Hepatocellular CarcinomaPhase 3NCT04229355
DEB-TACE Plus Lenvatinib or Sorafenib or PD-1 Inhibitor for Unresectable Hepatocellular Carcinoma
A Phase 3 study testing DEB-TACE plus Sorafenib, DEB-TACE plus Lenvatinib and DEB-TACE plus PD-1 inhibitor in people with Hepatocellular Carcinoma, run by Guangxi Medical University at 1 site in China.
Trial summary
Transarterial chemoembolization (TACE) based on drug-eluting beads (DEB-TACE) is widely used for unresectable hepatocellular carcinoma (HCC). However, the long-term survival is still low after DEB-TACE treatment. In recent years, lenvatinib and anti-PD-1 have exhibited potential therapeutic effects for advanced HCC. Read more about this study
- Who is it for?
- Ages 18 to 75 yearsHealthy volunteers can take part
- Conditions the study is for
- Hepatocellular Carcinoma
- What is being tested?
- DEB-TACE plus Sorafenib, DEB-TACE plus Lenvatinib and DEB-TACE plus PD-1 inhibitor
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 1 siteChina
- Study dates
- 2 Feb 2021to 30 Dec 2022
- Phase
- Phase 3
- 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 to 75 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Age 18 - 75 years
- Patients with unresectable primary hepatocellular carcinoma.
- With Child-Pugh A liver function.
Who cannot join
- Patients received targeted drugs, anti-PD1, or anti-PD-L1 treatment.
- Patients with recurrent hepatocellular carcinoma.
- Patient compliance is poor.
- The blood supply of tumor lesions is absolutely poor or arterial-venous shunt that TACE can not be performed.
- Known history of human immunodeficiency virus (HIV) infection.
- Known Central Nervous System tumors including metastatic brain disease.
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- Patients with clinically significant gastrointestinal bleeding within 30 days prior to study entry.
- History of organ allograft.
- Known or suspected allergy to the investigational agent or any agent given in association with this trial.
- Any condition that is unstable or which could jeopardize the safety of the patient and his/her compliance in the study.
- Pregnant or breast-feeding patients. Women of childbearing potential must have a negative pregnancy test performed within seven days prior to the start of study drug. Both men and women enrolled in this trial must use adequate barrier birth control measures during the course of the trial.
Trial locations and contacts
1 site in 1 country.
China1 site, 1 recruiting
- Recruiting
Guangxi Medical University Cancer Hospital
Nanning, Guangxi, 530021
Fei-Xiang Wu, PhD, 07715301253, wufx2013@163.com
About this study
Official title: Drug-eluting Bead Transarterial Chemoembolization Plus Lenvatinib or Sorafenib or PD-1 Inhibitor for Unresectable Hepatocellular Carcinoma: a Multicentric Prospective Study
Transarterial chemoembolization (TACE) based on drug-eluting beads (DEB-TACE) is widely used for unresectable hepatocellular carcinoma (HCC). However, the long-term survival is still low after DEB-TACE treatment. In recent years, lenvatinib and anti-PD-1 have exhibited potential therapeutic effects for advanced HCC. And sorafenib is the standard drug for advanced HCC. Combining targeted drugs or immunotherapies with DEB-TACE may provide synergistic effects and facilitate the development of personalized medicine. Therefore, this prospective study aims to investigate the safety and efficacy of DEB-TACE plus sorafenib or lenvatinib or PD-1 Inhibitor for unresectable HCC.
Read the detailed description
Hepatocellular carcinoma (HCC) is the most common type of liver cancer. Most patients with HCC are diagnosed as advanced stage or unresectable disease because of the lack of signs and symptoms. Despite significant research efforts, only a few effective treatment approaches have been developed for HCC. Conventional transarterial chemoembolization (cTACE) is widely used as a palliative treatment for inoperable HCC. TACE based on drug-eluting beads (DEB-TACE) has recently been introduced into the clinic. This technique relies on drug-loaded microspheres to embolize and release antitumor medication gradually and locally in order to maximize local ischemia and tumor necrosis. Nowadays, many RCTs and meta-analyses found DEB-TACE is associated with higher overall survival than cTACE for unresectable HCC. However, the long-term survival is still low after DEB-TACE treatment. In recent years, targeted drugs (such as sorafenib, lenvatinib) and immune checkpoint inhibitor (anti-PD-1) have exhibited potential therapeutic effects for advanced HCC. Lenvatinib is non-inferior to sorafenib in overall survival in untreated advanced HCC. Combining targeted drugs or immunotherapies with conventional therapeutic approaches may provide synergistic effects and facilitate the development of personalized medicine. However, it is still unknown which is the best combining treatment. Therefore, this prospective study aims to investigate the safety and efficacy of DEB-TACE plus sorafenib or lenvatinib or PD-1 Inhibitor for unresectable HCC.
