Liver Metastasis Colon CancerPhase 2HYPER-LIV01NCT03841305
Simultaneous Portal and Hepatic Vein Versus Portal Vein Embolizations for Hypertrophy of the Future Liver Remnant
A Phase 2 study testing Liver preparation before major hepatectomy in people with Liver Metastasis Colon Cancer, run by University Hospital, Montpellier at 12 sites in France.
Trial summary
The hypothesis is that liver venous deprivation (LVD) could strongly improve hypertrophy of the future remnant liver (FRL) at 3 weeks, as compared to portal vein embolization (PVE) in patient with liver metastases from colo-rectal origin considered as resectable. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Liver Metastasis Colon Cancer
- What is being tested?
- Liver preparation before major hepatectomy
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 64 participants
- Where
- 12 sitesFrance
- Study dates
- 29 Apr 2019to 10 Oct 2024
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Liver metastases from colo-rectal origin considered as resectable (as validated by a multidisciplinary committee with at least one senior hepatic surgeon) provided sufficient FRL volume
- Percentage of FRL volume < 30%
- Age ≥ 18 years
- General health status World Health Organisation 0,1
- Estimated life expectancy > 3 months
- Patients whose biological parameters are :
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- Platelets ≥100,000/mm3,
- Polynuclear neutrophils ≥ 1000/mm3,
- Hemoglobin≥ 9g/dL (even transfused patients can be included)
- Creatininemia < 1.5 times the normal value
- Creatinine clearance > 30 milliliters (mL)/min
- Bilirubinemia ≤ 1,5 times the normal value
- liver transaminases ≤ 5 times the normal value
- prothrombin rate > 70%
- Reference liver CT-Scan or MRI done during the 30 days preceding PVE or LVD.
- Written informed consent
- National health insurance cover
Who cannot join
- Patient with cirrhosis
- Presence of clinical ascites
- Ongoing participation or participation within the 21 days prior to inclusion in the study in another therapeutic trial with an experimental drug
- Serious non-stabilized disease, active uncontrolled infection or other serious underlying disorder likely to prevent the patient from receiving the treatment
- Pregnancy (betaHCG positive), breast-feeding or the absence of effective contraception for women of child-bearing age
- Contraindication for the MRI : Pacemaker or neurosensorial stimulator or implantable defibrillator, cochlear implant, ferromagnetic foreign body similar to the nervous structure.
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- Allergy or contra-indication to iodine contrast agents (thyrotoxicosis, allergy to the active substance or excipients)
- Treatment with anticoagulants (heparin or AVK) that cannot be interrupted for 48 hours
- Treatment with anti-platelets that cannot be interrupted for 5 days for aspirin or Plavix
- Legal incapacity (persons in custody or under guardianship)
- Deprived of liberty Subject (by judicial or administrative decision)
- Impossibility to sign the informed consent document or to adhere to the medical follow-up of the trial for geographical, social or psychological reasons
Trial locations and contacts
12 sites in 1 country.
12 sites in 1 country
France12 sites
CHU d'Angers
Angers, 49933
Bordeaux University Hospital
Bordeaux
CHU de Dijon
Dijon, 21079
CHU de Grenoble
Grenoble, 38043
Hospices Civils de Lyon
Lyon, 69317
Centre Léon Berard
Lyon, 69373
CHU de Montpellier
Montpellier, Hérault, 34295
CHU de Nice
Nice, 06202
APHP - Cochin hospital
Paris
CHU de Poitiers
Poitiers, 80000
Hôpital Paul Brousse
Villejuif, 94800
Institut Gustave Roussy
Villejuif, 94805
About this study
Official title: Simultaneous Portal and Hepatic Vein Embolization Versus Portal Vein Embolization for Hypertrophy of the Future Liver Remnant Before Major Hepatectomy of Non-cirrhotic Liver : a Multicentric Comparative Randomized Phase II Trial
The hypothesis is that liver venous deprivation (LVD) could strongly improve hypertrophy of the future remnant liver (FRL) at 3 weeks, as compared to portal vein embolization (PVE) in patient with liver metastases from colo-rectal origin considered as resectable.
Read the detailed description
Portal vein embolization (PVE) has been widely used to generate hypertrophy of the nonembolized lobe in patients undergoing major hepatectomy in order to prevent small-for-size remnant liver resulting in post-operative liver insufficiency.
