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Intrahepatic CholangiocarcinomaPhase 2NCT05174650

Treatment of Atezolizumab and Derazantinib in Patients With Advanced iCCA With FGFR2 Fusions/Rearrangements

A Phase 2 study testing Atezolizumab and Derazantinib in people with Intrahepatic Cholangiocarcinoma, run by Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest at 17 sites in Germany.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The study trial is a open-label, single-arm, multicenter phase II trial investigating the combined treatment of atezolizumab and derazantinib in patients with advanced intrahepatic cholangiocarcinoma with FGFR2 fusions/rearrangements Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Intrahepatic Cholangiocarcinoma
What is being tested?
Atezolizumab and Derazantinib
Could I receive a placebo?
No, everyone receives an active treatment
How many people
27 participants
Where
17 sitesGermany
Study dates
20 Apr 2022to Aug 2026
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients must meet all of the following criteria to be eligible for the study:
  • Fully informed written consent and locally required authorization (European Union [EU] Data Privacy Directive in the EU) obtained from the patient prior to performing any protocol-related procedures, including screening evaluations.
  • Patients*, age ≥ 18 years at the time of signing the Informed Consent Form.
  • Histologically documented diagnosis of non-resectable iCCA with positively confirmed FGFR2 fusion/rearrangement via NGS-Analysis.
  • Note: Only CE-IVD marked NGS-tests are applicable which cover FGFR2 fusions and rearrangements.
  • Performance status (PS) ≤ 2 (ECOG scale).
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  • At maximum one previous line of systemic anti-cancer therapy, (chemotherapy, hormonal, targeted therapy, experimental therapy) for which treatment was discontinued at least 4 weeks before the first dose of study treatment, or five half-lives of the respective anti-cancer therapy, whichever is the longer period.
  • Note: For mABs in previous therapy the restriction to five half-lives does not apply.
  • No prior treatment with any FGFR or immune checkpoint inhibitor (including but not limited to antiCTLA-4, antiPD-1, and antiPD-L1 therapeutic antibodies) apart from Durvalumab as PD-L1 inhibitor in first line therapy.
  • Body weight > 30 kg AND BMI ≥ 15.
  • At least one measurable site of disease as defined by RECIST 1.1 criteria.
  • Adequate bone marrow and renal function including the following:
  • Hemoglobin ≥ 9.0 g/dL (previous transfusion permitted);
  • Absolute neutrophil count (ANC) ≥ 1.500 per µL (1.5×109/L);
  • Platelet count ≥ 75,000 per µL (75 × 109/L);
  • International normalized ratio (INR) between 0.8 × ULN to 1.0 × ULN OR ≤ 3 × ULN for subjects receving anticoagulant therapy
  • Creatinine ≤ 1.5 × ULN OR CLCR ≥ 50 mL/min (as calculated by the Cockcroft-Gault formula);
  • serum phosphate ≤ ULN;
  • corrected serum calcium ≥ 1.75 mmol/L (≥ 7.0 mg/dL) AND ≤ 3.1 mmol/L (≤ 12.5 mg/dL);
  • serum sodium ≥ LLN.
  • Adequate hepatic function (with stenting for any obstruction, if required) including the following:
  • o Total bilirubin ≤ 2 × ULN;
  • AST or ALT ≤ 3 × ULN (or ≤ 5 × ULN for subjects with liver metastases);
  • Prothrombin time ≥ 60%;
  • Albumin ≥ 2.8 g/dL.
  • For patients with active hepatitis B virus (HBV):
  • HBV DNA ≤ 500 IU/mL obtained within 28 days prior to initiation of study treatment, AND
  • Anti-HBV treatment (per local standard of care; e.g., entecavir) prior to study entry and willingness to continue treatment for the length of the study.
  • For patients with active hepatitis C virus (HCV):
  • Patients positive for hepatitis C virus (HCV) antibody are eligible, also if polymerase chain reaction testing is positive for HCV ribonucleic acid (RNA).
  • However, anti-viral therapy against HCV is only allowed prior to trial but not during the trial.
  • Negative HIV test.
  • Negative pregnancy test within 72 h prior to dosing.
  • Females of childbearing potential must agree to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 5 months or for a period of at least 5 half-lives of the respective drug/IMP (whichever is longer) after the last study treatment. A woman is considered to be of childbearing potential if she is postmenarcheal, has not reached a postmenopausal state (has not had ≥ 12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus). Examples of contraceptive methods with a failure rate of < 1% per year include bilateral tubal ligation, male sterilization, hormonal implants, established, proper use of combined oral or injected hormonal contraceptives, and certain intrauterine devices. The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception.
  • With female partners of childbearing potential, men must remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of 1% per year from screening to 5 months after the last dose of combination therapy or for a period of at least 5 half-lives of the respective drug/IMP after the last dose of combination therapy (whichever is longer). Men must refrain from donating sperm during this same period. Men with a pregnant partner must agree to remain abstinent or to use a condom for the duration of the pregnancy to avoid exposing the embryo.
  • The patient is willing and able to comply with the protocol for the duration of the study, including hospital visits for treatment and scheduled follow-up visits and examinations.
  • Must have a life expectancy of at least 12 weeks. *There are no data that indicate special gender distribution. Therefore, patients will be enrolled in the study gender-independently.

