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A Study Evaluating Atezolizumab and Bevacizumab, With or Without Tiragolumab, in Participants With Untreated Locally Advanced or Metastatic Hepatocellular Carcinoma (IMbrave152)

Phase 3
Active, not recruiting
Conditions
Carcinoma, Hepatocellular
Interventions
Registration Number
NCT05904886
Lead Sponsor
Hoffmann-La Roche
Brief Summary

The purpose of this study is to assess the efficacy and safety of tiragolumab, an anti-TIGIT monoclonal antibody, when administered in combination with atezolizumab and bevacizumab as first-line treatment, in participants with unresectable, locally advanced or metastatic hepatocellular carcinoma (HCC).

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
650
Inclusion Criteria
  • Locally advanced or metastatic and/or unresectable HCC with diagnosis confirmed by histology/cytology or clinically by American Association for the Study of Liver Diseases (AASLD) criteria in cirrhotic participants
  • Disease that is not amenable to curative surgical and/or locoregional therapies
  • No prior systemic treatment for locally advanced or metastatic and/or unresectable HCC
  • Measurable disease according to RECIST v1.1
  • ECOG Performance Status of 0 or 1 within 7 days prior to randomization
  • Child-Pugh Class A within 7 days prior to randomization
  • Adequate hematologic and end-organ function
  • Female participants of childbearing potential must be willing to avoid pregnancy within 5 months after the final dose of atezolizumab, within 6 months after the final dose of bevacizumab, and within 90 days after the final dose of tiragolumab/placebo
  • Male participants with a female partner of childbearing potential or pregnant female partner must remain abstinent or use a condom during the treatment period and for 6 months after the final dose of bevacizumab and for 90 days after the final dose of tiragolumab/placebo to avoid exposing the embryo.
Exclusion Criteria
  • Pregnancy or breastfeeding within 5 months after the final dose of atezolizumab, within 6 months after the final dose of bevacizumab, and within 90 days after the final dose of tiragolumab/placebo
  • Prior treatment with CD137 agonists or immune checkpoint blockade therapies
  • Treatment with investigational therapy within 28 days prior to initiation of study treatment
  • Treatment with locoregional therapy to liver within 28 days prior to initiation of study treatment, or non-recovery from side effects of any such procedure
  • Treatment with systemic immunostimulatory agents
  • Treatment with systemic immunosuppressive medication
  • Untreated or incompletely treated esophageal and/or gastric varices with bleeding or that are at high risk for bleeding
  • A prior bleeding event due to esophageal and/or gastric varices within 6 months prior to initiation of study treatment
  • Active or history of autoimmune disease or immune deficiency
  • History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan
  • History of malignancy other than HCC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death
  • Mixed histology or other subtypes/variants of HCC, including, but not limited to, known liver adenocarcinoma, fibrolamellar HCC, sarcomatoid HCC, other rare HCC variant, or mixed cholangiocarcinoma and HCC
  • Co-infection with hepatitis B virus (HBV) and hepatitis C virus (HCV)
  • Acute Epstein-Barr virus (EBV) infection or known or suspected chronic active EBV infection
  • Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Atezolizumab + Bevacizumab + TiragolumabTiragolumabAtezolizumab plus bevacizumab plus tiragolumab will be administered every 3 weeks (Q3W) until unacceptable toxicity or loss of clinical benefit as determined by the investigator.
Atezolizumab + Bevacizumab + PlaceboPlaceboAtezolizumab, bevacizumab plus placebo will be administered every 3 weeks (Q3W) until unacceptable toxicity or loss of clinical benefit as determined by the investigator.
Atezolizumab + Bevacizumab + TiragolumabAtezolizumabAtezolizumab plus bevacizumab plus tiragolumab will be administered every 3 weeks (Q3W) until unacceptable toxicity or loss of clinical benefit as determined by the investigator.
Atezolizumab + Bevacizumab + TiragolumabBevacizumabAtezolizumab plus bevacizumab plus tiragolumab will be administered every 3 weeks (Q3W) until unacceptable toxicity or loss of clinical benefit as determined by the investigator.
Atezolizumab + Bevacizumab + PlaceboAtezolizumabAtezolizumab, bevacizumab plus placebo will be administered every 3 weeks (Q3W) until unacceptable toxicity or loss of clinical benefit as determined by the investigator.
Atezolizumab + Bevacizumab + PlaceboBevacizumabAtezolizumab, bevacizumab plus placebo will be administered every 3 weeks (Q3W) until unacceptable toxicity or loss of clinical benefit as determined by the investigator.
Primary Outcome Measures
NameTimeMethod
Investigator-Assessed Progression-Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 36 months)
Overall Survival (OS)From randomization to death from any cause (up to approximately 36 months)
Secondary Outcome Measures
NameTimeMethod
Investigator-Assessed Duration of Objective Response (DOR) According to RECIST v1.1From the first occurrence of a documented confirmed objective response to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 36 months)
OS Rate at 1 and 2 YearsYear 1, Year 2
Time to Confirmed Deterioration (TTCD) Assessed Using European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire for Cancer 30 (QLQ-C30) SubscalesFrom randomization up to approximately 36 months