Although PVE is a safe and effective procedure, it does not always induce sufficient hypertrophy of the future remnant liver (FRL) even after a long time. In case of insufficient liver regeneration following PVE, some authors suggested to embolize hepatic vein(s) (Hwang, Ann Surg 2009).
Interestingly, the sequential right hepatic vein embolization (HVE) after right PVE demonstrated an incremental effect on the FRL. Although attractive, this approach requires two different procedures and does not spare time as compared to PVE alone.
To shorten and optimize the phase of liver preparation before surgery,the so-called liver venous deprivation (LVD) technique that combines both PVE and HVE during the same procedure was developed.
The aim of this randomized phase II trial is to compare the percentage of change in FRL volume at 3 weeks after LVD or PVE using MRI or CT-scan.
- Conditions
- Liver Metastasis Colon Cancer
- Being tested
- Liver preparation before major hepatectomy
- Keywords
- Liver, Interventional radiology, Portal vein embolization, Portal and hepatic vein embolization, Future liver remnant, Surgery, Non-cirrhotic liver, Liver metastases, Colorectal cancer, Liver Regeneration, Liver resection
- Medical subject headings
- Colorectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Liver preparation before major hepatectomyProcedure or surgery
Simultaneous portal and hepatic vein embolization versus Portal vein embolization, also called venous deprivation OR portal vein embolization.
| Study group | Role | What they receive |
|---|---|---|
| portal vein embolization | Active comparator | Liver preparation before major hepatectomy : portal vein embolization (PVE) in patient with liver metastases from colo-rectal origin considered as resectable. Receives: Procedure: Liver preparation before major hepatectomy |
| liver venous deprivation | Experimental | Liver preparation before major hepatectomy : Patients with the liver venous deprivation (LVD) technique that combines both PVE and hepatic vein embolization (HVE) during the same procedure. Receives: Procedure: Liver preparation before major hepatectomy |
What is being measured
The primary outcome is the main question the study is designed to answer.
increase in volume of the future remnant liver (FRL)
The primary outcomes is to compare the increase in volume of the future remnant liver (FRL)
Measured: at 3 weeks after liver venous deprivation (LVD) or portal vein embolization (PVE) using MRI or CT-scan
Secondary outcomes (15)
Tolerance
Toxicities are evaluated according to NCI-CTCAE version 4.03 published 14 June 2010
Measured: between the day of liver preparation and 90 days after surgery
Post-operative mortality
Post-operative mortality defined as any death within 90 days after surgery or within the hospital stay
Measured: 90 days after surgery
Post-operative morbidity
Post-operative morbidity defined as the percentages of grade I/II/III/IV/V complications according to Clavien-Dindo classification within the 90 days after surgery or within the hospital stay.
Measured: 90 days after surgery
Post-hepatectomy liver failure
Post-hepatectomy liver failure defined according to the "50-50" criteria or peak bilirubin >7mg/dL.
Measured: between the day of the surgery and 90 days after surgery
Rate of non-resectability due to insufficient FRL
Rate of non-resectability due to insufficient FRL defined as the percentage of patients for whom resection will be not attempted due to insufficient FRL
Measured: between the day of the treatment and the day of the surgery
Rate of non-resectability due to tumor progression
Rate of non-resectability due to tumor progression defined as the percentage of patients for whom resection will not be attempted due to tumor progression.
Measured: between the day of the treatment and the day of the surgery
Rate of per-operative difficulties
Rate of per-operative difficulties defined as the percentage of patients for whom per-operative difficulties are encountered by the surgeon
Measured: between the day of the surgery and 90 days after surgery
Blood loos, operating time, transfusion
Blood loss are evaluated in mL. Operating time avec evaluated in minutes and transfusion are evaluated by number of packed red blood cells
Measured: the day of the surgery
R0 resection rate
Rate of R0 resection defined as no microscopic tumor residual
Measured: the day of the surgery
R1 resection rate
Rate of R1 resection defined as the percentage of patients resected with margin <1mm
Measured: the day of the surgery
Pre and post-operative liver volumes
Pre and post-operative liver volumes will be evaluated through CT or MRI acquisitions by calculating whole liver, tumor and FRL volumes
Measured: Baseline, week 1, week 3 then every 2 weeks until surgery or week 7 and 4 weeks after surgery
Recurrence-free survival
Recurrence-free survival defined as the time from date of randomization to date of recurrence or death from their tumor. Patients alive will be censored at the date of last news.