- Conditions
- Hepatocellular Carcinoma
- Being tested
- DEB-TACE plus Sorafenib, DEB-TACE plus Lenvatinib, DEB-TACE plus PD-1 inhibitor
- Medical subject headings
- Carcinoma, Hepatocellular
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
DEB-TACE plus SorafenibDrug
Drug-eluting bead transarterial chemoembolization plus sorafenib (400 mg/d, po, bid)
DEB-TACE plus LenvatinibDrug
Drug-eluting bead transarterial chemoembolization plus lenvatinib (8 mg/d, po, qd)
DEB-TACE plus PD-1 inhibitorDrug
Drug-eluting bead transarterial chemoembolization plus PD-1 inhibitor
| Study group | Role | What they receive |
|---|---|---|
| DEB-TACE plus Sorafenib | Experimental | Patients with unresectable hepatocellular carcinoma (HCC) in this group will receive drug-eluting bead transarterial chemoembolization (DEB-TACE).And then, they will receive sorafenib (400 mg/d, po, bid) one week after DEB-TACE therapy. The second DEB-TACE will be performed after one month later the first DEB-TACE. Lenvatinib will be taken orally for six months, untill tumor progression, or intolerable adverse reactions. Receives: Drug: DEB-TACE plus Sorafenib |
| DEB-TACE plus Lenvatinib | Experimental | Patients with unresectable hepatocellular carcinoma (HCC) in this group will receive drug-eluting bead transarterial chemoembolization (DEB-TACE).And then, they will receive lenvatinib (8 mg/d, po, qd) one week after DEB-TACE therapy. The second DEB-TACE will be performed after one month later the first DEB-TACE. Lenvatinib will be taken orally for six months, untill tumor progression, or intolerable adverse reactions. Receives: Drug: DEB-TACE plus Lenvatinib |
| DEB-TACE plus PD-1 inhibitor | Active comparator | Patients with unresectable hepatocellular carcinoma (HCC) in this group will receive drug-eluting bead transarterial chemoembolization (DEB-TACE).And then, they will receive PD-1 inhibitor (200 mg, iv, 3 weeks) one week after DEB-TACE therapy. The second DEB-TACE will be performed after one month later the first DEB-TACE. PD-1 inhibitor will be taken for six months, untill tumor progression, or intolerable adverse reactions. Receives: Drug: DEB-TACE plus PD-1 inhibitor |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-free survival
Primary endpoint is progression-free survival (PFS).
Measured: one month
Secondary outcomes (1)
Overall survival
Overall survival is measured from the date of enrollment until the date of death from any cause. Patients who is lost to follow-up are censored at the last date they are known to be alive, and patients who remain alive are censored at the time of data cutoff.
Measured: one month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jan 2020
- Study start2 Feb 2021 (estimated)
- Primary completion30 Dec 2022 (estimated)
- Study completion30 Dec 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Hepatocellular CarcinomaStudies 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
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Guangxi Medical University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Jian-Hong Zhong, Guangxi Medical University
- Investigators
- Le-Qun Li, PhD, Study chair, Guangxi Medical University Cancer Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04229355
- Sponsor's protocol ID
- DEEP
- Status last verified
- Feb 2021
- First submitted
- 12 Jan 2020
- Last updated
- 9 Feb 2021
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Kudo M, Finn RS, Qin S, Han KH, Ikeda K, Piscaglia F, Baron A, Park JW, Han G, Jassem J, Blanc JF, Vogel A, Komov D, Evans TRJ, Lopez C, Dutcus C, Guo M, Saito K, Kraljevic S, Tamai T, Ren M, Cheng AL. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet. 2018 Mar 24;391(10126):1163-1173. doi: 10.1016/S0140-6736(18)30207-1.
PubMed 29433850Hatanaka T, Kakizaki S, Nagashima T, Namikawa M, Tojima H, Shimada Y, Takizawa D, Naganuma A, Arai H, Sato K, Harimoto N, Shirabe K, Uraoka T. Analyses of objective response rate, progression-free survival, and adverse events in hepatocellular carcinoma patients treated with lenvatinib: A multicenter retrospective study. Hepatol Res. 2020 Mar;50(3):382-395. doi: 10.1111/hepr.13460. Epub 2019 Dec 10.
