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Hepatocellular Carcinoma (HCC)Phase 2CONV3RSIONNCT07483359

Conversion Therapy With FOLFOX-HAIC Plus Lenvatinib And Tislelizumab For Hepatocellular Carcinoma With Vp3 Portal Vein Tumor Thrombus

A Phase 2 study testing HAIC + Tislelizumab +lenvatinib in people with Hepatocellular Carcinoma (HCC) and Portal Vein Tumor Thrombus, run by First Hospital of China Medical University at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Patients with hepatocellular carcinoma (HCC) complicated by Vp3 portal vein tumor thrombus (PVTT) face a poor prognosis and are typically ineligible for surgical resection. This prospective study evaluates a conversion therapy regimen-utilizing a combination of FOLFOX-HAIC, Lenvatinib, and Tislelizumab-designed to… Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
HAIC + Tislelizumab +lenvatinib
Could I receive a placebo?
No, everyone receives an active treatment
How many people
38 participants
Where
1 siteChina
Study dates
20 May 2026to May 2028
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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participants must meet all of the following inclusion criteria to be enrolled in this trial:
  • Voluntarily sign the written informed consent form.
  • Age 18 to 80 years (inclusive), male or female.
  • Histologically or cytologically confirmed Hepatocellular Carcinoma (HCC) according to the "Clinical Practice Guideline for Primary Liver Cancer (2024 Edition)," and evaluated by a Multi-Disciplinary Team (MDT) as initially unresectable.
  • No prior systemic anti-tumor therapy (including targeted therapy, immunotherapy, and systemic chemotherapy).
  • Barcelona Clinic Liver Cancer (BCLC) stage C and China Liver Cancer (CNLC) stage IIIa, complicated with imaging-confirmed Vp3 portal vein tumor thrombus (PVTT, defined as tumor thrombus invading the first-order branches of the portal vein but not the main trunk).
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  • At least one measurable target lesion according to RECIST v1.1 criteria.
  • Expected survival time of ≥ 3 months.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 0 or 1.
  • Child-Pugh liver function class A or B (score ≤ 7).
  • Adequate major organ function, meeting the following baseline laboratory criteria:
  • Hematology: Hemoglobin ≥ 90 g/L; Absolute Neutrophil Count (ANC) ≥ 1.5 x 10^9/L; Platelet count ≥ 75 x 10^9/L.
  • Biochemistry: Albumin ≥ 28 g/L; Total Bilirubin ≤ 3 x Upper Limit of Normal (ULN); AST and ALT ≤ 5 x ULN; Alkaline Phosphatase (ALP) ≤ 5 x ULN; Serum Creatinine ≤ 1.5 x ULN.
  • Coagulation: INR or Prothrombin Time (PT) ≤ 1.5 x ULN; Activated Partial Thromboplastin Time (APTT) ≤ 1.5 x ULN.
  • Women of childbearing potential must have a negative serum or urine pregnancy test within 72 hours prior to enrollment, must not be breastfeeding, and must agree to use highly effective contraception during the study treatment and for at least 6 months after the last dose.
  • Good compliance and willingness to cooperate with all study-related follow-up procedures.
  • Assessed by the MDT as "Potentially Resectable" according to the "Chinese expert consensus on conversion and perioperative therapy of primary liver cancer (2024 edition)". This is defined as participants who are temporarily unsuitable for upfront surgical resection due to oncological factors (e.g., Vp3 PVTT indicating a high risk of early post-operative recurrence) or technical factors (e.g., massive tumor size leading to insufficient future liver remnant [FLR]), but who are expected to convert to an R0 resection and achieve significant clinical benefit following downstaging with the combination of FOLFOX-HAIC and systemic therapy.