Measured: 90 days after surgery
Overall survival
Overall survival defined as the time from date of randomization to date of death from any cause. Patients alive will be censored at the date of last news.
Measured: Between the liver preparation and 90 days after surgery
Evaluation of pre and post-operative liver function
Evaluation of pre and post-operative liver function will be evaluated using 99mTc mebrofenine scintigraphy through SPECT/CT acquisitions by calculating mebrofenin clearance in %/min/m² of whole liver and FRL at the same time points as CT/MRI
Measured: Baseline, week 1, week 3 then every 2 weeks until surgery or week 7 and 4 weeks after surgery
To search for biomarkers predictive of liver hypertrophy/regeneration and immune cell response
Biomarkers predictive of liver hypertrophy/regeneration are evaluated by blood samples and liver biopies
Measured: The day of liver preparation, on day 1, day 2 and day 3 after liver preparation and the day of surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Feb 2019
- Study start29 Apr 2019
- Primary completion10 Oct 2024
- Study completion10 Oct 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Liver Metastasis Colon CancerStudies of the same condition, open and under way.
- More trials run by University Hospital, MontpellierThe sponsor's other registered studies.
- 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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 64 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital, Montpellier
- Sponsor type
- University, hospital or other
- Collaborators
- Federation Francophone de Cancerologie Digestive
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03841305
- Sponsor's protocol ID
- RECHMPL18_0025
- Other IDs
- UF 7595
- Acronym
- HYPER-LIV01
- Status last verified
- Jan 2025
- First submitted
- 13 Feb 2019
- Last updated
- 3 Jan 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Deshayes E, Piron L, Bouvier A, Lapuyade B, Lermite E, Vervueren L, Laurent C, Pinaquy JB, Chevallier P, Dohan A, Rode A, Sengel C, Guillot C, Quenet F, Guiu B. Study protocol of the HYPER-LIV01 trial: a multicenter phase II, prospective and randomized study comparing simultaneous portal and hepatic vein embolization to portal vein embolization for hypertrophy of the future liver remnant before major hepatectomy for colo-rectal liver metastases. BMC Cancer. 2020 Jun 19;20(1):574. doi: 10.1186/s12885-020-07065-z.
PubMed 32560632
Study at a glance
From the registry record, last updated by the sponsor on 3 Jan 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Simultaneous Portal and Hepatic Vein Embolization Versus Portal Vein Embolization for Hypertrophy of the Future Liver Remnant Before Major Hepatectomy of Non-cirrhotic Liver : a Multicentric Comparative Randomized Phase II Trial
- ClinicalTrials.gov ID
- NCT03841305
- Acronym / sponsor ID
- HYPER-LIV01 / RECHMPL18_0025
- Conditions
- Liver Metastasis Colon Cancer
- Keywords
- Liver, Interventional radiology, Portal vein embolization, Portal and hepatic vein embolization, Future liver remnant, Surgery, Non-cirrhotic liver, Liver metastases
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 64 participants (actual)
- Lead sponsor
- University Hospital, MontpellierUniversity, hospital or other
- Collaborators
- Federation Francophone de Cancerologie Digestive
- Study start
- 29 Apr 2019 (actual)
- Primary completion
- 10 Oct 2024 (actual)
- Study completion
- 10 Oct 2024 (actual)
- First posted
- 15 Feb 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The hypothesis is that liver venous deprivation (LVD) could strongly improve hypertrophy of the future remnant liver (FRL) at 3 weeks, as compared to portal vein embolization (PVE) in patient with liver metastases from colo-rectal origin considered as resectable.
Detailed description
Portal vein embolization (PVE) has been widely used to generate hypertrophy of the nonembolized lobe in patients undergoing major hepatectomy in order to prevent small-for-size remnant liver resulting in post-operative liver insufficiency.
Although PVE is a safe and effective procedure, it does not always induce sufficient hypertrophy of the future remnant liver (FRL) even after a long time. In case of insufficient liver regeneration following PVE, some authors suggested to embolize hepatic vein(s) (Hwang, Ann Surg 2009).
Interestingly, the sequential right hepatic vein embolization (HVE) after right PVE demonstrated an incremental effect on the FRL. Although attractive, this approach requires two different procedures and does not spare time as compared to PVE alone.
To shorten and optimize the phase of liver preparation before surgery,the so-called liver venous deprivation (LVD) technique that combines both PVE and HVE during the same procedure was developed.
