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In the present study, we aim to investigate the efficacy and safety of concurrent therapy of Immunotherapy based combination therapy and Radiotherapy in patients with advanced HCC showing macrovascular invasion.
Enrollment
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Inclusion criteria
Signed informed consent form
Age >= 19 at the time of signing Informed consent form
Histological or clinical diagnosis of HCC based on the guidelines of the Korean Liver Cancer Association -National Cancer Center
Unresectable and/or locally advanced or metastatic disease showing major vascular invasion
a. Presence of major vascular invasion on dynamic CT or dynamic MRI (1+2)
Having at least one measurable target lesion (per RECIST v1.1)
a. Participants who received prior locoregional therapy (e.g., radiofrequency ablation, microwave ablation, transarterial chemoembolization, transarterial radioembolization, transarterial embolization, radiation therapy etc.) are eligible provided that other target lesion(s) have not been previously treated with locoregional therapy or the target lesion(s) within the field of locoregional therapy have subsequently progressed in accordance with RECIST v1.1.
Child-Pugh class A
Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-1
Adequate hematologic and end-organ function, defined by the following laboratory test results, obtained within 28 days prior to screening:
Documented virology status of hepatitis, as confirmed by screening tests for HBV and HCV
a. Participants with HBV or HCV infection must be treated with antiviral therapy as per institutional practice.
Female participants of childbearing potential must agree to either remain abstinent or use effective contraception (with a failure rate of <1% per year) since signing of the informed consent form until at least 6 months after the last study drug administration.
Male participants must agree to remain abstinent or use a condom and refrain from donating sperm since signing of the informed consent form until at least 6 months after the last study drug administration.
Exclusion criteria
Fibrolamellar carcinoma or sarcomatoid carcinoma
Receipt of 2 or more prior systemic therapy for advanced HCC. Additional prior systemic therapies used as adjuvant or local therapy are allowed.
Receipt of other first-line systemic therapy than immune checkpoint inhibitor-based regimen
Receipt of prior radiation therapy to liver
a. Participants are excluded if the potential radiation field overlaps with a previously irradiated area.
Receipt of locoregional therapy for HCC within 28 days prior to initiation of study treatment or non-recovery from complications due to the procedure (radiofrequency ablation, microwave ablation, cryoablation, trans-arterial embolization including chemo- and radio-embolization, or radiation therapy).
a. A 7-day washout is permitted for palliative radiation to bone lesions
Active or history of autoimmune disease or immune deficiency, including, but not limited to, myasthenia gravis, myositis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, antiphospholipid antibody syndrome, Wegener granulomatosis, or multiple sclerosis with following exceptions:
Prior allogeneic stem cell or solid organ transplantation
Any condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days prior to initiation of study treatment
History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins
Having active brain metastasis or leptomeningeal metastasis
Moderate to severe or intractable ascites
Presence of hepatic encephalopathy
History of malignancy other than HCC within 2 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death (e.g., 5-year OS rate >90%)
Uncontrolled severe medical comorbidities, including significant cardiovascular disease (such as New York Heart Association Class II or greater cardiac disease, myocardial infarction, or cerebrovascular accident) within 3 months prior to the initiation of study treatment, unstable arrhythmia, or unstable angina or any significant medical illness or abnormal laboratory findings that, in the investigator's judgement, would increase the risk to the participant associated with study participation
Female participants who are pregnant or breastfeeding or male or female participants of reproductive potential who are not willing to employ effective birth control from screening to 6 months after the last study drug administration
Judgment by the investigator that the participant should not participate in the study if the participant is unlikely to comply with study procedures, restrictions, and requirements
Primary purpose
Allocation
Interventional model
Masking
128 participants in 2 patient groups
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Central trial contact
Yumi Yang
Data sourced from clinicaltrials.gov
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