Esophageal Varices Prophylaxis in Hepatocellular Carcinoma Treated With Atezolizumab and Bevacizumab

NCT ID: NCT06961526

Last Updated: 2025-05-08

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

110 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-15

Study Completion Date

2026-07-31

Brief Summary

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The goal of this prospective cohort study is to evaluate the progression of esophagogastric varices in patients treated with atezolizumab-bevacizumab. Assess the efficacy of primary prophylaxis of small esophageal varices with no risky signs and shortening endoscopic follow-up time intervals to reduce the risk of variceal hemorrhage.

Researchers will assess the progression of esophageal varices (EVs) with no bleeding stigmata in patients treated with atezolizumab-bevacizumab therapy at 3, 6, 9, and 12 months with endoscopic examination. Evaluate the effect of shortening the endoscopic follow-up intervals to reduce the risk of variceal bleeding in patients treated with atezolizumab-bevacizumab therapy. Researchers will also assess the efficacy of variceal band ligation in small varices without bleeding stigmata before starting atezolizumab-bevacizumab therapy to reduce the progression of EVs.

Participants will undergo history-taking, clinical examination, laboratory investigations, Triphasic CT abdomen with contrast or MRI (for evaluation of tumor site, size and number), abdominal ultrasonography, and upper endoscopy (within 6 months before beginning of systemic therapy and followed up after 3, 6, 9, and 12 months).

Detailed Description

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Conditions

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Esophageal and/or Gastric Varices Hepatocellular Carcinoma (HCC)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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HCC patients with small non-risky EGVs

55 patients with small EGVs that had no red signs undergoing variceal band ligation.

Group Type ACTIVE_COMPARATOR

Esophageal band ligation

Intervention Type PROCEDURE

upper endoscopy will be performed within 6 months before starting atezolizumab-bevacizumab therapy in HCC patients. Esophageal band ligation for small non-risky varices before starting atezolizumab-bevacizumab therapy. Endoscopy will be repeated 3, 5, 9, 12 months after atezolizumab-bevacizumab therapy

HCC patients with no or small non-risky EGVs

55 patients with no or small EGVs that had no red signs. patients will be followed up after 3, 6, 9, 12 months of atezolizumab-bevacizumab therapy.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Esophageal band ligation

upper endoscopy will be performed within 6 months before starting atezolizumab-bevacizumab therapy in HCC patients. Esophageal band ligation for small non-risky varices before starting atezolizumab-bevacizumab therapy. Endoscopy will be repeated 3, 5, 9, 12 months after atezolizumab-bevacizumab therapy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients with confirmed advanced HCC (Diagnosed by two imaging modalities or liver biopsy) eligible for atezolizumab-bevacizumab therapy.
* Patients with preserved liver function (compensated Child-Pugh A if there is underlying cirrhosis).
* Patients with performance status ≤2 at staging work-up.
* Patients with no or grade 1 non-risky esophageal varices on pretreatment endoscopic examination.

Exclusion Criteria

* Child-Pugh class C patients.
* Patients with performance status \>2 at staging work-up.
* Vascular disorders and arterial hypertension.
* Severe autoimmune disorders.
* Patients who lost follow-up.
* Pregnant or breastfeeding women.
* Unwilling to participate in our study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tanta University

OTHER

Sponsor Role lead

Responsible Party

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Rania Mamdouh Elkafoury

Lecturer of Tropical Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rania M Elkafoury, MD

Role: PRINCIPAL_INVESTIGATOR

Tropical medicine and infectious diseases Department, Faculty of Medicine, Tanta University

Locations

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Tanta University Hospitals

Tanta, Gharbyea, Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Rania M Elkafoury, MD

Role: CONTACT

+201004672358

Nabila A Elgazzar, MD

Role: CONTACT

00201288585733

Facility Contacts

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Dina H Ziada, MD, head of department

Role: primary

00201117109990

Other Identifiers

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36264PR1125/3/25

Identifier Type: -

Identifier Source: org_study_id

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