The aim of this randomized phase II trial is to compare the percentage of change in FRL volume at 3 weeks after LVD or PVE using MRI or CT-scan.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| portal vein embolization | Active comparator | Procedure: Liver preparation before major hepatectomyLiver preparation before major hepatectomy : portal vein embolization (PVE) in patient with liver metastases from colo-rectal origin considered as resectable. |
| liver venous deprivation | Experimental | Procedure: Liver preparation before major hepatectomyLiver preparation before major hepatectomy : Patients with the liver venous deprivation (LVD) technique that combines both PVE and hepatic vein embolization (HVE) during the same procedure. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (17 listed)
- Liver metastases from colo-rectal origin considered as resectable (as validated by a multidisciplinary committee with at least one senior hepatic surgeon) provided sufficient FRL volume
- Percentage of FRL volume < 30%
- Age ≥ 18 years
- General health status World Health Organisation 0,1
- Estimated life expectancy > 3 months
Key exclusion criteria (12 listed)
- Patient with cirrhosis
- Presence of clinical ascites
- Ongoing participation or participation within the 21 days prior to inclusion in the study in another therapeutic trial with an experimental drug
- Serious non-stabilized disease, active uncontrolled infection or other serious underlying disorder likely to prevent the patient from receiving the treatment
- Pregnancy (betaHCG positive), breast-feeding or the absence of effective contraception for women of child-bearing age
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Liver preparation before major hepatectomySimultaneous portal and hepatic vein embolization versus Portal vein embolization, also called venous deprivation OR portal vein embolization. | Procedure or surgery | liver venous deprivation, portal vein embolization |
Primary outcome
increase in volume of the future remnant liver (FRL)
Time frame: at 3 weeks after liver venous deprivation (LVD) or portal vein embolization (PVE) using MRI or CT-scan
The primary outcomes is to compare the increase in volume of the future remnant liver (FRL)
15 secondary outcomes
Tolerance
Time frame: between the day of liver preparation and 90 days after surgery
Post-operative mortality
Time frame: 90 days after surgery
Post-operative morbidity
Time frame: 90 days after surgery
Post-hepatectomy liver failure
Time frame: between the day of the surgery and 90 days after surgery
Rate of non-resectability due to insufficient FRL
Time frame: between the day of the treatment and the day of the surgery
Rate of non-resectability due to tumor progression
Time frame: between the day of the treatment and the day of the surgery
Rate of per-operative difficulties
Time frame: between the day of the surgery and 90 days after surgery
Blood loos, operating time, transfusion
Time frame: the day of the surgery
R0 resection rate
Time frame: the day of the surgery
R1 resection rate
Time frame: the day of the surgery
Pre and post-operative liver volumes
Time frame: Baseline, week 1, week 3 then every 2 weeks until surgery or week 7 and 4 weeks after surgery
Recurrence-free survival
Time frame: 90 days after surgery
Overall survival
Time frame: Between the liver preparation and 90 days after surgery
Evaluation of pre and post-operative liver function
Time frame: Baseline, week 1, week 3 then every 2 weeks until surgery or week 7 and 4 weeks after surgery
To search for biomarkers predictive of liver hypertrophy/regeneration and immune cell response
Time frame: The day of liver preparation, on day 1, day 2 and day 3 after liver preparation and the day of surgery
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jan 2025.
- Derived from this study: PubMed 32560632Deshayes E, Piron L, Bouvier A, Lapuyade B, Lermite E, Vervueren L, Laurent C, Pinaquy JB, Chevallier P, Dohan A, Rode A, Sengel C, Guillot C, Quenet F, Guiu B. Study protocol of the HYPER-LIV01 trial: a multicenter phase II, prospective and randomized study comparing simultaneous portal and hepatic vein embolization to portal vein embolization for hypertrophy of the future liver remnant before major hepatectomy for colo-rectal liver metastases. BMC Cancer. 2020 Jun 19;20(1):574. doi: 10.1186/s12885-020-07065-z.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
12 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Liver preparation before major hepatectomy in people with Liver Metastasis Colon Cancer, run by University Hospital, Montpellier at 12 sites in France.
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 12 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: finished, as of the sponsor's last update on 3 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 12 sites in France. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
increase in volume of the future remnant liver (FRL) (time frame: at 3 weeks after liver venous deprivation (LVD) or portal vein embolization (PVE) using MRI or CT-scan). 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 NCT03841305, 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 3 Jan 2025; AzTrials last refreshed its copy on 8 Nov 2026.