.
Measured: Treatment Day 1 up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Number of patients whose durvalumab and/or tremelimumab treatment was temporarily halted, postponed or permanently discontinued due to an AE.
Measured: Treatment Day 1 up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in liver function tests (aspartate aminotransferase [AST], alanine aminotransferase [ALT], gamma-glutamyl transpeptidase [GGT], alkaline phosphatase [ALK], bilirubin, albumin).
Measured: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in Child-Pugh score.
Minimum value is 5 (better) and maximum value is 15 (worse).
Measured: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in Albumin Bilirubin (ALBI) score.
Minimum value is 1 (better) and maximum value is 3 (worse).
Measured: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in Eastern Cooperative Oncology Group (ECOG) score.
Minimum value is 0 (better) and maximum value is 5 (worse).
Measured: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
ORR according to localized mRECIST and RECIST 1.1.
Measured: Start of Treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is Treated ).
DoR according to mRECIST, localized mRECIST, and RECIST 1.1.
Measured: Time of response up to progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Disease Control Rate (DCR) according to localized mRECIST, mRECIST, RECIST 1.1.
Measured: Start of Treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is Treated).
Duration of disease control (DoDC) according to localized mRECIST, mRECIST, RECIST 1.1.
Measured: Time of disease control up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Time to best response (CR or PR) according to localized mRECIST, mRECIST, RECIST 1.1.
Measured: Start of Treatment (Day 1) up to best response (CR or PR), subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Complete response rate (CRR) according to localized mRECIST, mRECIST, RECIST 1.1.
Measured: Start of Treatment (Day 1) up to complete response, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Duration of complete response (DoCR) according to localized mRECIST, mRECIST, RECIST 1.1.
Measured: Time of complete response up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Hepatic time to progression (hTTP) according to mRECIST, RECIST 1.1.
Measured: Start of treatment (Day 1) up to hepatic progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Time to progression (TTP) according to localized mRECIST, mRECIST, RECIST 1.1.
Measured: Start of treatment (Day 1) up to progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Progression free survival (PFS) according to localized mRECIST, mRECIST, RECIST 1.1; this will include an evaluation of the PFS rate at 6, 12, 18 and 24 months.
Measured: Start of treatment (Day 1) up to progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Hepatic progression free survival (hPFS) by mRECIST, RECIST 1.1.
Measured: Start of treatment (Day 1) up to hepatic progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Overall survival (OS).
Measured: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Disease Specific Survival (DSS)
Measured: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Proportion of patients receiving subsequent treatment for HCC after study treatment, and type of HCC treatment received.
Measured: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Proportion of patients to undergo curative therapy (transplantation or resection).
Measured: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Time to subsequent HCC treatment (local or systemic therapy).
Measured: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Reason for starting subsequent HCC treatment.
Measured: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Alpha fetoprotein (AFP) response.
Measured: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in quality of life (QoL) by FACT-Hep.
Measured: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in QoL by EQ-5D.
Measured: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Pre-treatment volumes and absorbed doses to the following volumes of interest (VOIs) using 99mTc-MAA SPECT/CT imaging and Simplicit90Y dosimetry software will be determined.
Only tumor ≥3cm of longest diameter should be considered for dosimetry assessment.
- Tumoral VOIs i. All Tumor(s) ii. Target lesion(s) according to mRECIST b. Perfused Liver VOI c. Normal liver tissue VOIs i. Perfused normal tissue ii. Whole liver normal tissue
Measured: Baseline Visit
Post-treatment volumes and absorbed doses to the following volumes of interest (VOIs) using Y-90 PET imaging and Simplicit90Y dosimetry software will be determined.
Only tumor ≥3cm of longest diameter should be considered for dosimetry assessment.
- Tumoral VOIs i. All Tumor(s) ii. Target lesion(s) according to mRECIST b. Perfused Liver VOI c. Normal liver tissue VOIs i. Perfused normal tissue ii. Whole liver normal tissue
Measured: Treatment Visit
Correlation between tumoral absorbed doses in Gy, determined by 99mTc-MAA SPECT/CT, assessing impact on tumor response and, survival.
