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Hepatocellular CarcinomaPhase 1NCT05803928

Ablation in Combination With Lenvatinib and Anti-PD-1 Antibodies

A Phase 1 study testing lenvatinib + anti-PD-1 antibodies and ablation in people with Hepatocellular Carcinoma, run by Hua Li at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Lenvatinib is an oral multi-target receptor tyrosine kinase inhibitor (TKI) inhibitor that mainly inhibits the Endothelial growth factor receptor (VEGFR) VEGFR-1,2,3; Fibroblast growth factor receptor, FGFR) FGFR-1,2,3,4; Platelet-derived growth factor receptor (PDGFR) PDGFRα; The kinases RET and KIT, thereby… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Hepatocellular Carcinoma
What is being tested?
lenvatinib + anti-PD-1 antibodies and ablation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
70 participants
Where
1 siteChina
Study dates
1 Jan 2024to 1 Apr 2025
Phase
Phase 1
Are there results?
None posted in the registry

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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 years old, ≤75 years old, gender unlimited;
  • primary hepatocellular carcinoma proved pathologically and clinically;
  • 2 months after radical resection or ablation, imaging examination (MRI, CT plain enhanced) showed no tumor lesions, HCC recurred within 3 years after surgery, no extrahepatic metastasis;
  • ECOG score 0-1;
  • Recurrent liver cancer meets the Milan criteria: single tumor diameter ≤5cm or multiple tumors less than 3 with a maximum diameter ≤3cm, no major vascular invasion, no lymph node metastasis or extrahepatic metastasis;
  • Child-Pugh liver function grades: A, B;
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  • Expected survival > 6 months;
  • Adequate organ function: ① no need for growth factors and blood components within 2 weeks prior to enrollment; (2) Cardiac function: no heart disease, coronary heart disease, cardiac function level 1-2; ③ In the first 7 days of enrollment, liver and kidney function was adequate and laboratory indicators were suitable (untreated) : HGB≧9.0g/dl, neutrophils ≧1,500/mm3, PLT≧50x109/L, serum ALB≧28g/L, TBIL<2mg /dL, ALT, AST< 5 times of the upper limit of normal value, Bun, Cr< 1.5 times of the upper limit of normal value, INR<1.7 or extended PT<3s;
  • Patients with normal blood pressure or hypertension should use antihypertensive drugs to control blood pressure within the normal range;
  • Diabetic patients should control fasting blood glucose ≤8mmol/L by hypoglycemic drugs;
  • No other serious diseases (such as autoimmune diseases, immune deficiency, organ transplantation, etc.) that conflict with the Plan;
  • No history of other malignant tumors;
  • Women of childbearing age must have a negative blood pregnancy test within seven days, and subjects of childbearing age must use appropriate contraception during the test and for six months after the test;
  • The patient agrees to participate in the clinical study and sign the Informed Consent.

