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Hepatocellular Carcinoma (HCC)ARTENCT06806579

Atezolizumab-bevacizumab and Other Immunotherapies: Real-life Experience for Treatment of Hepatocellular Carcinoma

An observational study of Hepatocellular Carcinoma (HCC), run by IRCCS Azienda Ospedaliero-Universitaria di Bologna at 24 sites in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Background Hepatocellular carcinoma (HCC), is the fifth most common cancer worldwide and the third leading cause of cancer-related death. In most cases (about 80%), HCC develops in a cirrhotic liver - a condition where the liver has been damaged over time, leading to scarring. This makes treatment more challenging. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hepatocellular Carcinoma (HCC)
How many people
1,000 participants
Where
24 sitesItaly
Study dates
21 Dec 2022to 31 Oct 2031
Phase
Observational
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

Study population: Data will be collected from patients with hepatocellular carcinoma (HCC) who are candidates for treatment with atezolizumab-bevacizumab or durvalumab-tremelimumab. Patients will be evaluated in outpatient clinics or inpatient departments of the participating centers as part of the standard care pathway for HCC patients. Data will be collected at the patient's first evaluation and during subsequent assessments (approximately every 3-4 weeks), as per the routine care process for HCC patients receiving pharmacological treatments. The follow-up observation for each patient will continue as part of the standard care pathway.

Who may be able to join

  • Hepatocellular carcinoma not amenable to locoregional procedures
  • Candidate to frontline systemic treatment with atezolizumab-bevacizumab or other immunotherapies

Who cannot join

  • Concurrent treatment with other antineoplastic agents
  • Other active neoplasia

Trial locations and contacts

24 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Francesco Tovoli, MD contact

+390512142214

francesco.tovoli@unibo.it

24 sites in 1 country

Italy24 sites, 24 recruiting
  • AUSL Bologna Via Castiglione 15 40136 Bologna BO

    Bologna, BO, 40136

    Stefania De Lorenzo, 0542662672, stefania.delorenzo@auslbologna.bo.it

    Recruiting
  • IRCCS Azienda Ospedaliero-Universitaria di Bologna (Oncology Unit), Bologna, BO 40136

    Bologna, BO, 40136

    Giovanni Brandi, +390512143838, giovanni.brandi@unibo.it

    Recruiting
  • IRCCS Azienda Ospedaliero-Universitaria di Bologna (Semiotics Unit)

    Bologna, BO, 40136

    Paolo Caraceni, +390512142718, paolo.caraceni@unibo.it

    Recruiting
  • IRCCS Azienda Ospedaliero-Universitaria di Bologna

    Bologna, BO, 40136

    Francesco Tovoli, MD, +390512142214, francesco.tovoli@unibo.it

    Recruiting
  • I.R.C.C.S. "S. De Bellis", Via Turi, 27, 70013 Castellana Grotte BA

    Castellana Grotte, BA, 70013

    Francesco Losito, +39 080 499 4111, francesco.losito@gmail.com

    Not yet recruiting
  • Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione "Garibaldi, Piazza Santa Maria di Gesù, 5, 95123 Catania CT

    Catania, CT, 95123

    Maurizio Russello, +39 095 759 1111, m.russello@arnasgaribalidi.it

    Not yet recruiting
  • Ospedale degli Infermi Viale Stradone, 9 48018 Faenza (RA)

    Faenza, RA, 48018

    Francesco Giuseppe Foschi, 0546 601214, francesco.foschi@auslromagna.it

    Recruiting
  • AOU Careggi. Largo G. Alessandro Brambilla, 3. 50134 Firenze FI

    Florence, FI, 50134

    Fabio Marra, +39 055 2758095, fabio.marra@unifi.it

    Recruiting
  • Ospedali Riuniti. Viale Pinto Luigi, 1, 71122 Foggia FG.

    Foggia, FG, 71122

    Rodolfo Sacco, +39 0881 731111, saccorodolfo@hotmail.com

    Recruiting
  • Ospedali Riuniti. Viale Pinto Luigi, 1, 71122 Foggia FG

    Foggia, FG, 71122

    Gaetano Serviddio, +39 0881 731111, gaetano.serviddio@unifg.it

    Not yet recruiting
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico. via Francesco Sforza, 28 - 20122 Milano.

    Milan, MI, 20122

    Massimo Alberto Iavarone, + 39 02 5503.5432, massimo.iavarone@gmail.com

    Recruiting
  • ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162 Milano

    Milan, MI, 20162

    Chiara Mazzarelli, +39 02 64441, chiara.mazzarelli@ospedaleniguarda.it

    Not yet recruiting
  • Policlinico di Modena Via del Pozzo, 71, 41125 Modena MO

    Modena, Missouri, 41125

    Antonio Colecchia, 059 4222111, antonio.colecchia@unimore.it

    Not yet recruiting
  • P.O. Ospedale del Mare. Via Enrico Russo, 11, 80147 Napoli NA