Measured: Start of treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Correlation between normal tissue absorbed doses in Gy, determined by 99mTc-MAA SPECT/CT, assessing impact on number of Grade 3 or higher AEs and SAEs.
Measured: Start of treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Correlation between tumoral absorbed doses in Gy, determined by Y-90 PET, assessing impact on tumor response and survival.
Measured: Start of treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Correlation between normal tissue absorbed doses in Gy, determined by Y-90 PET, assessing impact on number of Grade 3 or higher AEs and SAEs.
Measured: Start of treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Correlation between tumoral absorbed doses in Gy determined by 99mTc-MAA SPECT/CT and Y-90 PET.
Measured: Baseline up to post-treatment imaging visit.
Correlation between normal tissue absorbed doses in Gy determined by 99mTc-MAA SPECT/CT and by Y-90 PET.
Measured: Baseline up to post-treatment imaging visit.
Determination of dose volume histogram (DVH) for tumoral VOIs and normal liver tissue VOIs, using 99mTc-MAA SPECT/CT and Y-90 PET.
Measured: Baseline up to post-treatment imaging visit.
Whole liver and remnant liver volumes at baseline and follow-up imaging assessments measured using Simplicit90Y software.
Measured: Start of Treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Oct 2021
- Study start3 Nov 2023
- Primary completionJun 2027 (estimated)
- Study completionJun 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Hepatocellular CarcinomaStudies of the same condition, open and under way.
- More trials run by Boston Scientific CorporationThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Boston Scientific Corporation
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Biocompatibles UK Ltd
- Responsible party
- Sponsor
- Investigators
- Beau Toskich, MD, Principal investigator, Mayo ClinicAiwu Ruth He, MD PhD, Principal investigator, Georgetown University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05063565
- Sponsor's protocol ID
- S2472
- Acronym
- ROWAN
- Status last verified
- Oct 2026
- First submitted
- 1 Sep 2021
- Last updated
- 30 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- Yes
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 30 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Open-Label, Prospective, Multi-Center Clinical Trial to Evaluate the Efficacy and Safety of TheraSphere™ Followed by Durvalumab (Imfinzi®) With Tremelimumab (Imjudo®) for Hepatocellular Carcinoma (HCC)
- ClinicalTrials.gov ID
- NCT05063565
- Acronym / sponsor ID
- ROWAN / S2472
- Conditions
- Hepatocellular Carcinoma
- Keywords
- Carcinoma, Carcinoma, Hepatocellular, Neoplasms, Glandular and Epithelial, Neoplasms by Histologic Type, Neoplasms, Adenocarcinoma, Liver Neoplasms, Digestive System Neoplasms
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- Boston Scientific CorporationIndustry (pharma, biotech, devices)
- Collaborators
- Biocompatibles UK Ltd
- Study start
- 3 Nov 2023 (actual)
- Primary completion
- Jun 2027 (estimated)
- Study completion
- Jun 2027 (estimated)
- First posted
- 1 Oct 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The objective of the ROWAN clinical study is to assess the efficacy of local tumor control in HCC patients who receive TheraSphere followed by durvalumab and tremelimumab.
Detailed description
A global open-label, prospective, multi-center Phase II trial designed to assess the safety and efficacy of TheraSphere administered before initiation of Durvalumab with Tremelimumab in HCC patients who are not a candidate for resection, thermal ablation or liver transplant at the time of study entry.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| TheraSphere followed by Durvalumab and Tremelimumab | Experimental | Device: TheraSphere Y-90 glass microsphere therapy, Drug: Durvalumab (Imfinzi) immunotherapy, Drug: Tremelimumab immunotherapyTheraSphere followed by Tremelimumab plus Durvalumab administered once, then repeated administration of Durvalumab monthly up 18 months. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (33 listed)
- Participants must be aged ≥18 years at the time of screening.