Who cannot join

  • (1) previous radiotherapy, hormone therapy or molecular targeted therapy; (2) Patients with distant metastasis confirmed by imaging; (3) The subject has had or co-has other malignancies (other than cured basal cell carcinoma of the skin and carcinoma in situ of the cervix); (4) The subject is known to be allergic to macromolecular protein preparations, or to any component of anti-PD-1 antibodies; (5) Subject has any history of active autoimmune disease or autoimmune disease (e.g., but not limited to: autoimmune hepatitis, interstitial pneumonia, uveitis, enteritis, hepatitis, pituitaritis, vasculitis, nephritis, hyperthyroidism, hypothyroidism; Subjects with childhood leukoplectic disease or complete remission of asthma can be incorporated into adults without any intervention; Subjects requiring medical intervention with bronchodilators are not included; (6) Subjects were taking immunosuppressants, or systemic or absorbable topical hormone therapy for immunosuppressive purposes (doses >10mg/ day of prednisone or other therapeutic hormones) and were still taking them within 2 weeks prior to enrollment; (7) Clinical symptoms of heart disease or disease not well controlled, such as: heart failure of grade 2 or above A.N. B. Unstable angina pectoris; C. Myocardial infarction within 1 year; D. Patients with clinically significant supraventricular or ventricular arrhythmias requiring treatment or intervention; (8) Abnormal coagulation function (PT>16s, APTT>43s, TT>21s, Fbg>2g/L), bleeding tendency or receiving thrombolytic or anticoagulant therapy; (9) The patient has current (within 3 months) gastrointestinal conditions such as esophageal varices, active gastric and duodenal ulcers, ulcerative colitis, portal hypertension, or active bleeding from unexcised tumors, or other conditions identified by the investigator as likely to cause gastrointestinal bleeding and perforation; (10) Previous or current severe bleeding (bleeding >30 ml within 3 months), hemoptysis (fresh blood >5 ml within 4 weeks), or thromboembolic events (including stroke events and/or transient brain dysfunction) within 12 months; (11) Previous and current patients with objective evidence of pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, radiation pneumonia, drug-induced pneumonia, severe impairment of lung function, etc.; (12) of congenital or acquired immune deficiency, such as HIV infection, active hepatitis (transaminase does not meet the criteria for the hepatitis b reference: HBV DNA of 10 or higher ⁴ / ml; Hepatitis C reference: HCV RNA≥103/ml); Chronic hepatitis B virus carriers with HBV DNA<2000 IU/ml (<104 copies /ml) must also receive antiviral therapy during the trial to be enrolled; (13) Subjects are participating in other clinical studies or less than one month has passed since the end of the previous clinical study; Subjects may receive other systemic antitumor therapies during the study; (14) The subject is known to have a history of psychotropic, alcohol, or drug abuse; (15) Imaging examination confirmed tumor recurrence or metastasis 2 months after surgery; (16) The researcher believes that it should be excluded from this study. For example, in the researchers' judgment, the subjects had other factors that might have led to the study's termination, such as other serious medical conditions (including mental illness) requiring combination treatment. Serious laboratory abnormalities, accompanied by family or social factors, may affect the safety of the subject or the collection of data and samples.

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • Third Affiliated Hospital, Sun Yat-Sen University

    Guangzhou, Guangdong, 510000

    Haoyuan Yu, 13724028868, Alexanderyhy@hotmail.com

    Linsen Ye, 18520788663, ye_linsen@163.com

    Recruiting

Other trials in China

About this study

Official title: Ablation in Combination With Lenvatinib and Anti-PD-1 Antibodies in Patients With Early Recurrence After Radical Resection/Ablation of HCC: a Prospective, Randomized, Controlled Clinical Study

Lenvatinib is an oral multi-target receptor tyrosine kinase inhibitor (TKI) inhibitor that mainly inhibits the Endothelial growth factor receptor (VEGFR) VEGFR-1,2,3; Fibroblast growth factor receptor, FGFR) FGFR-1,2,3,4; Platelet-derived growth factor receptor (PDGFR) PDGFRα; The kinases RET and KIT, thereby inhibiting tumor cell proliferation, inducing apoptosis, and playing an anti-angiogenic role, have been approved by the FDA and CFDA as first-line treatment for patients with advanced liver cancer. lenvatinib showed longer disease progression than sorafenib (8.9 months vs. sorafenib. 3.7 months), longer progression-free survival (7.4 months vs. 3.7 months), and higher disease control rates (24.1% vs. 9.2%). Therefore, lenvatinib has obvious advantages in HCC treatment because of its strong anti-angiogenic and anti-tumor growth effects.

Cindilimab is a human immunoglobulin G4 (IgG4) monoclonal antibody that specifically binds to PD-1 molecules on the surface of T cells, thereby blocking the programmed death receptor-1 (PD-1)/programmed death receptor-1 ligand (PD-L1) pathway induced by tumor immune tolerance, and reactivating the antitumor activity of lymphocytes.

In summary, recurrence after radical treatment of liver cancer is an urgent clinical problem. Recurrent HCC treatment represented by resection, ablation and TACE is difficult to achieve more satisfactory efficacy. The main ablative techniques includes radiofrequency ablation, microwave ablation and cryoablation.As a local treatment for liver cancer, ablation has the risk of incomplete ablation and insufficient ablation margin, and because RFA cannot resolve micrometastases, tumor growth, invasion and metastasis occur. Therefore, ablation combined with lenvatinib and immune checkpoint inhibitors have theoretical complementary advantages, and this study intends to compare the clinical efficacy and safety of ablation combined with lenvatinib plus anti-PD-1 antibodies in the treatment of patients with early recurrent liver cancer compared with ablation alone.

