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Intrahepatic CholangiocarcinomaPhase 2NCT06335927

HAIC Combined With Cadonilimab and Regorafenib as 2nd-line Treatment for ICC

A Phase 2 study testing HAIC-GEMOX+Cadonilimab+Regorafenib in people with Intrahepatic Cholangiocarcinoma, run by Fudan University 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 The sponsor has not verified this record for over two years, so it may be out of date.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

This study is a single-arm Phase II clinical trial aiming to evaluate the safety and efficacy of HAIC combined with Cadonilimab and Regorafenib as second-line treatment for unresectable intrahepatic cholangiocarcinoma. The study plans to enroll approximately 45 participants. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Intrahepatic Cholangiocarcinoma
What is being tested?
HAIC-GEMOX+Cadonilimab+Regorafenib
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
1 siteChina
Study dates
11 May 2023to 10 May 2026
Phase
Phase 2
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

  • To be eligible for enrollment in the study, participants must meet the following inclusion criteria:
  • Voluntarily provide written informed consent.
  • Age at enrollment is ≥18 years and ≤75 years, both males and females.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Expected survival period of ≥3 months.
  • Patients with histologically or cytologically confirmed unresectable intrahepatic cholangiocarcinoma. Patients who have failed standard treatment (standard treatment includes gemcitabine plus cisplatin plus pembrolizumab, gemcitabine plus gemcitabine plus oxaliplatin, capecitabine plus oxaliplatin, chemotherapy mainly based on albumin-bound paclitaxel, 5-fluorouracil (5-FU) plus platinum-based therapy) or are intolerant to standard treatment, or patients for whom standard treatment is not accessible. Note: Patients who have received adjuvant/neoadjuvant chemotherapy targeting non-metastatic disease with curative intent and experience disease progression within ≤6 months after the last treatment are eligible.
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  • At least one measurable lesion according to RECIST v1.1 that can be accurately measured repeatedly. Note: Brain metastases cannot be considered as target lesions.
  • Adequate organ function determined by the following requirements:
  • Hematology (no use of any blood components or growth factors within 7 days prior to starting the study treatment): i. Absolute Neutrophil Count (ANC) ≥ 1.5 × 109/L (1,500/mm3). ii. Platelet count ≥ 80 × 109/L (100,000/mm3). iii. Hemoglobin ≥ 90 g/L.
  • Kidney:
  • Serum creatinine ≤ 1.5 × Upper Limit of Normal (ULN). ii. Calculated creatinine clearance* (CrCl) ≥ 50 mL/min.
  • CrCl will be calculated using the Cockcroft-Gault formula (Cockcroft-Gault formula).
  • CrCl (mL/min) = {(140 - age) × body weight (kg) × F} / (SCr (mg/dL) × 72) For males, F = 1; for females, F = 0.85; SCr = serum creatinine. iii. Urine protein ≤ 1+ or 24-hour urinary protein quantification < 1.0 g. c) Liver: i. Total bilirubin (TBil) ≤ 3 × ULN. ii. AST and ALT ≤ 5 × ULN. iii. Serum albumin (ALB) ≥ 28 g/L. d) Coagulation function: i. International Normalized Ratio (INR) and Activated Partial Thromboplastin Time (APTT) ≤ 1.5 × ULN (unless the subject is receiving anticoagulant therapy and coagulation parameters [PT/INR and APTT] are within the expected range for anticoagulant treatment at screening).
  • Cardiac function: i. Left Ventricular Ejection Fraction (LVEF) ≥ 50%.
  • Female participants of childbearing potential must undergo urine or serum pregnancy testing within 3 days prior to the first dose of study medication (if the urine pregnancy test results cannot be confirmed as negative, a serum pregnancy test must be conducted, with the serum pregnancy test result being definitive). If female participants of childbearing potential engage in sexual activity with a nonsterilized male partner, they must use an acceptablemethod of contraception from the start of screening and agree to continue using contraception for up to 120 days after the last dose of the study medication. The decision to stop contraception after this time should be discussed with the investigator.
  • Male participants with a female partner of childbearing potential must use effective contraception from the start of screening until 120 days after the last dose of the study medication. The decision to stop contraception after this time should be discussed with the investigator.
  • Participants must be willing and able to comply with the scheduled visits, treatment plan, laboratory tests, and other study requirements.

