Using yttrium-90 carbon microspheres for treating liver cancer

Yttrium-90 Carbon Microspheres in Patients With Unresectable Hepatocellular Carcinoma: A Multicentre, Prospective, Open-label, Single-arm Trial

This study is testing if yttrium-90 carbon microspheres can safely help people with liver cancer that can’t be removed by surgery.

Quick facts

• Phase: PHASE1
• Study type: Interventional
• Enrollment: 40 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: Zhongda Hospital (other)
• Drugs / interventions: chemotherapy, immunotherapy, radiation
• Locations: 1 site (Nanjing)
• Trial ID: NCT05957640 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the safety and efficacy of yttrium-90 carbon microspheres in patients with unresectable hepatocellular carcinoma. It is a multicenter, prospective, open-label, single-arm trial focusing on the local objective response rate of liver lesions as the primary endpoint. Secondary endpoints include time to progression, progression-free survival rates, disease control rates, duration of response, quality of life, and the distribution characteristics of the microspheres. The trial aims to provide insights into a novel treatment approach for patients who cannot undergo surgery.

Who should consider this trial

Good fit: Ideal candidates are patients with unresectable hepatocellular carcinoma who meet specific health criteria and have a life expectancy of at least three months.

Not a fit: Patients with extrahepatic metastases or those who are not suitable for the treatment due to severe liver dysfunction may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could offer a new therapeutic option for patients with advanced liver cancer.

How similar studies have performed: Previous studies using similar approaches have shown promise, but this specific application of yttrium-90 carbon microspheres is relatively novel.

Eligibility criteria

Inclusion Criteria:

1. Eastern Cooperative Oncology Group performance status ≤ 1;
2. Expected survival time ≥ 3 months;
3. Confirmed hepatocellular carcinoma based on EASL or AASLD guidelines;
4. Without extrahepatic metastases, inoperable or refuse surgical resection;
5. At least one well defined tumor (mRECIST 1.1);
6. Tumor burden ≤ 50% of the total liver volume;
7. Child-Pugh score ≤ 7;
8. Adequate organ function: # Blood routine \[no blood transfusion or colony-stimulating factor (G-CSF) treatment within 14 days\]: absolute neutrophil count ≥ 1.5 × 109/L; platelet ≥ 75 × 109/L; hemoglobin ≥ 90 g/ L; # Liver function: total bilirubin ≤ 2 times upper limit of normal (ULN); alanine transaminase and aspartate aminotransferase ≤ 5. 0 ULN; alkaline phosphatase ≤ 2.5 ULN; Albumin \> 30 g/L; # Renal function: Cr ≤ 1.5 ULN; creatinine clearance ≥ 50 mL/min (calculated according to Cockcroft-Gault formula); # Coagulation function: international normalized ratio, prothrombin time and activated partial thromboplastin time were less than 1.5 ULN; # Cardiovascular function: left ventricular ejection fraction ≥ 50%;
9. According to CTCAE 5.0 standard, all adverse events of previous systematic anti-cancer treatment have recovered to baseline or ≤ 1 grade, \[except for the following: neuropathy induced by previous anticancer treatment is stable (≤ 2 grade) and hair loss\];
10. Women and men of childbearing age must agree to take strict and effective contraceptive measures during the study period and within 6 m after the end of the trial. Men are forbidden to donate sperm. The pregnancy test results of female patients of childbearing age during the screening period and within 24 hours before administration must be negative.

Exclusion Criteria:

1. With previous history of hepatic encephalopathy;
2. Severe pulmonary insufficiency (forced expiratory volume at one second / forced vital capacity \< 50% or forced expiratory volume at one second /predicting value \< 50% or maximum volume per minute \< 50 L/min);Obvious chronic obstructive pulmonary disease or interstitial pneumonia;
3. Percentage of hepatopulmonary shunt \> 10%, or the single lung radiation absorbed dose \> 30 Gy;
4. With hepatic artery malformation and unable to intubate hepatic artery;
5. Tumor thrombus in main portal vein;
6. Have received radiotherapy or transcatheter arterial chemoembolization (patients who have received transcatheter arterial non-iodized oil chemoembolization are judged by researchers);
7. The last anti-tumor treatment (surgery, chemotherapy, immunotherapy, targeted therapy) was less than 4 weeks before the drug administration;
8. Clinical manifestations of portal hypertension, moderate-severe or refractory ascites, or decompensated liver cirrhosis;
9. Participated in other trial within 1 month before yttrium-90 administration;
10. Pregnant and lactating women;
11. Serious infections in active stage or need systematic treatment;
12. With positive results of HIV antibody test;
13. The researchers judge that there is unresolved toxicity from previous treatment and will continue to exist, which may endanger the safety of patients;
14. The researcher judged clinical or laboratory examination abnormality or other reasons;
15. Extrahepatic disease or combined with other malignant tumors;
16. Hepatic artery angiography and 99mTc MAA hepatic artery perfusion imaging demonstrate gastrointestinal shunts, which may not be remedied through vascular intervention techniques.

Where this trial is running

Nanjing

• Gao-Jun Teng — Nanjing, China (RECRUITING)

Study contacts

• Principal investigator: Gao-Jun Teng, MD — Zhongda Hospital
• Study coordinator: Lei Zhang, MD

Conditions: Unresectable Hepatocellular Carcinoma, SIRT