Hepato Cellular Carcinoma (HCC)Phase 3NCT07461675
Effects of Neoadjuvant Immunotherapy on Anti-tumour Immunity in Hepatocellular Carcinoma Patients Undergoing Liver Resection
A Phase 3 study testing Atezolizumab in people with Hepato Cellular Carcinoma (HCC) and Immunotherapy, run by University of Geneva, Switzerland at 1 site in Switzerland.
Trial summary
Our study aims to evaluate the benefit of the administration of immunotherapy (atezolizumab), in patients with hepatocellular carcinoma (HCC), prior surgical resection of the tumor. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hepato Cellular Carcinoma (HCC), Immunotherapy
- What is being tested?
- Atezolizumab
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 siteSwitzerland
- Study dates
- 25 Mar 2026to 31 Dec 2029
- Phase
- Phase 3
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
- All adult patients undergoing liver resection for HCC at the Geneva University Hospitals (HUG), with prior informed and signed consent.
- Patients of childbearing age must be willing to use a contraception at the day of inclusion and for at least 5 months after the last infusion.
- Negative pregnancy test at inclusion
- Patients will require to be eligible for surgical resection according to the BCLC guidelines (very early to early stage with preserved liver function and good patient condition) (4).
- The control group will include data from the patients in our ongoing research project (study protocol 2023-02372), undergoing liver resection without prior ICI therapy (n = 30).
Who cannot join
- Patients who do not ultimately undergo liver resection due to unforeseen reasons (this happens rarely, such as in the presence of unexpected HCC progression discovered during surgery).
- Patients with an ongoing pregnancy (an unlikely event, as non-surgical HCC treatments would be prioritized in such cases).
- Patients unable to follow procedures due to language barriers, insufficient comprehension of project language, or unable to give consent.
- Patients <18 years.
- Patients with medical history of allergy or severe AEs to ICI therapy
- Pregnant and/or breastfeeding women. Lactating women should stop lactation or will be excluded from the study as breastfeeding under atezolizumab is not recommended. Furthermore, breastfeeding is not recommended for at least 5 months after the last dose.
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- Immunosuppressed patients and patients with haematological disorder leading to a deficient immunity
- Patients with hepatic and/or cardiovascular deficiencies that contra-indicate surgery. Compensated cirrhotic patients are expected and will be included in the study as no dosage modification of the atezolizumab is required for these patients.
- Patients who received a live or attenuated vaccine in the last 28 days before inclusion in the study.
- Patients with untreated Hepatitis B and/or C or HIV. HIV patients under treatment with normal CD4 counts can be included. Hepatitis B and/or C patients under antiviral therapies can be included.
- Patients with history of inflammatory pneumopathy, active brain metastasis and patients treated with a systemic immunotherapy in the last 6 months.
- Patients under steroid treatment during the inclusion will be excluded.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Switzerland1 site
Geneva University Hospitals
Geneva, 1205
Charles-Henri Wassmer, MD-PhD, +41786682206, charles-henri.wassmer@hug.ch
About this study
Our study aims to evaluate the benefit of the administration of immunotherapy (atezolizumab), in patients with hepatocellular carcinoma (HCC), prior surgical resection of the tumor.
HCC is the most prevalent primary liver cancer, responsible for nearly 800,000 deaths annually, making it the third leading cause of cancer-related mortality worldwide. Ablation by radiologic micro-waves or surgical resection represent at the moment the only curative therapies for early stages of the disease. Despite these curative options, HCC recurrence is frequent.
Recently, immunotherapy has demonstrated good results on patient overall survival for advanced stages of HCC in comparison to sorafenib. Because of the beneficial effect of immunotherapy on HCC, several groups have attempt to use it as adjuvant therapy in order to reduce the recurrence rate. However the results are at the moment controversial. One can hypothetize that postoperative inflammation and liver regeneration can negatively impact the effect of the immunotherapy. Therefore, the administration of the treatmeent before surgical resection could overcome this issue.
- Conditions
- Hepato Cellular Carcinoma (HCC), Immunotherapy
- Being tested
- Atezolizumab
- Keywords
- Neoadjuvant treatment, Hepatocellular carcinoma, atezolizumab, hepatectomy
- Medical subject headings
- Carcinoma, Hepatocellular
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AtezolizumabDrug
Patients will receive two doses of atzolizumab 6 and 3 weeks before surgery
| Study group | Role | What they receive |
|---|---|---|
| Treated group. Patients receiving immunotherapy before surgical resection of their HCC | Experimental | Not described Receives: Drug: Atezolizumab |
| Control group | No intervention | Patients undergoing surgical resection for HCC without any neoadjuvant treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Difference in frequency of flow cytometry-assessed HCC-specific CD8+ cells in the periphery (PBMC) between patients with vs without ICI therapy prior to liver surgery
We will assess the impact of ICI therapy on the frequency of HCC-specific CD8+ lymphocytes. The currently recruited patients will be compared to historical patients without ICI treatment. After flow cytometry sorting, bulk RNA sequencing of CD8+ cells will be performed. The SEQTR method will define the frequency of HCC-specific TCR.
Measured: Four years
Secondary outcomes (3)
Tumor microenvironment changes induced by ICI therapy
Especially changes in HCC-specific T cell response in the periphery after versus prior to surgery. TCR subtypes will be identified by TCR single cell sequencing in the peripheral blood and in the tumor. Additionnaly immune cell type population, their activation and suppression markers as well as the frequency of the subtypes will be assesed by flow cytometry (CD8, CD4, memory T cells, exhausted markers (PD-L1, TIM-3, LAG-2)).
Measured: four years
Overall survival and recurrence free survival
We will analyze the survival and recurrence rates in order to evaluate the impact or potential benefit of neoadjuvant atezolizumab
Measured: four years
Tumor burden
We will evaluate the impact of atezolizumab on the tumor burden such as the number and size of HCC nodules and compare it before the treatment and before surgery to evaluate the level of downstaging of the tumor that we can expect.
Measured: Four years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Mar 2026
- Study start25 Mar 2026 (estimated)
- Primary completion1 Jun 2029 (estimated)
- Study completion31 Dec 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Hepato Cellular Carcinoma (HCC)Studies of the same condition, open and under way.
- 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 3
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Geneva, Switzerland
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Christian Toso, University of Geneva, Switzerland
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07461675
- Sponsor's protocol ID
- HCCsurgICI2025
- Status last verified
- Mar 2026
- First submitted
- 24 Mar 2025
- Last updated
- 10 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No