Who cannot join

  • Participants who meet any of the following criteria will be excluded from the study:
  • History of other active malignancies within 5 years (except for adequately treated basal cell carcinoma of the skin or papillary thyroid cancer).
  • Evidence of extrahepatic metastasis confirmed by chest, abdomen, and pelvis CT and/or MRI scans.
  • Presence of clinically significant ascites.
  • History of hepatic encephalopathy.
  • History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on chest CT scan at screening.
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  • Severe infection within 4 weeks prior to enrollment, including but not limited to hospitalization due to infectious complications, bacteremia, or severe pneumonia.
  • History of hypertensive crisis; or major cardiovascular disease within 3 months prior to starting study treatment (e.g., New York Heart Association [NYHA] Class II or worse heart failure, myocardial infarction, cerebrovascular accident, unstable arrhythmia, or unstable angina).
  • Inadequately controlled arterial hypertension, defined as systolic blood pressure (BP) ≥ 150 mmHg and/or diastolic BP > 100 mmHg (based on an average of ≥ 3 BP readings obtained from ≥ 2 measurements). Achieving these parameters through the use of antihypertensive therapy is permitted.
  • Severe vascular disease within 6 months (e.g., aortic aneurysm requiring surgical repair or peripheral arterial thrombosis); or a current or recent history of active autoimmune disease or immunodeficiency (including but not limited to myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, antiphospholipid syndrome, Wegener's granulomatosis, Sjögren's syndrome, Guillain-Barré syndrome, or multiple sclerosis).
  • Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding that contraindicates the use of the investigational drugs, may affect the interpretation of the results, or may place the patient at high risk for treatment-related complications.
  • Use of systemic immunosuppressive medications within 2 weeks prior to the first dose of study treatment, or the expected need for long-term systemic immunosuppressive therapy during the study. Exceptions permitting the use of corticosteroids include: (1) prophylactic use to prevent allergic reactions to imaging contrast media (e.g., short-term dexamethasone); (2) topical, ophthalmic, intra-articular, otic, or inhaled corticosteroids with minimal systemic absorption; (3) physiological replacement doses of systemic corticosteroids (defined as ≤ 10 mg/day of prednisone or an equivalent corticosteroid).
  • Evidence of bleeding diathesis or severe coagulopathy.
  • Patients preparing to undergo, or who have previously received, a solid organ or allogeneic bone marrow transplant.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Haibo Shao, MD, PhD contact

+8613840150051

hbshao@cmu.edu.cn

Jiaxi Liu, MD contact

+8618940279150

dmuvictor@163.com

China1 site, 1 recruiting
  • The First Hospital of China Medical University

    Shenyang, Liaoning, 110000

    Haibo Shao, MD, PhD, +8613840150051, hbshao@cmu.edu.cn

    Jiaxi Liu, MD, +8618940279150, dmuvictor@163.com

    Recruiting

Other trials in China

About this study

Official title: Conversion Therapy With FOLFOX-HAIC Plus Lenvatinib and Tislelizumab for Hepatocellular Carcinoma With Vp3 Portal Vein Tumor Thrombus: A Prospective, Multicenter, Single-arm Study

Patients with hepatocellular carcinoma (HCC) complicated by Vp3 portal vein tumor thrombus (PVTT) face a poor prognosis and are typically ineligible for surgical resection. This prospective study evaluates a conversion therapy regimen-utilizing a combination of FOLFOX-HAIC, Lenvatinib, and Tislelizumab-designed to induce significant regression of both the tumor burden and the PVTT. The primary objective is to determine the Technical Resectability Rate (TRR), assessing the potential for this triple-combination therapy to downstage initially unresectable disease to a state suitable for curative-intent R0 surgical resection.

Read the detailed description

This prospective, multicenter, single-arm clinical trial evaluates the efficacy and safety of a triple-combination conversion therapy for patients with initially unresectable hepatocellular carcinoma (HCC) complicated by Vp3 portal vein tumor thrombus (PVTT). The study aims to enroll 38 participants to assess the technical resectability rate (TRR) as the primary endpoint. Participants undergo a 21-day treatment cycle consisting regimens of intravenous Tislelizumab, FOLFOX-based hepatic arterial infusion chemotherapy (HAIC), while receiving daily oral Lenvatinib. This combination is designed to leverage the synergistic effects of high-concentration local chemotherapy and systemic targeted-immunotherapy to induce significant regression of both the tumor burden and the PVTT.