- Written informed consent and any locally required authorization (e.g., Health Insurance Portability and accountability Act in the US, European Union (EU) data privacy regulations in the EU) obtained from the patient/legal representative prior to performing any protocol-related procedures, including screening evaluations.
- Life expectancy ≥6 months.
- HCC, diagnosed by radiographic imaging or histology.
- Patient not a candidate for liver resection, thermal ablation, or transplantation at the time of study entry.
Key exclusion criteria (52 listed)
- Any contraindication to angiography or selective visceral catheterization.
- Cone Beam CT (CBCT) or Technetium-99m macroaggregated Albumin (99mTc-MAA) hepatic arterial perfusion scintigraphy shows any deposition to the gastrointestinal tract that may not be corrected by angiographic techniques.
- 99mTc-MAA hepatic arterial perfusion scintigraphy shows poor tumor and/or portal vein thrombosis (PVT) targeting that would lead to a dose that does not meet the liver dosing criteria.
- Shunting of blood to the lungs that could result in delivery of >30 Gy to the lungs in a single treatment or >50 Gy cumulative dose to the lungs in case of multiple TheraSphere treatments, as seen on 99mTc-MAA hepatic arterial perfusion scintigraphy.
- Vp3, Vp4, hepatic vein invasion, or inferior vena cava (IVC) invasion
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TheraSphere Y-90 glass microsphere therapyTheraSphere Y-90 glass microsphere therapy administered through the hepatic artery at index procedure. | Device | TheraSphere followed by Durvalumab and Tremelimumab |
| Durvalumab (Imfinzi) immunotherapy1500 mg, every 4 weeks that continues for a maximum duration of 18 months or until confirmed progression (by site assessment), unacceptable toxicity, study withdrawal, or study early termination by the sponsor. Treatment beyond confirmed radiographic progression is permitted per patient consent if the following criteria are met: * Absence of clinical symptoms or signs indicating clinically significant disease progression * No decline in performance status * Absence of rapid disease progression or threat to vital organs or critical anatomical sites (i.e. new CNS metastasis, respiratory failure due to tumor compression, spinal cord compression) requiring urgent alternative medical intervention * No other treatment discontinuation criteria are met | Drug | TheraSphere followed by Durvalumab and Tremelimumab |
| Tremelimumab immunotherapy300 mg, single administration | Drug | TheraSphere followed by Durvalumab and Tremelimumab |
Primary outcome
Objective Response Rate (ORR)
Time frame: Start of Treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated)
Complete response and partial response evaluated by mRECIST.
36 secondary outcomes
Number of immune mediated AEs and SAEs.
Time frame: Treatment Day 1 up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Number of patients whose durvalumab and/or tremelimumab treatment was temporarily halted, postponed or permanently discontinued due to an AE.
Time frame: Treatment Day 1 up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in liver function tests (aspartate aminotransferase [AST], alanine aminotransferase [ALT], gamma-glutamyl transpeptidase [GGT], alkaline phosphatase [ALK], bilirubin, albumin).
Time frame: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in Child-Pugh score.
Time frame: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in Albumin Bilirubin (ALBI) score.
Time frame: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in Eastern Cooperative Oncology Group (ECOG) score.
Time frame: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
ORR according to localized mRECIST and RECIST 1.1.
Time frame: Start of Treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is Treated ).
DoR according to mRECIST, localized mRECIST, and RECIST 1.1.
Time frame: Time of response up to progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Disease Control Rate (DCR) according to localized mRECIST, mRECIST, RECIST 1.1.
Time frame: Start of Treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is Treated).
Duration of disease control (DoDC) according to localized mRECIST, mRECIST, RECIST 1.1.
Time frame: Time of disease control up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Time to best response (CR or PR) according to localized mRECIST, mRECIST, RECIST 1.1.
Time frame: Start of Treatment (Day 1) up to best response (CR or PR), subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Complete response rate (CRR) according to localized mRECIST, mRECIST, RECIST 1.1.
Time frame: Start of Treatment (Day 1) up to complete response, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Duration of complete response (DoCR) according to localized mRECIST, mRECIST, RECIST 1.1.
