TACE Versus HAIC, Combined With PD-1 Inhibitors and Lenvatinib for Unresectable Hepatocellular Carcinoma: a Multicenter, Prospective, Observational Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 364
- 主要终点
- Progression-free survival (PFS)
研究概览
简要总结
Although the combination of transarterial chemoembolization (TACE) with PD-1 inhibitor plus lenvatinib has become a new standard, the therapeutic efficacy for unresectable hepatocellular carcinoma (uHCC) still requires improvement, as TACE remains limited for patients with multifocal lesions, hypovascular tumors, or those complicated with portal vein tumor thrombosis (PVTT). Hepatic arterial infusion chemotherapy (HAIC), as an alternative locoregional therapy, has demonstrated advantages in treating these refractory cases. Therefore, this study innovatively designs a prospective cohort study to conduct a comparison of the two triple-combination regimens-"HAIC plus PD-1 inhibitor and lenvatinib" versus "TACE plus PD-1 inhibitor and lenvatinib"-in terms of real-world efficacy and safety, with a focus on enrolling patients who are likely to have suboptimal responses to TACE. This research aims to provide high-level evidence for selecting the optimal combined locoregional strategy for uHCC patients, thereby directly guiding clinical practice and potentially advancing the optimization of treatment strategies and personalized precision medicine to improve patient survival outcomes.
详细描述
This is a multicenter, prospective, observational cohort study designed to compare the efficacy and safety of transarterial chemoembolization (TACE) versus hepatic arterial infusion chemotherapy (HAIC), each combined with a programmed cell death protein-1 (PD-1) inhibitor and lenvatinib, for the treatment of unresectable hepatocellular carcinoma (uHCC), with a primary focus on progression-free survival (PFS). A total of 364 patients are planned to be enrolled and prospectively followed for efficacy and adverse events. The primary endpoint is PFS. Secondary endpoints include the objective response rate (ORR), overall survival (OS), and safety. Tumor response will be evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST v1.1). Assessments will be performed every 56 days (with a ±3-day window) from the initiation of study treatment until disease progression, patient death, withdrawal of consent, loss to follow-up, or study termination (whichever occurs first). For patients who experience disease progression or initiate other antitumor therapies, survival follow-up will be conducted every 8 weeks (56 days, with a ±7-day window) from the time the event is documented to collect information on subsequent antitumor treatments and survival status until death, withdrawal of consent, loss to follow-up, or study termination.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged between 18 and 75 years;
- •Tumor stage classified as BCLC-A to -C, with no evidence of extrahepatic metastasis;
- •Newly diagnosed, treatment-naïve hepatocellular carcinoma with no prior anticancer therapy;
- •Child-Pugh liver function score ≤ 7;
- •Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 or 1;
- •Absence of severe organic diseases affecting major organs (e.g., heart, lung, brain).
排除标准
- •Decompensated liver cirrhosis;
- •Concurrent other malignancies or recurrent hepatocellular carcinoma;
- •Any active, known, or suspected autoimmune disease;
- •History of hypersensitivity to any component of PD-1 inhibitors or lenvatinib;
- •Human immunodeficiency virus (HIV) infection; or active viral hepatitis (e.g., hepatitis B or C);
- •Tumor thrombus involving the inferior vena cava, hepatic veins, or the main portal vein trunk.
研究组 & 干预措施
TACE-based combination treatment cohort
Patients in this group were treated with TACE plus a PD-1 inhibitor and lenvatinib
干预措施: TACE (Procedure)
TACE-based combination treatment cohort
Patients in this group were treated with TACE plus a PD-1 inhibitor and lenvatinib
干预措施: PD-1inhibitors (Drug)
TACE-based combination treatment cohort
Patients in this group were treated with TACE plus a PD-1 inhibitor and lenvatinib
干预措施: Lenvatinib (Drug)
HAIC-based combination treatment cohort
Patients in this group were treated with HAIC plus a PD-1 inhibitor and lenvatinib
干预措施: HAIC (Procedure)
HAIC-based combination treatment cohort
Patients in this group were treated with HAIC plus a PD-1 inhibitor and lenvatinib
干预措施: PD-1inhibitors (Drug)
HAIC-based combination treatment cohort
Patients in this group were treated with HAIC plus a PD-1 inhibitor and lenvatinib
干预措施: Lenvatinib (Drug)
结局指标
主要结局
Progression-free survival (PFS)
时间窗: From the date of enrollment, until the tumor progresses, the patient dies, or the study concludes (whichever occurs first), the assessment period can last up to 60 months.
PFS was defined as the time from enrollment to tumor progression.
次要结局
- Overall survival(OS)(From date of enrollment until the date of death from any cause, assessed up to 96 months.)
- Objective Response Rate (ORR)(From the date of enrollment, until the tumor progresses, the patient dies, or the study concludes (whichever occurs first), the assessment period can last up to 60 months.)