The clinical pathway centers on regular response evaluations conducted every two cycles using multimodal radiological imaging. During these intervals, a dual-evaluation mechanism is employed: a Multi-Disciplinary Team (MDT) reviews the clinical and radiological data to guide real-time surgical decision-making, while a Blinded Independent Review Committee (IRC) independently evaluates the scans to formally determine the primary endpoint of technical resectability. This assessment focuses on anatomical feasibility for R0 resection, the adequacy of the future liver remnant, and the successful downstaging of the PVTT. Patients meeting the clinical conversion criteria proceed to curative-intent surgical intervention, followed by a pathological complete response (pCR) assessment.

For participants who remain technically unresectable but continue to demonstrate clinical benefit, the HAIC intervention is limited to a maximum of six cycles. In these cases, systemic targeted and immunotherapy are maintained until disease progression, intolerable toxicity, or a maximum treatment duration of 24 months. The study officially concludes upon the earliest occurrence of either: the completion of the protocol-defined one-year overall survival follow-up for the final enrolled participant (including the achievement of the pre-specified data cutoff), or the point at which all surviving participants have experienced definitive disease progression or death and further data collection is no longer required.

Being tested
HAIC + Tislelizumab +lenvatinib
Keywords
Conversion Therapy, Hepatic Arterial Infusion Chemotherapy, Tislelizumab, Lenvatinib, Vp3 Portal Vein Tumor Thrombus
Medical subject headings
Carcinoma, Hepatocellular

What participants receive

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

  • HAIC + Tislelizumab +lenvatinibCombination product

    Tislelizumab: 200 mg administered intravenously each 21-day cycle.

    FOLFOX-HAIC: Administered every 21 days for up to a maximum of 6 cycles. The regimen consists of Oxaliplatin 85 mg/m², Leucovorin 400 mg/m², and 5-Fluorouracil 2500 mg/m² given as a continuous hepatic arterial infusion over 46-48 hours.

    Lenvatinib: Administered orally once daily on a continuous basis. Dosing is weight-adjusted: 12 mg/day for patients weighing ≥60 kg, and 8 mg/day for patients weighing <60 kg.

Study groups in NCT07483359
Study groupRoleWhat they receive
HAIC plus lenvatinib and tislelizumabExperimentalParticipants receive a 21-day cycle consisting of intravenous immunotherapy (Tislelizumab), local hepatic arterial infusion chemotherapy (FOLFOX-HAIC), and daily oral targeted therapy (Lenvatinib).
Receives: Combination Product: HAIC + Tislelizumab +lenvatinib

What is being measured

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

  1. Technical Resectability Rate (TRR)

    The percentage of participants whose disease converts from initially unresectable to technically resectable, as evaluated by a Blinded Independent Review Committee (IRC) based on multimodal radiological imaging. The criteria for successful conversion include the anatomical feasibility of achieving an R0 resection, the adequacy of the future liver remnant (FLR), and the successful downstaging of the Vp3 portal vein tumor thrombus (PVTT).

    Measured: Up to approximately 2 years.

Secondary outcomes (11)
  1. 1-Year Overall Survival (OS) Rate

    The percentage of participants who remain alive at 12 months from the date of the first dose of study treatment.

    Measured: 12 months from the first dose of study treatment.

  2. Progression-Free Survival (PFS) per RECIST v1.1

    Time from the first dose of study treatment to the first documented objective disease progression, as assessed by the IRC using RECIST v1.1 criteria, or death from any cause, whichever occurs first.

    Measured: Up to approximately 2 years.

  3. Progression-Free Survival (PFS) per mRECIST

    Time from the first dose of study treatment to the first documented objective disease progression, as assessed by the IRC using modified RECIST (mRECIST) criteria for hepatocellular carcinoma, or death from any cause, whichever occurs first.