Time frame: Time of complete response up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Hepatic time to progression (hTTP) according to mRECIST, RECIST 1.1.
Time frame: Start of treatment (Day 1) up to hepatic progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Time to progression (TTP) according to localized mRECIST, mRECIST, RECIST 1.1.
Time frame: Start of treatment (Day 1) up to progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Progression free survival (PFS) according to localized mRECIST, mRECIST, RECIST 1.1; this will include an evaluation of the PFS rate at 6, 12, 18 and 24 months.
Time frame: Start of treatment (Day 1) up to progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Hepatic progression free survival (hPFS) by mRECIST, RECIST 1.1.
Time frame: Start of treatment (Day 1) up to hepatic progression, subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Overall survival (OS).
Time frame: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Disease Specific Survival (DSS)
Time frame: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Proportion of patients receiving subsequent treatment for HCC after study treatment, and type of HCC treatment received.
Time frame: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Proportion of patients to undergo curative therapy (transplantation or resection).
Time frame: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Time to subsequent HCC treatment (local or systemic therapy).
Time frame: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Reason for starting subsequent HCC treatment.
Time frame: Start of treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Alpha fetoprotein (AFP) response.
Time frame: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in quality of life (QoL) by FACT-Hep.
Time frame: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Change from baseline in QoL by EQ-5D.
Time frame: Baseline up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Pre-treatment volumes and absorbed doses to the following volumes of interest (VOIs) using 99mTc-MAA SPECT/CT imaging and Simplicit90Y dosimetry software will be determined.
Time frame: Baseline Visit
Post-treatment volumes and absorbed doses to the following volumes of interest (VOIs) using Y-90 PET imaging and Simplicit90Y dosimetry software will be determined.
Time frame: Treatment Visit
Correlation between tumoral absorbed doses in Gy, determined by 99mTc-MAA SPECT/CT, assessing impact on tumor response and, survival.
Time frame: Start of treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Correlation between normal tissue absorbed doses in Gy, determined by 99mTc-MAA SPECT/CT, assessing impact on number of Grade 3 or higher AEs and SAEs.
Time frame: Start of treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Correlation between tumoral absorbed doses in Gy, determined by Y-90 PET, assessing impact on tumor response and survival.
Time frame: Start of treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Correlation between normal tissue absorbed doses in Gy, determined by Y-90 PET, assessing impact on number of Grade 3 or higher AEs and SAEs.
Time frame: Start of treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Correlation between tumoral absorbed doses in Gy determined by 99mTc-MAA SPECT/CT and Y-90 PET.
Time frame: Baseline up to post-treatment imaging visit.
Correlation between normal tissue absorbed doses in Gy determined by 99mTc-MAA SPECT/CT and by Y-90 PET.
Time frame: Baseline up to post-treatment imaging visit.
Determination of dose volume histogram (DVH) for tumoral VOIs and normal liver tissue VOIs, using 99mTc-MAA SPECT/CT and Y-90 PET.
Time frame: Baseline up to post-treatment imaging visit.
Whole liver and remnant liver volumes at baseline and follow-up imaging assessments measured using Simplicit90Y software.
Time frame: Start of Treatment (Day 1) up to participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Oct 2026.
- Boston Scientific Website ROWAN Clinical Trial OverviewLink provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Beau Toskich, MD principal investigator
Mayo Clinic
Aiwu Ruth He, MD PhD principal investigator
Georgetown University
35 sites in 5 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing TheraSphere Y-90 glass microsphere therapy, Durvalumab (Imfinzi) immunotherapy and Tremelimumab immunotherapy in people with Hepatocellular Carcinoma, run by Boston Scientific Corporation at 35 sites in 5 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 33 inclusion and 52 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 30 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 35 sites in United States, France, Spain, Italy, Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Objective Response Rate (ORR) (time frame: Start of Treatment (Day 1) up to subsequent anti-cancer therapy, participant's death, opposition to data collection, lost to follow-up, or study termination (18 months after the last patient is treated)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Oct 2026.