PubMed 31760660Feng Z, Rong P, Wang W. Meta-analysis of the efficacy and safety of PD-1/PD-L1 inhibitors administered alone or in combination with anti-VEGF agents in advanced hepatocellular carcinoma. Gut. 2020 Oct;69(10):1904-1906. doi: 10.1136/gutjnl-2019-320116. Epub 2019 Dec 18. No abstract available.
PubMed 31852768Xie ZB, Wang XB, Peng YC, Zhu SL, Ma L, Xiang BD, Gong WF, Chen J, You XM, Jiang JH, Li LQ, Zhong JH. Systematic review comparing the safety and efficacy of conventional and drug-eluting bead transarterial chemoembolization for inoperable hepatocellular carcinoma. Hepatol Res. 2015 Jan;45(2):190-200. doi: 10.1111/hepr.12450. Epub 2014 Dec 24.
PubMed 25388603
Study at a glance
From the registry record, last updated by the sponsor on 9 Feb 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Drug-eluting Bead Transarterial Chemoembolization Plus Lenvatinib or Sorafenib or PD-1 Inhibitor for Unresectable Hepatocellular Carcinoma: a Multicentric Prospective Study
- ClinicalTrials.gov ID
- NCT04229355
- Acronym / sponsor ID
- DEEP
- Conditions
- Hepatocellular Carcinoma
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- Guangxi Medical UniversityUniversity, hospital or other
- Study start
- 2 Feb 2021 (estimated)
- Primary completion
- 30 Dec 2022 (estimated)
- Study completion
- 30 Dec 2022 (estimated)
- First posted
- 18 Jan 2020 (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.
Transarterial chemoembolization (TACE) based on drug-eluting beads (DEB-TACE) is widely used for unresectable hepatocellular carcinoma (HCC). However, the long-term survival is still low after DEB-TACE treatment. In recent years, lenvatinib and anti-PD-1 have exhibited potential therapeutic effects for advanced HCC. And sorafenib is the standard drug for advanced HCC. Combining targeted drugs or immunotherapies with DEB-TACE may provide synergistic effects and facilitate the development of personalized medicine. Therefore, this prospective study aims to investigate the safety and efficacy of DEB-TACE plus sorafenib or lenvatinib or PD-1 Inhibitor for unresectable HCC.
Detailed description
Hepatocellular carcinoma (HCC) is the most common type of liver cancer. Most patients with HCC are diagnosed as advanced stage or unresectable disease because of the lack of signs and symptoms. Despite significant research efforts, only a few effective treatment approaches have been developed for HCC. Conventional transarterial chemoembolization (cTACE) is widely used as a palliative treatment for inoperable HCC. TACE based on drug-eluting beads (DEB-TACE) has recently been introduced into the clinic. This technique relies on drug-loaded microspheres to embolize and release antitumor medication gradually and locally in order to maximize local ischemia and tumor necrosis. Nowadays, many RCTs and meta-analyses found DEB-TACE is associated with higher overall survival than cTACE for unresectable HCC. However, the long-term survival is still low after DEB-TACE treatment. In recent years, targeted drugs (such as sorafenib, lenvatinib) and immune checkpoint inhibitor (anti-PD-1) have exhibited potential therapeutic effects for advanced HCC. Lenvatinib is non-inferior to sorafenib in overall survival in untreated advanced HCC. Combining targeted drugs or immunotherapies with conventional therapeutic approaches may provide synergistic effects and facilitate the development of personalized medicine. However, it is still unknown which is the best combining treatment. Therefore, this prospective study aims to investigate the safety and efficacy of DEB-TACE plus sorafenib or lenvatinib or PD-1 Inhibitor for unresectable HCC.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| DEB-TACE plus Sorafenib | Experimental | Drug: DEB-TACE plus SorafenibPatients with unresectable hepatocellular carcinoma (HCC) in this group will receive drug-eluting bead transarterial chemoembolization (DEB-TACE).And then, they will receive sorafenib (400 mg/d, po, bid) one week after DEB-TACE therapy. The second DEB-TACE will be performed after one month later the first DEB-TACE. Lenvatinib will be taken orally for six months, untill tumor progression, or intolerable adverse reactions. |
| DEB-TACE plus Lenvatinib | Experimental | Drug: DEB-TACE plus LenvatinibPatients with unresectable hepatocellular carcinoma (HCC) in this group will receive drug-eluting bead transarterial chemoembolization (DEB-TACE).And then, they will receive lenvatinib (8 mg/d, po, qd) one week after DEB-TACE therapy. The second DEB-TACE will be performed after one month later the first DEB-TACE. Lenvatinib will be taken orally for six months, untill tumor progression, or intolerable adverse reactions. |
| DEB-TACE plus PD-1 inhibitor | Active comparator | Drug: DEB-TACE plus PD-1 inhibitorPatients with unresectable hepatocellular carcinoma (HCC) in this group will receive drug-eluting bead transarterial chemoembolization (DEB-TACE).And then, they will receive PD-1 inhibitor (200 mg, iv, 3 weeks) one week after DEB-TACE therapy. The second DEB-TACE will be performed after one month later the first DEB-TACE. PD-1 inhibitor will be taken for six months, untill tumor progression, or intolerable adverse reactions. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Age 18 - 75 years
- Patients with unresectable primary hepatocellular carcinoma.
