Combination therapy for advanced liver cancer patients

A Single-arm Phase II Clinical Study Evaluating the Efficacy and Safety of Systemic Chemotherapy(mFOLFOX7) Combined With Camrelizumab and Apatinib in BCLC Stage A/B Hepatocellular Carcinoma Patients Beyond Milan Criteria

This study is testing a new combination treatment for patients with advanced liver cancer to see if it can improve their chances of survival and how well they tolerate it.

Quick facts

• Phase: Phase 2
• Study type: Interventional
• Enrollment: 29 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University (Academic / other)
• Drugs / interventions: Lenvatinib, apatinib, immunotherapy, Camrelizumab, Trastuzumab, Carolizumab, chemotherapy
• Locations: 1 site (Guangzhou, Guangdong)
• Trial ID: NCT06607107 on ClinicalTrials.gov

What this trial studies

This study evaluates the effectiveness and safety of a combination therapy using mFOLFOX7, Camrelizumab, and Apatinib for patients with hepatocellular carcinoma (HCC) who exceed the Milan criteria. The primary focus is on measuring the primary pathological response rate, while secondary outcomes include overall survival and progression-free survival rates. The study aims to provide a new treatment option for patients with limited choices and poor prognosis in advanced stages of liver cancer. It also assesses the safety and tolerability of this combined therapy.

Who should consider this trial

Good fit: Ideal candidates are patients diagnosed with BCLC stage A/B hepatocellular carcinoma who exceed the Milan criteria and have not received prior first-line treatments.

Not a fit: Patients with advanced liver cancer who have already undergone first-line treatments or have severe liver dysfunction may not benefit from this study.

Why it matters

Potential benefit: If successful, this therapy could offer a new effective treatment option for patients with advanced hepatocellular carcinoma.

How similar studies have performed: Preliminary studies have shown promising results with similar combination therapies, indicating potential effectiveness in treating advanced liver cancer.

Eligibility criteria

Inclusion Criteria:

1. Before treatment, histologically or cytologically or clinically diagnosed as hepatocellular carcinoma (HCC) and the clinical stage belongs to BCLC stage A/B HCC that exceeds the Milan criteria.
2. Child-pugh liver function grading: Grade A or B
3. Did not received any type of other first-line drugs such as Sorafenib or Lenvatinib.
4. According to RECIST 1.1 standard and mRECIST standard, patients have at least one measurable lesion (CT scan long diameter ≥10mm and the lesion has not received radiotherapy, freezing or other local treatments)；
5. ECOG PS score 0-2;
6. Expected survival ≥ 12 weeks;
7. Blood routine:White blood cells count ≥3.0×10\^9/L Platelet count ≥70×10\^9/L Hemoglobin ≥80g/L(without blood transfusion within 14 days); kidney function: Serum creatinine (SCr) ≤ 1.5 times upper limit of normal value (ULN); Liver function:Total bilirubin (TBIL) ≤ 1.5 times the upper limit of normal value (ULN); AST or ALT levels ≤ 3 times the upper limit of normal value (ULN)
8. Patients with hepatitis B or C coinfection need to use antiviral drugs and have not used interferon.
9. Women of childbearing age should have a negative serum or urine pregnancy test within 7 days before enrollment and they must be non-lactating patients and agree to use contraceptive measures during the study period and within 6 months after the end of the study. Men should agree to use contraceptive measures during the study period and within 6 months after the end of the study period.
10. Patients volunteered to participate in this study and signed informed consent;

Exclusion Criteria:

1. Have received immunotherapeutic drugs or interferon in the past.
2. Allergic to the drugs in the treatment ;
3. Female subjects with pregnancy or on feeding.
4. Have received other immunotherapy drugs (targeting PD1/PDL1).
5. Patients with combined uncontrolled cardiac clinical symptoms or diseases, such as: (1) heart failure above NYHA class II; (2) unstable angina pectoris; (3) myocardial infarction within 1 year; (4) patients with clinically significant supraventricular or ventricular arrhythmias requiring clinical intervention; (5) those with poorly controlled hypertension by drugs and assessed by doctors as having a high risk of using apatinib.
6. Past medical history includes other tumors or a second tumor, except for cured basal cell carcinoma of the skin, cervical carcinoma in situ and papillary thyroid cancer.
7. Combined with severe infection (CTCAE greater than grade 2) before the start of treatment, such as severe pneumonia requiring hospitalization, active tuberculosis, bacteremia, infectious complications, etc.; baseline chest imaging examination indicates active pulmonary inflammation. There are symptoms and signs of infection within 2 weeks before the first use of the study drug or oral or intravenous antibiotic treatment is required (excluding prophylactic use of antibiotics).
8. Have a history of immunodeficiency, such as positive HIV monitoring, have other acquired or congenital immunodeficiency diseases (such as interstitial pneumonia, colitis, hepatitis, hypophysitis, vasculitis, nephritis, hyperthyroidism, hypothyroidism, including but not limited to these diseases and syndromes), or have a history of organ transplantation or bone marrow transplantation; or are taking hormones or other immunosuppressive drugs orally or intravenously; but excluding vitiligo or cured childhood asthma/allergies, and patients who do not require any intervention as adults.
9. Severe coagulation disorders (INR\>2.0, PT\>16s), those with obvious bleeding tendencies (including but not limited to vomiting blood and having bloody stools every day in the past 3 months).
10. Have the history of abusing psychotropic drugs and unable to quit ,or with mental disorders; with brain metastases or hepatic encephalopathy.
11. As judged by the investigator, the patient may have other factors that may cause the study to be terminated prematurely, such as other serious diseases or serious abnormal laboratory tests or accompanied by other family or social factors that will affect the safety of the subject or the collection of trial data and samples.

Where this trial is running

Guangzhou, Guangdong

• Sun Yat-sen Memorial Hospital of Sun Yat-sen University — Guangzhou, Guangdong, China (Recruiting)

Study contacts

• Principal investigator: linhui Peng, Prof — Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
• Study coordinator: linhui Peng, Prof

Conditions Hepatocellular Carcinoma Non-resectable