Who cannot join

  • Subjects meeting any of the following criteria will be ineligible to participate in this study:
  • Diagnosis of malignant tumors with non-biliary cancers such as hepatocellular carcinoma, mixed-cell carcinoma, or fibrolamellar carcinoma.
  • History of other malignant tumors within the past 3 years, except for cured localized tumors (e.g., basal cell carcinoma, squamous cell carcinoma of the skin, superficial bladder cancer, cervical carcinoma in situ).
  • Concurrent participation in another clinical study unless it is an observational, non-interventional study or follow-up period of an interventional study.
  • Palliative local therapy performed on non-target lesions within 2 weeks prior to the first dose; non-specific immune modulating therapy (e.g., interleukins, interferons, thymosin, excluding IL-11 for thrombocytopenia) within 2 weeks prior to the first dose; use of traditional Chinese medicine or herbal remedies with anti-tumor indications within 1 week prior to the first dose.
  • Previous receipt of any immune anti-tumor therapy, including immune checkpoint stimulants (e.g., ICOS, CD40, CD137, GITR, OX40 antibodies), immune cell therapy.
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  • Previous receipt of targeted therapy.
  • Active autoimmune diseases requiring systemic treatment within the past two years (e.g., medications for disease improvement, corticosteroids, immunosuppressive therapy); replacement therapy (e.g., thyroid hormones, insulin, physiological corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered systemic treatment.
  • History of active or prior documented inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis, or chronic diarrhea).
  • History of immunodeficiency; positive HIV antibody test; current long-term use of systemic corticosteroids or other immunosuppressive agents.
  • Known active tuberculosis (TB) or suspected active TB requiring clinical evaluation; known active syphilis infection.
  • History of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation.
  • History of or current non-infectious pneumonitis/interstitial lung disease requiring systemic corticosteroid therapy.
  • Severe infection within 4 weeks prior to the first dose, including complications requiring hospitalization, sepsis, or severe pneumonia; active infection requiring systemic anti-infective treatment within 2 weeks prior to the first dose (excluding antiviral therapy for hepatitis B or C).
  • Subjects with active hepatitis B (positive HBsAg and HBV-DNA >1000 copies/mL [200 IU/mL] or above the lower limit of detection, whichever is higher). Note: Subjects with hepatitis B should receive antiviral therapy during the study treatment period.
  • Subjects with active hepatitis C (positive HCV antibody and HCV-RNA above the lower limit of detection).
  • Presence of obstructive jaundice (eligible if actively treated with biliary drainage or stenting and liver function has recovered).
  • Major surgery or significant traumatic injury within 30 days prior to the first dose, or planned major surgery within 30 days after the first dose (as determined by the investigator); minor surgical procedures within 3 days prior to the first dose (excluding placement of peripheral intravenous catheters and implantation of venous infusion ports).
  • Subjects with active central nervous system (CNS) metastases. Note: Subjects with previously treated brain metastases (e.g., surgery, radiotherapy) may be eligible if clinically stable for at least two weeks after treatment (from the start of study drug administration) and off corticosteroids for three days prior to study drug administration. Subjects with untreated, asymptomatic brain metastases (i.e., no neurological symptoms, no requirement for corticosteroids, and no brain metastases with a longest diameter >1.5 cm) may be eligible and should have regular assessments of brain metastases during the course of the study treatment.
  • Known brainstem, meningeal, spinal cord, or leptomeningeal metastases or compression.
  • Subjects with clinically significant symptoms or requiring repeated drainage of pleural effusion, pericardial effusion, or ascites.
