A Study of Durvalumab or Tremelimumab Monotherapy, or Durvalumab in Combination With Tremelimumab or Bevacizumab in Advanced Hepatocellular Carcinoma

NCT ID: NCT02519348

Last Updated: 2025-10-14

Study Results

Results available

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Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

433 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-19

Study Completion Date

2026-04-01

Brief Summary

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This is a multicenter, open-label, stratified, randomized study to evaluate the safety, tolerability, antitumor activity, pharmacokinetics, pharmacodynamics, and immunogenicity of durvalumab or tremelimumab monotherapy, or durvalumab in combination with tremelimumab or bevacizumab in advanced hepatocellular carcinoma.

Detailed Description

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The study will comprise of 6 parts. Participants in Part 1A (safety run-in cohort), Part 1B (efficacy-gating cohort), Part 2A, and Part 4 will receive weight-based dosing regimens; and participants in Part 2B and Part 3 will receive fixed dosing regimens. Part 1A Stage 2 of the study may start after the first 3 participants in Stage 1 have been observed on study for at least 4 weeks. In addition, a separate cohort of participants will be enrolled in mainland China (China cohort) once global recruitment in Part 2A will be closed.

* In Part 1 (both 1A and 1B), participants will receive tremelimumab 1 mg/kg intravenous (IV) every 4 weeks (Q4W) 4 doses and durvalumab 20 mg/kg Q4W.
* In Part 2A, participants will be randomized in a 1:1:1 ratio to receive:

* Durvalumab 20 mg/kg Q4W
* Tremelimumab 10 mg/kg Q4W × 7 doses followed by every 12 weeks (Q12W)
* Tremelimumab 1 mg/kg Q4W × 4 doses + durvalumab 20 mg/kg Q4W, followed by durvalumab 20 mg/kg Q4W
* In China cohort, Part 2A study design will be followed.
* In Part 2B, participants will receive tremelimumab 300 mg × 1 dose + durvalumab 1500 mg Q4W.
* In Part 3, participants will be randomized in a 2:2:1:2 ratio to receive:

* Durvalumab 1500 mg Q4W
* Tremelimumab 300 mg × 1 dose + durvalumab 1500 mg Q4W
* Tremelimumab 750 mg Q4W for 7 doses followed by Q12W
* Tremelimumab 75 mg Q4W × 4 doses + durvalumab 1500 mg Q4W, followed by durvalumab 1500 mg Q4W.

Following protocol amendment 5, enrollment into 'Tremelimumab 75 mg Q4W × 4 doses + durvalumab 1500 mg' arm will close. Participants will be randomized at a ratio of 2:1:2 in 'Durvalumab 1500 mg Q4W', 'Tremelimumab 750 mg Q4W for 7 doses followed by Q12W', and 'Tremelimumab 300 mg × 1 dose + durvalumab 1500 mg Q4W' arms, respectively.

• In Part 4, participants will receive durvalumab 1120 mg (15 mg/kg) + bevacizumab 15 mg/kg every 3 weeks (Q3W).

Participants will receive the treatment until confirm progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurs first.

All participants will be followed for survival until the end of study visit (last participant discontinues the study treatment).

Conditions

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Hepatocellular Carcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Part 1: Tremelimumab 1 mg/kg + Durvalumab 20 mg/kg

Participants in Part 1A (safety run-in cohort) and Part 1 B (efficacy-gating cohort) will receive tremelimumab 1 mg/kg every 4 weeks (Q4W) 4 doses and durvalumab 20 mg/kg Q4W until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurs first.

Group Type EXPERIMENTAL

Tremelimumab

Intervention Type BIOLOGICAL

Tremelimumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Durvalumab

Intervention Type BIOLOGICAL

Durvalumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Parts 2 and 3: Durvalumab 1500 mg

Participants will receive durvalumab 1500 mg Q4W until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurs first.

Group Type EXPERIMENTAL

Durvalumab

Intervention Type BIOLOGICAL

Durvalumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Parts 2 and 3: Tremelimumab 300 mg + Durvalumab 1500 mg

Participants will receive tremelimumab 300 mg 1 dose and durvalumab 1500 mg Q4W until confirmed progressive disease, withdrawal of consent, lost to follow, or development of other reason for treatment discontinuation, whichever occurs first.

Group Type EXPERIMENTAL

Tremelimumab

Intervention Type BIOLOGICAL

Tremelimumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Durvalumab

Intervention Type BIOLOGICAL

Durvalumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Parts 2 and 3: Tremelimumab 750 mg

Participants will receive tremelimumab 750 mg Q4W 7 doses followed by every 12 weeks (Q12W) until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurs first.

Group Type EXPERIMENTAL

Tremelimumab

Intervention Type BIOLOGICAL

Tremelimumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Parts 2 and 3: Tremelimumab 75 mg + Durvalumab 1500 mg

Participants will receive tremelimumab 75 mg Q4W 4 doses and durvalumab 1500 mg Q4W until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurs first. Participant recruitment to this arm was closed following protocol amendment 5.

Group Type EXPERIMENTAL

Tremelimumab

Intervention Type BIOLOGICAL

Tremelimumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Durvalumab

Intervention Type BIOLOGICAL

Durvalumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Part 4: Durvalumab 1120 mg + Bevacizumab 15 mg/kg

Participants will receive durvalumab 1120 mg and bevacizumab 15 mg/kg every 3 weeks (Q3W) until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurs first

Group Type EXPERIMENTAL

Durvalumab

Intervention Type BIOLOGICAL

Durvalumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Bevacizumab

Intervention Type BIOLOGICAL

Bevacizumab 15 mg/kg will be administered by IV infusion every 3 weeks until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurred first.