Who cannot join

  • Patients who meet any of the following criteria will be excluded from study entry:
  • Mixed cholangiocarcinoma and HCC.
  • Concurrent enrolment in another clinical study, unless it is an observational (non-interventional) study or a study without a medical intervention (specifically the PLATON registry [ClinicalTrials.gov identifier: NCT04484636] is allowed).
  • Note: After the Safety Follow-up (28 days post treatment discontinuation) participation in another clinical study is allowed.
  • Major surgery (as defined by the Investigator) within 4 weeks prior to enrollment into the study; patients must have recovered from effects of any major surgery.
  • Note: Local non-major surgery for palliative intent (e.g. surgery of isolated lesions, per-cutaneous biliary drainage or biliary stenting) is acceptable.
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  • Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious active, uncontrolled, gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent.
  • History of another primary malignancy except for:
  • Malignancy treated with curative intent and with no known active disease ≥ 3 years before the first dose of IMP and of low potential risk for recurrence;
  • Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease;
  • Adequately treated carcinoma in situ without evidence of disease.
  • Female patients who are pregnant or breastfeeding or male or female patients of reproductive potential who are not willing to employ effective birth control from screening to 5 months after the last dose of combination therapy or for a period of at least 5 half-lives of the respective drug/IMP after the last dose of combination therapy (whichever is longer).
  • Known allergy or hypersensitivity to any of the IMPs or any of the constituents of the product.
  • Any co-existing medical condition that in the investigator's judgement will substantially increase the risk associated with the patient's participation in the study.
  • Active or History of autoimmune disease including, but not limited to, myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, antiphospholipid antibody syndrome, Wegener's granulomatosis, Sjögren's syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis.
  • Note: History of autoimmune-related hypothyroidism on a stable dose of thyroid replacement hormone, or controlled Type 1 diabetes mellitus on a stable insulin regimen may be eligible based on consultation with the sponsor. Patients with eczema, psoriasis, lichen simplex chronicus, or vitiligo with dermatologic manifestations only (e.g., patients with psoriatic arthritis are excluded) are eligible for the study provided all following conditions are met:
  • Rash must cover < 10% of body surface area;
  • Disease is well controlled at baseline and requires only low- potency topical corticosteroids;
  • No occurrence of acute exacerbations of the underlying condition requiring psoralen plus ultraviolet A radiation, methotrexate, retinoids, biologic agents, oral calcineurin inhibitors, or high potency or oral corticosteroids within the previous 12 months.
  • 10. History of non-infectious pneumonitis requiring steroids, or patients with Grade ≥ 2 pneumonitis.
  • 11. History of active primary immunodeficiency. 12. History of allogeneic bone marrow transplantation or prior solid organ transplantation.
  • 13. Treatment with systemic immunosuppressive medication (including, but not limited 14. 15. to, corticosteroids, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-TNF-α agents) within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during study treatment, with the following exceptions:
  • Patients who received acute, low-dose systemic immunosuppressant medication or a one-time pulse dose of systemic immunosuppressant medication (e.g., 48 hours of corticosteroids for a contrast allergy) are eligible for the study.
  • Patients who received mineralocorticoids (e.g., fludrocortisone), corticosteroids for chronic obstructive pulmonary disease (COPD) or asthma, or low-dose corticosteroids for orthostatic hypotension or adrenal insufficiency are eligible for the study.
  • 16. Administration of a live, attenuated vaccine within four weeks or for a period of at least 5 half-lives of the respective drug/IMP (whichever is longer) prior to start of enrollment, or anticipation that such a live attenuated vaccine will be required during the study or within 5 months after the last dose of atezolizumab.
  • 17. Significant cardiovascular disease, such as cardiac disease (New York Heart Association Class II or greater), myocardial infarction or cerebrovascular accident within 3 months prior to initiation of study treatment, unstable arrhythmias, unstable angina, and/or concurrent and clinically significant abnormalities on electrocardiogram (ECG) at Screening, including QTcF > 450 ms for males or > 460 ms for females.
  • 18. Clinically significant valvular defect. 19. Unable or unwilling to swallow the complete daily dose of derazantinib capsules.
  • 20. Clinically unstable central nervous system (CNS) metastases (to be eligible, subjects must have stable disease > 3 months, confirmed by magnetic resonance imaging (MRI) or computed tomography (CT) scan, and/or have CNS metastases well controlled by low-dose steroids, anti-epileptics, or other symptom-relieving medications).
  • 21. Current evidence of clinically significant corneal or retinal disorder, including but not limited to bullous/band keratopathy, keratoconjunctivitis (except for keratoconjunctivits sicca), corneal abrasion (except if related to trauma), inflammation/ulceration, confirmed by ophthalmologic examination.
  • 22. Significant gastrointestinal disorder(s) that could, in the opinion of the Investigator, interfere with the absorption, metabolism, or excretion of derazantinib and/or atezolizumab (e.g., Crohn's disease, ulcerative colitis, extensive gastric resection).
  • 23. Active tuberculosis. 24. Co-infection with hepatitis B and hepatitis C. Patients who are negative for HCV RNA will be considered non-infected for HCV.
  • 25. Severe bacterial, fungal, viral and/or parasitic infections on therapeutic oral or IV medication at the time of first dose of study drug administration.
  • 26. Treatment with strong CYP3A4 inducers within 14 days prior to initiation of study treatment, including rifampin (and its analogues) or St. John's wort.
  • 27. Patient who has been incarcerated or involuntarily institutionalized by court order or by the authorities § 40 Abs. 1 S. 3 Nr. 4 AMG.
  • 28. Patients who are unable to consent because they do not understand the nature, significance and implications of the clinical trial and therefore cannot make a rational/informed decision after receiving the study information [§ 40 Abs. 1 S. 3 Nr. 3a AMG].