    Naples, 80147

    Piera Federico, +39 081 254 1111, piera.federico@yahoo.it

    Recruiting
  • Azienda Ospedaliero- Universitaria Maggiore della Carità, Padiglione G, L.go Bellini, 28100 Novara NO

    Novara, 28100

    Cristina Rigamonti, +39 03213731, cristina.rigamonti@uniupo.it

    Not yet recruiting
  • Istituto Oncologico Veneto. Via Gattamelata, 64, 35128 Padova PD

    Padova, PD, 35128

    Caterina Soldà, +39 049 821 1111, caterina.solda@iov.veneto.it

    Recruiting
  • Azienda Ospedaliero- Universitaria Paolo Giaccone. Via Liborio Giuffrè, 5, 90127 Palermo

    Palermo, PA, 90127

    Giuseppe Cabibbo, +39 091 655 1111, giuseppe.cabibbo@unipa.it

    Recruiting
  • AOU Pisana. Via Roma 67. 56126 Pisa PI

    Pisa, PI, 56126

    Masi Gianluca, +39 050 992725, gianluca.masi@unipi.it

    Recruiting
  • IRCCS Santa Maria Nuova Viale Risorgimento, 80, 42123 Reggio Emilia

    Reggio Emilia, RE, 42123

    Silvia Fanello, 0522296610, silvia.fanello@ausl.re.it

    Not yet recruiting
  • Policlinico Gemelli. Largo Agostino Gemelli, 8, 00168 Roma RM

    Roma, RM, 00168

    Francesca Ponziani, 06 30151, francesca.ponziani@gmail.com

    Recruiting
  • Humanitas Research Hospital. Via Alessandro Manzoni, 56, 20089 Rozzano MI

    Rozzano, MI, 20089

    Tiziana Pressiani, + 39 02 82241, tiziana.pressiani@cancercenter.humanitas.it

    Recruiting
  • Ospedali Riuniti Ancona, Via Conca, 71, 60126 Torrette AN

    Torrette, AN, 60126

    Gianluca Svegliati-Baroni, +39 071 5961, gsvegliati@gmail.com

    Recruiting
  • Azienda sanitaria universitaria Friuli Centrale, Piazzale Santa Maria della Misericordia, 15 33100 Udine (UD)

    Udine, UD, 33100

    Pierluigi Toniutto, +39 0432 5521, pierluigi.toniutto@uniud.it

    Not yet recruiting
  • Azienda Ospedaliera Universitaria Integrata di Verona. Piazzale Aristide Stefani, 1, 37126 Verona VR

    Verona, VR, 37126

    +39 045 812 1111, andrea.dalbeni@univr.it

    Recruiting

Other trials in Italy

About this study

  • Background Hepatocellular carcinoma (HCC), is the fifth most common cancer worldwide and the third leading cause of cancer-related death. In most cases (about 80%), HCC develops in a cirrhotic liver - a condition where the liver has been damaged over time, leading to scarring. This makes treatment more challenging.

This study will gather and analyze data from patients treated in real-world settings to:

Read more
  1. Understand the effectiveness and safety of new treatment combinations (e.g., atezolizumab-bevacizumab and durvalumab-tremelimumab). Identify the best treatment sequences for patients with advanced liver cancer.
  2. Discover clinical and laboratory markers that predict treatment responses, helping personalize care and optimize outcomes.

By addressing these questions, this study will provide valuable information to healthcare providers and guide future treatment decisions for patients with liver cancer.

Read the detailed description
  • Background Hepatocellular carcinoma (HCC), is the fifth most common cancer worldwide and the third leading cause of cancer-related death. In most cases (about 80%), HCC develops in a cirrhotic liver - a condition where the liver has been damaged over time, leading to scarring. This makes treatment more challenging.
  • New Advances in Treatment Options

For many years, sorafenib was the only approved drug for advanced liver cancer when local treatments like surgery were not possible. However, significant advancements have changed the treatment landscape:

  1. Atezolizumab and Bevacizumab (Immunotherapy Combination): In 2019, a groundbreaking study (ImBRAVE-150, Phase 3) demonstrated that combining atezolizumab (an immunotherapy drug) and bevacizumab (an anti-angiogenic drug) significantly improved disease-free survival (time without cancer worsening) and overall survival compared to sorafenib. This combination was approved in 2019 by the European Medicines Agency (EMA) and later by the Italian Medicines Agency (AIFA) in 2022.
  2. Durvalumab and Tremelimumab (Dual Immunotherapy):

In February 2024, another combination-durvalumab and tremelimumab-was introduced following the results of the Phase 3 HIMALAYA trial, which also showed improved outcomes compared to sorafenib.

Several other immunotherapy-based combinations, such as camrelizumab-rivoceranib and nivolumab-ipilimumab, are under evaluation and may become available in the future.