- With Child-Pugh A liver function.
Key exclusion criteria (11 listed)
- Patients received targeted drugs, anti-PD1, or anti-PD-L1 treatment.
- Patients with recurrent hepatocellular carcinoma.
- Patient compliance is poor.
- The blood supply of tumor lesions is absolutely poor or arterial-venous shunt that TACE can not be performed.
- Known history of human immunodeficiency virus (HIV) infection.
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 |
|---|---|---|
| DEB-TACE plus SorafenibDrug-eluting bead transarterial chemoembolization plus sorafenib (400 mg/d, po, bid) | Drug | DEB-TACE plus Sorafenib |
| DEB-TACE plus LenvatinibDrug-eluting bead transarterial chemoembolization plus lenvatinib (8 mg/d, po, qd) | Drug | DEB-TACE plus Lenvatinib |
| DEB-TACE plus PD-1 inhibitorDrug-eluting bead transarterial chemoembolization plus PD-1 inhibitor | Drug | DEB-TACE plus PD-1 inhibitor |
Primary outcome
Progression-free survival
Time frame: one month
Primary endpoint is progression-free survival (PFS).
1 secondary outcome
Overall survival
Time frame: one month
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Feb 2021.
- Background: PubMed 29433850Kudo M, Finn RS, Qin S, Han KH, Ikeda K, Piscaglia F, Baron A, Park JW, Han G, Jassem J, Blanc JF, Vogel A, Komov D, Evans TRJ, Lopez C, Dutcus C, Guo M, Saito K, Kraljevic S, Tamai T, Ren M, Cheng AL. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet. 2018 Mar 24;391(10126):1163-1173. doi: 10.1016/S0140-6736(18)30207-1.
- Background: PubMed 31760660Hatanaka T, Kakizaki S, Nagashima T, Namikawa M, Tojima H, Shimada Y, Takizawa D, Naganuma A, Arai H, Sato K, Harimoto N, Shirabe K, Uraoka T. Analyses of objective response rate, progression-free survival, and adverse events in hepatocellular carcinoma patients treated with lenvatinib: A multicenter retrospective study. Hepatol Res. 2020 Mar;50(3):382-395. doi: 10.1111/hepr.13460. Epub 2019 Dec 10.
- Background: PubMed 31852768Feng Z, Rong P, Wang W. Meta-analysis of the efficacy and safety of PD-1/PD-L1 inhibitors administered alone or in combination with anti-VEGF agents in advanced hepatocellular carcinoma. Gut. 2020 Oct;69(10):1904-1906. doi: 10.1136/gutjnl-2019-320116. Epub 2019 Dec 18. No abstract available.
- Background: PubMed 25388603Xie ZB, Wang XB, Peng YC, Zhu SL, Ma L, Xiang BD, Gong WF, Chen J, You XM, Jiang JH, Li LQ, Zhong JH. Systematic review comparing the safety and efficacy of conventional and drug-eluting bead transarterial chemoembolization for inoperable hepatocellular carcinoma. Hepatol Res. 2015 Jan;45(2):190-200. doi: 10.1111/hepr.12450. Epub 2014 Dec 24.
- Individual participant dataSharing planned: Undecided
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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.
Le-Qun Li, PhD study chair
Guangxi Medical University Cancer Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing DEB-TACE plus Sorafenib, DEB-TACE plus Lenvatinib and DEB-TACE plus PD-1 inhibitor in people with Hepatocellular Carcinoma, run by Guangxi 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 3 inclusion and 11 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: status not confirmed, as of the sponsor's last update on 9 Feb 2021. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Fei-Xiang Wu, PhD (+86 771 5301253, wufx2013@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Progression-free survival (time frame: one month). 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 NCT04229355, which also lists 4 linked publications.
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 9 Feb 2021.