China Cohort: Durvalumab 20 mg/kg

Participants will receive durvalumab 20 mg/kg Q4W until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurs first.

Group Type EXPERIMENTAL

Durvalumab

Intervention Type BIOLOGICAL

Durvalumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

China Cohort: Tremelimumab 10 mg/kg

Participants will receive tremelimumab 10 mg/kg Q4W 7 doses followed by Q12W until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurs first.

Group Type EXPERIMENTAL

Tremelimumab

Intervention Type BIOLOGICAL

Tremelimumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

China Cohort: Tremelimumab 1 mg/kg + Durvalumab 20 mg/kg

Participants will receive tremelimumab 1 mg/kg Q4W 4 doses and durvalumab 20 mg/kg Q4W until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurs first.

Group Type EXPERIMENTAL

Tremelimumab

Intervention Type BIOLOGICAL

Tremelimumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Durvalumab

Intervention Type BIOLOGICAL

Durvalumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Interventions

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Tremelimumab

Tremelimumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Intervention Type BIOLOGICAL

Durvalumab

Durvalumab will be administered by IV infusion according to doses and frequency mentioned in arms' description.

Intervention Type BIOLOGICAL

Bevacizumab

Bevacizumab 15 mg/kg will be administered by IV infusion every 3 weeks until confirmed progressive disease, withdrawal of consent, lost to follow-up, or development of other reason for treatment discontinuation, whichever occurred first.

Intervention Type BIOLOGICAL

Other Intervention Names

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MEDI4736

Eligibility Criteria

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Inclusion Criteria

1. Male or female participants
2. 18 years and older (Japan-20 years and older)
3. Confirmed hepatocellular carcinoma (HCC) based on histopathological findings from tumor tissues. Advanced HCC with diagnosis confirmed pathologically or with noninvasive methods.
4. Immunotherapy-naïve
5. Have either progressed on, are intolerant to, or refused treatment with sorafenib or another approved TKI. For arm 5 only: Have not received any prior systemic therapy for HCC.

Exclusion Criteria

1. Prior exposure to immune-mediated therapy
2. Hepatic encephalopathy within past 12 months or requirement for medications to prevent or control encephalopathy
3. Gastrointestinal bleeding (eg, esophageal varices or ulcer bleeding) within 12 months
4. Ascites requiring non-pharmacologic intervention (eg, paracentesis) to maintain symptomatic control, within 6 months prior to the first scheduled dose.
5. Main portal vein thrombosis (Vp4) as documented on imaging
6. Any concurrent chemotherapy, immunotherapy, or biologic or hormonal therapy for cancer treatment
7. Active or prior documented autoimmune or inflammatory disease with some exceptions
8. Current or prior use of immunosuppressive medication within 14 days with some exceptions
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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MedImmune LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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MedImmune, LLC MedImmune, LLC

Role: STUDY_DIRECTOR

MedImmune LLC

Locations

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Research Site

Phoenix, Arizona, United States

Site Status

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San Francisco, California, United States

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New Haven, Connecticut, United States

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Jacksonville, Florida, United States

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Tampa, Florida, United States

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Indianapolis, Indiana, United States

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Boston, Massachusetts, United States

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New York, New York, United States

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Stony Brook, New York, United States

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Durham, North Carolina, United States

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Portland, Oregon, United States

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Philadelphia, Pennsylvania, United States

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Philadelphia, Pennsylvania, United States

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Nashville, Tennessee, United States

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Dallas, Texas, United States

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Seattle, Washington, United States

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Hangzhou, , China

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Nanjing, , China

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Shanghai, , China

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Hong Kong, , Hong Kong

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Shatin, , Hong Kong

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Benevento, , Italy

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Milan, , Italy

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Roma, , Italy

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Chūōku, , Japan

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Kashiwa, , Japan

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Osakasayama-shi, , Japan

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Bukit Merah, , Singapore

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Singapore, , Singapore

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Singapore, , Singapore

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Busan, , South Korea

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Junggu, , South Korea

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Seongnam-si, , South Korea

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Seoul, , South Korea

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Seoul, , South Korea

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Seoul, , South Korea

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Seoul, , South Korea

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Barcelona, , Spain

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Barcelona, , Spain

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Córdoba, , Spain

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Pamplona, , Spain

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Kaohsiung City, , Taiwan

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Taipei, , Taiwan

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Taoyuan, , Taiwan

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Countries

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United States China Hong Kong Italy Japan Singapore South Korea Spain Taiwan

References

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Kelley RK, Sangro B, Harris W, Ikeda M, Okusaka T, Kang YK, Qin S, Tai DW, Lim HY, Yau T, Yong WP, Cheng AL, Gasbarrini A, Damian S, Bruix J, Borad M, Bendell J, Kim TY, Standifer N, He P, Makowsky M, Negro A, Kudo M, Abou-Alfa GK. Safety, Efficacy, and Pharmacodynamics of Tremelimumab Plus Durvalumab for Patients With Unresectable Hepatocellular Carcinoma: Randomized Expansion of a Phase I/II Study. J Clin Oncol. 2021 Sep 20;39(27):2991-3001. doi: 10.1200/JCO.20.03555. Epub 2021 Jul 22.

Reference Type DERIVED
PMID: 34292792 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2024-517085-41-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

2015-001663-39

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

D4190C00022

Identifier Type: -

Identifier Source: org_study_id

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