Trial locations and contacts

17 sites in 1 country.

17 sites in 1 country

Germany17 sites

  • HELIOS KLinikum Bad Saarow

    Bad Saarow

  • MVZ am Oskar-Helene Heim Berlin

    Berlin

  • Universitätsmedizin Berlin Charité

    Berlin

  • Vivantes Klinikum Berlin Friedrichshain

    Berlin

  • Johanniter Krankenhaus Bonn

    Bonn

  • Uniklinikum Köln

    Cologne

  • Klinikum Esslingen

    Esslingen am Neckar

  • Krankenhaus Nordwest gGmbH

    Frankfurt

  • Medizinische Hochschule Hannover

    Hanover

  • Alexianer Krefeld GmbH

    Krefeld

  • Universitätsklinikum Leipzig

    Leipzig

  • Universitätsmedizin Mainz

    Mainz

  • Universitätsmedizin Mannheim

    Mannheim

  • Klinikum rechts der Isar, Technische Universität München

    München

  • LMU München Großhadern

    Munich

  • Universitätsklinikum Tübingen

    Tübingen

  • Marienhospital Wesel

    Wesel

Other trials in Germany

About this study

Official title: A Phase II Single-arm, Open-label Study of Atezolizumab and Derazantinib for Patients With Advanced Intrahepatic Cholangiocarcinoma With FGFR2

The study trial is a open-label, single-arm, multicenter phase II trial investigating the combined treatment of atezolizumab and derazantinib in patients with advanced intrahepatic cholangiocarcinoma with FGFR2 fusions/rearrangements

Read the detailed description

The aim of this phase II study is to explore the safety and anti-tumor efficacy of the combination of atezolizumab and derazantinib in patients with advanced intrahepatic cholangiocarcinoma, with ORR as the primary endpoint.

