Atezolizumab and BEvacizumab With STereotactic Body Radiotherapy for Advanced Hepatocellular Carcinoma

NCT ID: NCT06595108

Last Updated: 2024-11-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

33 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-28

Study Completion Date

2028-03-27

Brief Summary

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To determine the efficacy and safety of atezolizumab-bevacizumab combination therapy plus stereotactic body radiotherapy(SBRT) in patients with advanced hepatocellular carcinoma, Subjects will start SBRT for one or more primary cancers and/or metastatic lesions and no more than 5 sites within two month before and after the start date of atezolizumab-bevacizumab combination therapy.

In this study, it is expected to improve the treatment response rate of atezolizumab-bevacizumab therapy, which is currently first-line chemotherapy but has a low treatment response rate.

Detailed Description

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The subjects with advanced hepatocellular carcinoma who are indicated for the first-line atezolizumab-bevacizumab combination therapy are the primary subjects, and if they voluntarily agree to the clinical trial after explanation of the clinical trial, they are included in the clinical trial. Subjects should begin SBRT(stereotactic body radiotherapy) to one or more but not more than five sites for primary cancer and/or metastatic lesions within two month before and after the start date of atezolizumab-bevacizumab combination therapy.

The followings are evaluation items for each visit.

Visit 1 (-6\~0 weeks) ± 7days \*Screening

* Informed consent form
* Inclusion Criteria/ Exclusion Criteria
* Medical history and physical examination
* Staging via CT, MRI, PET-CT, etc. (PET-CT examination is not compulsory)
* CBC, SMA, PT/aPTT, Tumor markers, Biomarkers
* Stool microbiota NGS
* QoL Questionnaire(EORTC-QLQ-C30 V3)

Visit 2 (0\~7 weeks) ± 7 days \*During SBRT

* Confirmation of adverse events
* QoL Questionnaire(EORTC-QLQ-C30 V3)

Visit 3 (1\~8 weeks) \*1 week after SBRT

* Confirmation of adverse events
* CBC, SMA, PT/aPTT, Tumor markers, Biomarkers
* QoL Questionnaire(EORTC-QLQ-C30 V3)

Visit 4 (6\~9 weeks) ± 7 days \*After 2 cycles of chemotherapy

* Confirmation of adverse events
* CBC, SMA, PT/aPTT, Tumor markers, Biomarkers
* Stool microbiota NGS
* QoL Questionnaire(EORTC-QLQ-C30 V3)

Visit: 5\~12 (3\~36 months) ± 2 weeks \*Follow-up

* Confirmation of adverse events
* Evaluation of effectiveness\* (Imaging tests, Tumor markers, CBC, SMA, PT/aPTT are performed according to the need)
* QoL Questionnaire(EORTC-QLQ-C30 V3)

Conditions

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Advanced Hepatocellular Carcinoma Chemotherapy Stereotactic Body Radiotherapy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Patients with advanced hepatocellular carcinoma who are indicated for the first-line atezolizumab-bevacizumab combination chemotherapy should begin stereotactic body radiotherapy to one or more but not more than five sites for primary cancer and/or metastatic lesions.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Patients with advanced hepatocellular carcinoma who are indicated for the first-line atezolizumab-bevacizumab combination chemotherapy should begin stereotactic body radiotherapy to one or more but not more than five sites for primary cancer and/or metastatic lesions.

Study Groups

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Patients with advanced hepatocellular carcinoma

Patients indicated for the first-line atezolizumab-bevacizumab combination therapy are the primary subjects, and those voluntarily agree to the clinical trial after explanation of the study, are enrolled in the study.

Group Type EXPERIMENTAL

Stereotactic body radiotherapy

Intervention Type RADIATION

Patients with advanced hepatocellular carcinoma who are indicated for the first-line atezolizumab-bevacizumab combination therapy are the primary subjects, and they should begin stereotactic radiotherapy to one or more but not more than five sites for primary cancer and/or metastatic lesions within two month before and after the start date of atezolizumab-bevacizumab combination therapy.

Interventions

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Stereotactic body radiotherapy

Patients with advanced hepatocellular carcinoma who are indicated for the first-line atezolizumab-bevacizumab combination therapy are the primary subjects, and they should begin stereotactic radiotherapy to one or more but not more than five sites for primary cancer and/or metastatic lesions within two month before and after the start date of atezolizumab-bevacizumab combination therapy.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

1. Age 19 to 80 years old
2. Liver function Child-Pugh class A
3. ECOG 0-1
4. Patient clinically or pathologically diagnosed with hepatocellular carcinoma
5. Advanced hepatocellular carcinoma that is inoperable
6. Satisfies the dose limits for normal organs and lesions of an appropriate size to be included in the scope of radiotherapy.