  • Why Is This Study Important?
  1. Real-World Effectiveness of Treatments: While clinical trials have shown promising results for atezolizumab-bevacizumab and durvalumab-tremelimumab, real-world data-information gathered from everyday clinical practice-are still limited. In particular, there is a lack of real-world evidence for the new durvalumab-tremelimumab combination. This study aims to fill that gap by collecting and analyzing data from patients treated in daily clinical practice.
  2. Understanding Treatment Sequences: After completing atezolizumab-bevacizumab or durvalumab-tremelimumab, what is the best next treatment? Currently, the only approved next-line drug is sorafenib, and for third-line treatment in Italy, cabozantinib is the only option. However, there is no clear scientific data on the effectiveness of these treatment sequences. As more therapies become available, it will be critical to identify the best sequence of treatments to extend survival and improve quality of life.
  3. Identifying Predictors of Response: Some patients respond better to treatment than others. This study seeks to identify clinical and laboratory markers that predict which patients will benefit most from specific therapies. For example, with sorafenib, the development of certain side effects (like skin reactions) was associated with better survival. It remains unclear whether similar markers exist for newer drug combinations. Additionally, the study will examine how factors such as treatment intolerance, patterns of disease progression, and second-line therapies influence survival outcomes.
  • What This Study Aims to Achieve

This study will gather and analyze data from patients treated in real-world settings to:

  1. Understand the effectiveness and safety of new treatment combinations (e.g., atezolizumab-bevacizumab and durvalumab-tremelimumab). Identify the best treatment sequences for patients with advanced liver cancer.
  2. Discover clinical and laboratory markers that predict treatment responses, helping personalize care and optimize outcomes.

By addressing these questions, this study will provide valuable information to healthcare providers and guide future treatment decisions for patients with liver cancer.

Keywords
atezolizumab, bevacizumab, tremelimumab, durvalumab, immunotherapy, real-life, outcome
Medical subject headings
Carcinoma, Hepatocellular

What is being measured

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

  1. Evaluate toxicity as first-line therapy

    To evaluate toxicity of therapeutic sequences in which atezolizumab-bevacizumab or other immunothrapies were administered as first-line therapy within the standard care pathway for patients with hepatocellular carcinoma.

    Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

    Measured: from enrollment up to 3 years from the first dose

Secondary outcomes (5)
  1. Progression-free survival

    defined as the time between the first administration of atezolizumab-bevacizumab or durvalumab-tremelimumab and radiological progression

    Measured: from enrollment up to 3 years from the first dose

  2. Overall survival

    defined as the time between the treatment start and the death of the patient, or to the last follow-up evaluation

    Measured: from enrollment up to 3 years from the first dose

  3. Objective response rate (ORR)

    defined as the percentage of patients who achieve a partial or complete response to the disease on follow-up imaging, according to RECIST 1.1 criteria, out of the total number of patients who undergo at least one radiological assessment.

    Measured: from enrollment up to 3 years from the first dose

  4. Rate of Patients Eligible for Second-Line Treatments

    defined as the percentage of patients who, after the definitive discontinuation of atezolizumab-bevacizumab or other immunotherapies, have sufficiently good general conditions and liver function to allow the prescription of an additional line of systemic treatment.

    Measured: from enrollment up to 3 years from the first dose

  5. Safety monitoring

    Incidence of Adverse Events Related to Atezolizumab-Bevacizumab or other immunotherapies

    Measured: from enrollment up to 3 years from the first dose

Timeline

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

  1. First posted4 Feb 2025
  2. Study start21 Dec 2022
  3. Primary completion31 Oct 2030 (estimated)
  4. Study completion31 Oct 2031 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
1,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06806579
Sponsor's protocol ID
ARTE
Acronym
ARTE
Status last verified
Dec 2024
First submitted
10 Jan 2025
Last updated
4 Feb 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Privacy regulations

Publications

  • Stefanini B, Rimassa L, Iavarone M, Cabibbo G, Marra F, Vivaldi C, Dalbeni A, Ponziani FR, Palloni A, Lonardi S, Lani L, Federico P, Svegliati-Baroni G, Pressiani T, Ielasi L, Mazzarelli C, De Lorenzo S, Sacco R, Bruccoleri M, Celsa C, Mastro A, Masi G, Auriemma A, Stella L, Toniutto P, Villani R, Deiana C, Ascari S, Marseglia M, Granito A, Piscaglia F, Tovoli F; ARTE Study Group. Stratifying Cardiovascular Risk in Patients With HCC Receiving Atezolizumab/Bevacizumab: A Comparison of ESC and CARDIOSOR Scores. Liver Int. 2026 Nov;46(11):e70909. doi: 10.1111/liv.70909.

    PubMed 42839680

Questions about this trial

What is this clinical trial studying?

An observational study of Hepatocellular Carcinoma (HCC), run by IRCCS Azienda Ospedaliero-Universitaria di Bologna at 24 sites in Italy.

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 2 inclusion and 2 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: looking for participants now, as of the sponsor's last update on 4 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 24 sites in Italy. 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.

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?

Contact Francesco Tovoli, MD (+390512142214, francesco.tovoli@unibo.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Evaluate toxicity as first-line therapy (time frame: from enrollment up to 3 years from the first dose). 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 NCT06806579, 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 4 Feb 2025; AzTrials last refreshed its copy on 8 Nov 2026.

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