  • Inability to swallow tablets, malabsorption syndrome, or any condition that could affect gastrointestinal absorption.
  • Current uncontrolled concurrent illness, including but not limited to decompensated cirrhosis, nephrotic syndrome, uncontrolled metabolic disorder, severe active peptic ulcer disease or gastritis, or any psychiatric/social condition that would limit compliance with study requirements or affect the subject's ability to provide written informed consent.
  • History of myocarditis, cardiomyopathy, malignant arrhythmia. Subjects with unstable angina, myocardial infarction, congestive heart failure (New York Heart Association functional class II or higher), or vascular disease with a risk of rupture requiring hospitalization within 12 months prior to the first dose of study drug, or other cardiac damage (e.g., poorly controlled arrhythmias, myocardial ischemia) that may affect the assessment of the safety of the study drug.
  • History within 6 months prior to the first dose of study drug of esophageal or gastric variceal bleeding, severe ulceration, unhealed wound, gastrointestinal perforation, fistula, intra-abdominal abscess, or acute gastrointestinal bleeding; any arterial thromboembolic event within 6 months prior to the first dose of study drug, grade 3 or higher venous thromboembolism according to NCI CTCAE version 5.0, transient ischemic attack, cerebrovascular accident, hypertensive crisis, or hypertensive encephalopathy; current hypertension with a systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥100 mmHg after oral antihypertensive therapy.
  • History of severe bleeding diathesis or coagulation disorder; clinically significant bleeding symptoms within 1 month prior to the first dose of study drug, including but not limited to gastrointestinal bleeding, bleeding gastric ulcer, hemoptysis (defined as coughing or spitting up ≥1 teaspoon of fresh blood or small clots or coughing blood without sputum, subjects with blood-tinged sputum are allowed), epistaxis (excluding nosebleeds and regurgitant epistaxis); subjects receiving continuous anticoagulant therapy within 10 days prior to the first dose of study drug.
  • Screening imaging showing tumor encasement or invasion of major blood vessels or organs (such as heart and pericardium, trachea, esophagus, aorta, superior vena cava, etc.) or presence of significant necrosis, cavitation, and the investigator determines that entry into the study would pose a risk of bleeding.
  • Previous unresolved toxicity from anticancer treatment, defined as toxicity not recovered to grade 0 or 1 according to NCI CTCAE version 5.0 or as specified in the inclusion/exclusion criteria, except for alopecia and residual neurotoxicity related to previous platinum-based treatment. Subjects with irreversible toxicity that is not expected to worsen with study drug administration (e.g., hearing loss) may be considered for inclusion in the study after consultation with the investigator. Subjects with late toxicities caused by radiotherapy that the investigator deems irrecoverable may be considered for inclusion in the study.
  • Administration of live vaccines within 30 days prior to the first dose or planned administration of live vaccines during the study is not allowed, but the use of inactivated vaccines is permitted.
  • Known allergies to any component of the investigational drug or a history of severe hypersensitivity reactions to other monoclonal antibodies.
  • Known history of mental illness, substance abuse, alcoholism, or drug addiction.
  • Pregnant or lactating women.
  • Previous or current presence of any condition, treatment, or laboratory abnormalities that may confound study results, affect the subject's full participation in the study, or be contrary to the subject's best interests.
  • Non-malignant diseases causing local or systemic symptoms or conditions secondary to the tumor, leading to higher medical risks and/or uncertainty in survival assessment, such as tumor-related leukemic reaction (white blood cell count >20 × 109/L), manifestations of cachexia (e.g., known weight loss exceeding 10% in the 3 months before screening), etc.