    Measured: Up to approximately 2 years.

  4. Time to Progression (TTP) per RECIST v1.1

    Time from the first dose of study treatment to the first documented objective disease progression, as assessed by the IRC using RECIST v1.1 criteria.

    Measured: Up to approximately 2 years.

  5. Time to Progression (TTP) per mRECIST

    Time from the first dose of study treatment to the first documented objective disease progression, as assessed by the IRC using modified RECIST (mRECIST) criteria for hepatocellular carcinoma.

    Measured: Up to approximately 2 years.

  6. Objective Response Rate (ORR) per RECIST v1.1

    The percentage of participants who achieve a confirmed Complete Response (CR) or Partial Response (PR), as assessed by the Blinded Independent Review Committee (IRC) using RECIST v1.1 criteria. To be considered a confirmed response, the CR or PR must be maintained and verified by a subsequent radiological assessment conducted at least 4 weeks (28 days) after the initial response criteria are met.

    Measured: Up to approximately 2 years.

  7. Objective Response Rate (ORR) per mRECIST

    The percentage of participants who achieve a confirmed Complete Response (CR) or Partial Response (PR), as assessed by the Blinded Independent Review Committee (IRC) using modified RECIST (mRECIST) criteria, which specifically evaluates viable (arterially enhancing) tumor tissue. To be considered a confirmed response, the CR or PR must be maintained and verified by a subsequent radiological assessment conducted at least 4 weeks (28 days) after the initial response criteria are met.

    Measured: Up to approximately 2 years.

  8. Portal Vein Tumor Thrombus (PVTT) Response Rate

    The percentage of participants in the Intent-to-Treat (ITT) population who achieve an objective response in the portal vein tumor thrombus. This is defined as either a PVTT Complete Response (PVTT-CR; complete disappearance of the thrombus with vascular recanalization) or a PVTT Partial Response (PVTT-PR; a downgrade in the Vp classification, such as from Vp3 to Vp2 or Vp1), as evaluated by the IRC using multimodal radiological imaging.

    Measured: Up to approximately 2 years.

  9. Actual Resection Rate (ARR)

    The percentage of participants in the Intent-to-Treat (ITT) population who actually undergo and successfully complete a curative-intent R0 surgical resection following the study treatment.

    Measured: Up to approximately 2 years.

  10. Pathological Complete Response (pCR) Rate

    The percentage of participants undergoing surgical resection who achieve a pathological complete response (pCR). This is defined as the complete absence of any residual viable tumor cells in both the primary hepatic lesion and the resected portal vein tumor thrombus (PVTT), as confirmed by post-operative histopathological examination of the resected specimens.

    Measured: Up to approximately 2 years.

  11. Incidence and Severity of Adverse Events (AEs)

    The number of participants experiencing Adverse Events (AEs) and Serious Adverse Events (SAEs) will be recorded. The severity of all AEs will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0. Special attention will be given to tracking adverse events of special interest (AESIs), including HAIC-related complications and immune-related adverse events (irAEs).

    Measured: Through 30 days after the last dose of study treatment (up to 2 years).

Timeline

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

  1. First posted19 Mar 2026
  2. Study start20 May 2026
  3. Primary completionJun 2027 (estimated)
  4. Study completionMay 2028 (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
38 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07483359
Sponsor's protocol ID
2026-CONV3RSION-01
Acronym
CONV3RSION
Status last verified
May 2026
First submitted
16 Mar 2026
Last updated
28 May 2026
Results posted
No
Data monitoring committee
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 2 study testing HAIC + Tislelizumab +lenvatinib in people with Hepatocellular Carcinoma (HCC) and Portal Vein Tumor Thrombus, run by First Hospital of China Medical 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 14 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: looking for participants now, as of the sponsor's last update on 28 May 2026. 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?

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?

Contact Haibo Shao, MD, PhD (+8613840150051, hbshao@cmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Technical Resectability Rate (TRR) (time frame: Up to approximately 2 years.). 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 28 May 2026.

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