Being tested
lenvatinib + anti-PD-1 antibodies, ablation
Medical subject headings
Carcinoma, Hepatocellular

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • lenvatinib + anti-PD-1 antibodiesDrug

    A ablation treatment group B ablation+ lenvatinib + anti-PD-1 antibodies treatment group

  • ablationProcedure or surgery

    radiofrequency ablation or microwave ablation

Study groups in NCT05803928
Study groupRoleWhat they receive
Ablation + Lenvatinib +anti-PD-1 AntibodiesExperimentalExperimental: ablation + lenvatinib +anti-PD-1 antibodies ablation: ultrasound-guided percutaneous ablation for recurrent hepatocellular carcinoma. After local anesthesia and intravenous sedation, the unipolar needle was gradually inserted into the lesion and placed at the deepest edge of the lesion. Ablation electrodes are unipolar needles with bare ends of 2 or 3cm (depending on tumor size). Lenvatinib: (TBILI<2 times the upper limit of normal) about 3 to 7 days after treatment. The dosage and usage of the regimen were 8mg qd po (body weight < 60kg) or 12mg qd po (body weight ≥60kg). Anti-PD-1 Antibodies: About 3 to 7 days after radiofrequency ablation, (TBILI<2 times the upper limit of normal). The dosage was used accordingt to the drug instructions., every 3 weeks for a course of treatment. The longest course of treatment is 6 months.
Receives: Drug: lenvatinib + anti-PD-1 antibodies; Procedure: ablation
AblationActive comparatorExperimental group: ablation Ablation: ultrasound-guided percutaneous ablation for recurrent hepatocellular carcinoma. After local anesthesia and intravenous sedation, the unipolar needle was gradually inserted into the lesion and placed at the deepest edge of the lesion. Ablation electrodes are unipolar needles with bare ends of 2 or 3cm (depending on tumor size). The ablation power is 150W (range from 100 to 200W). In general, the average ablation time per lesion is about 12 minutes (ranging from 10 to 15 minutes).
Receives: Procedure: ablation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Recurrence-free Survival, RFS

    Defined as the percentage of patients who had achieved 1 year of disease recurrence (i.e., intrahepatic recurrence or extrahepatic metastasis) or death (from any cause) from the date of enrollment, whichever occurred first.

    Measured: 1 year

Secondary outcomes (6)
  1. Recurrence free survival (RFS) at 2 years

    Defined as the percentage of patients with no disease recurrence (i.e., intrahepatic recurrence or extrahepatic metastasis) or death (from any cause) for 2 years from the date of enrollment.

    Measured: 2 years

  2. Recurrence free survival (RFS) at 3 years

    Defined as the percentage of patients with no disease recurrence (i.e., intrahepatic recurrence or extrahepatic metastasis) or death (from any cause) for 3 years from the date of enrollment.

    Measured: 3 years

  3. Safety: Incidence of adverse events

    Incidence of adverse events, severe AES, death, and laboratory abnormalities in treated patients.

    Measured: 18 months

  4. Overall Survival (OS)

    Overall Survival (OS): defined as the time from randomization to death from any cause throughout the trial. Patients who drop out or are lost to follow-up will be treated as deleted, with the last known date of survival as the last time of survival. Patients still alive at the end of the study will also be treated as deleted, with the last known date of survival as the last survival time.

    Measured: 18 months

  5. Recurrence free Survival (RFS)

    Recurrence free Survival (RFS): defined as the time between recurrence of tumor or death (from any cause) after recurrence of HCC.

    Measured: 18 months

  6. Biomarkers in tumors and peripheral blood

    Biomarkers in tumor and peripheral blood such as AFP, CEA, CA199, CA125, RBC, Alb

    Measured: 18 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Apr 2023
  2. Study start1 Jan 2024
  3. Primary completion1 Nov 2024 (estimated)
  4. Study completion1 Apr 2025 (estimated)

Resources

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 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
70 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05803928
Sponsor's protocol ID
[2023]02-116-16
Status last verified
Jul 2024
First submitted
22 Mar 2023
Last updated
24 Jul 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing lenvatinib + anti-PD-1 antibodies and ablation in people with Hepatocellular Carcinoma, run by Hua Li at 1 site in China.

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 14 inclusion and 1 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: status not confirmed, as of the sponsor's last update on 24 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Hua Li (13060975202, lihua100@yeah.net), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Recurrence-free Survival, RFS (time frame: 1 year). 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 24 Jul 2024.

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