Exclusion Criteria

1. Brain metastases
2. Have a history of malignancy other than hepatocellular carcinoma within the last 5 years (except for malignancies with little risk of metastasis or death, e.g., adequately treated cervical carcinoma in situ, non-melanoma skin cancer, localized prostate cancer, tubular carcinoma in situ, or stage 1 uterine cancer.)
3. Subjects with a high probability of untreated gastric or esophageal varices or bleeding
4. Serious uncontrolled medical comorbidities
5. History of liver transplant surgery
6. Autoimmune liver disease
Minimum Eligible Age

19 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yonsei University

OTHER

Sponsor Role lead

Responsible Party

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Hwa Kyung Byun

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hwakyung BYUN, Phd

Role: PRINCIPAL_INVESTIGATOR

Severance Hospital

Locations

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Yongin Severance Hospital

Yongin-si, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Hwakyung BYUN, Phd

Role: CONTACT

007981072098955

Facility Contacts

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Hwakyung BYUN, Phd

Role: primary

0079803151898166

References

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Meng L, Xu J, Ye Y, Wang Y, Luo S, Gong X. The Combination of Radiotherapy With Immunotherapy and Potential Predictive Biomarkers for Treatment of Non-Small Cell Lung Cancer Patients. Front Immunol. 2021 Sep 21;12:723609. doi: 10.3389/fimmu.2021.723609. eCollection 2021.

Reference Type BACKGROUND
PMID: 34621270 (View on PubMed)

Demaria S, Golden EB, Formenti SC. Role of Local Radiation Therapy in Cancer Immunotherapy. JAMA Oncol. 2015 Dec;1(9):1325-32. doi: 10.1001/jamaoncol.2015.2756.

Reference Type BACKGROUND
PMID: 26270858 (View on PubMed)

Demaria S, Guha C, Schoenfeld J, Morris Z, Monjazeb A, Sikora A, Crittenden M, Shiao S, Khleif S, Gupta S, Formenti SC, Vikram B, Coleman CN, Ahmed MM. Radiation dose and fraction in immunotherapy: one-size regimen does not fit all settings, so how does one choose? J Immunother Cancer. 2021 Apr;9(4):e002038. doi: 10.1136/jitc-2020-002038.

Reference Type BACKGROUND
PMID: 33827904 (View on PubMed)

Byun HK, Kim N, Park S, Seong J. Acute severe lymphopenia by radiotherapy is associated with reduced overall survival in hepatocellular carcinoma. Strahlenther Onkol. 2019 Nov;195(11):1007-1017. doi: 10.1007/s00066-019-01462-5. Epub 2019 Apr 15.

Reference Type BACKGROUND
PMID: 30989242 (View on PubMed)

Theelen WSME, Peulen HMU, Lalezari F, van der Noort V, de Vries JF, Aerts JGJV, Dumoulin DW, Bahce I, Niemeijer AN, de Langen AJ, Monkhorst K, Baas P. Effect of Pembrolizumab After Stereotactic Body Radiotherapy vs Pembrolizumab Alone on Tumor Response in Patients With Advanced Non-Small Cell Lung Cancer: Results of the PEMBRO-RT Phase 2 Randomized Clinical Trial. JAMA Oncol. 2019 Sep 1;5(9):1276-1282. doi: 10.1001/jamaoncol.2019.1478.

Reference Type BACKGROUND
PMID: 31294749 (View on PubMed)

Luke JJ, Lemons JM, Karrison TG, Pitroda SP, Melotek JM, Zha Y, Al-Hallaq HA, Arina A, Khodarev NN, Janisch L, Chang P, Patel JD, Fleming GF, Moroney J, Sharma MR, White JR, Ratain MJ, Gajewski TF, Weichselbaum RR, Chmura SJ. Safety and Clinical Activity of Pembrolizumab and Multisite Stereotactic Body Radiotherapy in Patients With Advanced Solid Tumors. J Clin Oncol. 2018 Jun 1;36(16):1611-1618. doi: 10.1200/JCO.2017.76.2229. Epub 2018 Feb 13.

Reference Type BACKGROUND
PMID: 29437535 (View on PubMed)

Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, Keall P, Lovelock M, Meeks S, Papiez L, Purdie T, Sadagopan R, Schell MC, Salter B, Schlesinger DJ, Shiu AS, Solberg T, Song DY, Stieber V, Timmerman R, Tome WA, Verellen D, Wang L, Yin FF. Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys. 2010 Aug;37(8):4078-101. doi: 10.1118/1.3438081.

Reference Type BACKGROUND
PMID: 20879569 (View on PubMed)

Timmerman R. A Story of Hypofractionation and the Table on the Wall. Int J Radiat Oncol Biol Phys. 2022 Jan 1;112(1):4-21. doi: 10.1016/j.ijrobp.2021.09.027. No abstract available.

Reference Type BACKGROUND
PMID: 34919882 (View on PubMed)

Other Identifiers

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09-2024-0026

Identifier Type: -

Identifier Source: org_study_id

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