Trial locations and contacts

1 site in 1 country.

Lu Wang, M.D. contact

+8618121299357

w.lr@hotmail.com

Li Tan contact

+86 158 0068 0751

China1 site, 1 recruiting
  • Fudan University Shanghai Cancer Center

    Shanghai, Shanghai Municipality, 200032

    Li Tan, +8615800680751

    Recruiting

Other trials in China

About this study

Official title: Hepatic Arterial Infusion Chemotherapy Combined With Cadonilimab and Regorafenib as Second-line Treatment for Unresectable Intrahepatic Cholangiocarcinoma: a Single-arm, Phase II Study

This study is a single-arm Phase II clinical trial aiming to evaluate the safety and efficacy of HAIC combined with Cadonilimab and Regorafenib as second-line treatment for unresectable intrahepatic cholangiocarcinoma.

The study plans to enroll approximately 45 participants. All enrolled participants will receive continuous treatment: HAIC-Gemox: Gemcitabine 1000mg/m2 on Day 1 + Oxaliplatin 85mg/m2 on Day 1, every 3 weeks (Q3W), for up to 6 treatment cycles, Cadonilimab(6mg/kg, D2, Q3W) and Regorafenib (80mg QD, Q3W) until the investigator determines that there is no longer any clinical benefit (based on comprehensive assessment including RECIST v1.1 imaging evaluation and clinical condition), intolerable toxicity, initiation of new anti-tumor therapy, or meeting other criteria for treatment discontinuation, whichever occurs first.

Being tested
HAIC-GEMOX+Cadonilimab+Regorafenib
Keywords
HAIC, Cadonilimab, Regorafenib, Second-line, Intrahepatic Cholangiocarcinoma
Medical subject headings
Cholangiocarcinoma

What participants receive

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

  • HAIC-GEMOX+Cadonilimab+RegorafenibDrug

    HAIC-GEMOX: Gemcitabine 1000mg/m2 on Day 1 + Oxaliplatin 85mg/m2 on Day 1, every 3 weeks (Q3W), for up to 6 treatment cycles in combination with Cadonilimab (6mg/kg, D2, Q3W) and Regorafenib (80mg QD, Q3W)

Study groups in NCT06335927
Study groupRoleWhat they receive
HAIC-GEMOX+Cadonilimab+RegorafenibExperimentalHAIC-GEMOX: Gemcitabine 1000mg/m2 on Day 1 + Oxaliplatin 85mg/m2 on Day 1, every 3 weeks (Q3W), for up to 6 treatment cycles in combination with Cadonilimab (6mg/kg, D2, Q3W) and Regorafenib (80mg QD, Q3W)
Receives: Drug: HAIC-GEMOX+Cadonilimab+Regorafenib

What is being measured

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

  1. Objective Response Rate (ORR)

    Objective Response Rate (ORR), based on RECIST v1.1 assessment.

    Measured: 54 weeks

Secondary outcomes (7)
  1. Hepatic Objective Response Rate (hORR)

    Hepatic Objective Response Rate (hORR) based on RECIST v1.1 assessment.

    Measured: 54 weeks

  2. Duration of Response (DoR)

    Duration of Response (DoR) based on RECIST v1.1 assessment.

    Measured: 54 weeks

  3. Disease Control Rate (DCR)

    Disease Control Rate (DCR) based on RECIST v1.1 assessment.

    Measured: 54 weeks

  4. Time to Response (TTR)

    Time to Response (TTR) based on RECIST v1.1 assessment.

    Measured: 54 weeks

  5. Progression-Free Survival (PFS)

    Progression-Free Survival (PFS)

    Measured: 54 weeks

  6. Overall Survival (OS)

    Time from enrollment to death

    Measured: Up to approximately 5 years

  7. Safety and tolerability

    Incidence of Adverse Events and Treatment-Emergent Adverse Events

    Measured: 54 weeks

Timeline

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

  1. First posted28 Mar 2024
  2. Study start11 May 2023
  3. Primary completion10 May 2025 (estimated)
  4. Study completion10 May 2026 (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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
45 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06335927
Sponsor's protocol ID
GWK2023-001
Status last verified
Mar 2024
First submitted
22 Mar 2024
Last updated
28 Mar 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Blair AB, Alobuia WM, Palta M, Raman SS, Levine MH, Benson AB 3rd, D'Angelica MI, Cloyd JM. Locoregional Treatment Options for Locally Advanced Intrahepatic Cholangiocarcinoma. J Natl Compr Canc Netw. 2025 Aug 14;23(9):e257085. doi: 10.6004/jnccn.2025.7085.

    PubMed 40812353

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing HAIC-GEMOX+Cadonilimab+Regorafenib in people with Intrahepatic Cholangiocarcinoma, run by Fudan University 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 17 inclusion and 34 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 28 Mar 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 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?

Results are not available in the source record.

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

Contact Lu Wang, M.D. (+8618121299357, w.lr@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective Response Rate (ORR) (time frame: 54 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06335927, which also lists 1 linked publication.

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 28 Mar 2024.

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