The primary endpoint is the Objective Response Rate (ORR [assessed every 8 weeks (±7 days)]):

Objective response rate (ORR) according to investigator-based RECIST 1.1 assessment, defined as the proportion of allocated subjects with best response of complete or partial response within 9 months after the date of first administration of study treatment.

The secondary endpoints are safety and efficacy and will be evaluated by

  • Incidence, treatment relationship, seriousness, and severity of all AEs, SAEs, AESIs according to CTCAE V5.0
  • ORR@EOT:

Objective response rate (ORR) according to investigator-based RECIST 1.1 assessment, defined as the proportion of allocated subjects with best response of complete or partial response within study treatment.

  • PFSR@6, 8 and 10 months: The proportion of patients known to be alive and without confirmed objective disease progression at 6, 8 and 10 months after first administration of study treatment, respectively.
  • PFS: Time from first administration of study treatment until the date of first objective disease progression or death.
  • OS: Time from first administration of study treatment until death of a patient due to any cause
Being tested
Atezolizumab, Derazantinib
Medical subject headings
Cholangiocarcinoma

What participants receive

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

  • AtezolizumabDrug

    Also called Tecentriq

    Infusion i.v. of atezolizumab on day 1 of a 3-week cycle, first infusion rate over 60 minutes, subsequent infusion rates 30 minutes if tolerated for a maximum of 20 cycles in total

  • DerazantinibDrug

    Also called ARQ 087

    Oral intake of 300 mg derazantinib continuously on day 1 to day 21 of a 3-week cycle for a maximum of 20 cycles in total

Study groups in NCT05174650
Study groupRoleWhat they receive
Combined treatment with Atezolizumab and DerazantinibExperimentalTreatment with Atezolizumab 1200 mg i.v. every 3 weeks and Derazantinib 300 mp p.o. once daily for a maximum of 60 weeks or until disease progression or unacceptable toxicity or study termination
Receives: Drug: Atezolizumab; Drug: Derazantinib

What is being measured

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

  1. Primary Objective: Assessment of Efficacy

    Objective Response Rate (ORR) will be assessed every 8 weeks (+/- 7 days) according to RECIST 1.1 criteria

    Measured: up to 4 years, at EOS

Secondary outcomes (4)

  1. Secondary Objective: Assessment of Safety

    All adverse events (including serious adverse events and adverse events of special interest) will be assessed for saftey of study treatment in accordance with CTCAE V 5.0

    Measured: up to 4 years, at EOS

  2. Secondary Objective: Assessment of Efficacy in relation to objection response rate at EOT

    Objective response rate (ORR) according to investigator-based RECIST 1.1 assessment, defined as the proportion of allocated subjects with best response of complete or partial response within study treatment.

    Measured: up to 4 years, at EOS

  3. Secondary Objective: Assessment of Efficacy in relation to progression free survival

    The proportion of patients known to be alive and without confirmed objective disease progression at 6, 8 and 10 months after first administration of study treatment, respectively and time from first administration of study treatment until the date of first objective disease progression or death.

    Measured: up to 4 years, at EOS

  4. Secondary Objective: Assessment of Efficacy in relation to overall survival

    Time from first administration of study treatment until death of a patient due to any cause

    Measured: 4 years, at EOS

Timeline

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

  1. First posted3 Jan 2022
  2. Study start20 Apr 2022
  3. Primary completionDec 2025 (estimated)
  4. Study completionAug 2026 (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
27 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05174650
Sponsor's protocol ID
ADVANCE_2020
Status last verified
Apr 2025
First submitted
9 Nov 2021
Last updated
5 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: No IPD will be shared

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Atezolizumab and Derazantinib in people with Intrahepatic Cholangiocarcinoma, run by Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest at 17 sites in Germany.

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 37 inclusion and 35 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: under way, not looking for participants, as of the sponsor's last update on 5 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in Germany. 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?

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?

Primary Objective: Assessment of Efficacy (time frame: up to 4 years, at EOS). 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 NCT05174650.

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 5 Dec 2025.

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