The following subscales of the EORTC QLQ-C30 will be used for the assessment: global health status/quality-of-life (GHS/QoL), physical functioning and role functioning. GHS and QoL are scored on a 7-point scale: 1=Very poor to 7=Excellent. Functioning items are scored on a 4-point scale: 1=Not at all to 4=Very much, with a higher score indicating a worse outcome. Scores will be linearly transformed with a minimum score of 0 and maximum score of 100. A higher score indicates a better outcome.

Change from Baseline in GHS/QoL, Physical Functioning, and Role Functioning Assessed Using the EORTC QLQ-C30From baseline up to approximately 36 months

GHS and QoL are scored on a 7-point scale: 1=Very poor to 7=Excellent. Functioning items are scored on a 4-point scale: 1=Not at all to 4=Very much, with a higher score indicating a worse outcome. Scores will be linearly transformed with a minimum score of 0 and maximum score of 100. A higher score indicates a better outcome.

Serum Concentrations of AtezolizumabPrior to the first infusion and 30 minutes after atezolizumab infusion on Day 1 of Cycle 1 (cycle = 21 days), prior to infusion on Day 1 of Cycles 2, 3, 4, 8, 12, 16 and at treatment discontinuation visit (up to approximately 36 months)
Investigator-Assessed PFS Rate According to RECIST v1.1 at 6 and 12 MonthsMonth 6, Month 12
Percentage of Participants With Adverse EventsUp to approximately 36 months
Serum Concentrations of TiragolumabPrior to the first infusion and 30 minutes after tiragolumab infusion on Day 1 of Cycle 1 (cycle = 21 days), prior to infusion on Day 1 of Cycles 2, 3, 4, 8, 12, 16 and at treatment discontinuation visit (up to approximately 36 months)
Investigator-Assessed DOR According to HCC mRECISTFrom the first occurrence of a documented confirmed objective response to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 36 months)
Percentage of Participants With Anti-Drug Antibodies (ADAs) to TiragolumabPrior to the first infusion on Day 1 of Cycles (cycle = 21 days) 1, 2, 3, 4, 8, 12, 16 and at treatment discontinuation visit (up to approximately 36 months)
Investigator-Assessed Confirmed Objective Response Rate (ORR) According to RECIST v1.1From randomization up to approximately 36 months
Investigator-Assessed PFS According to Hepatocellular Carcinoma (HCC) Modified RECIST (mRECIST)From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 36 months)
Investigator-Assessed Confirmed ORR According to HCC mRECISTFrom randomization up to approximately 36 months
Percentage of Participants With Anti-Drug Antibodies (ADAs) to AtezolizumabPrior to the first infusion on Day 1 of Cycles (cycle = 21 days) 1, 2, 3, 4, 8, 12, 16 and at treatment discontinuation visit (up to approximately 36 months)

Trial Locations

Locations (171)

Genesis Cancer Center

🇺🇸

Hot Springs, Arkansas, United States

UCSF Fresno at Community Cancer Institute

🇺🇸

Clovis, California, United States

City of Hope Cancer Center

🇺🇸

Duarte, California, United States

University of California San Diego Moores Cancer Center

🇺🇸

La Jolla, California, United States

University of Southern California

🇺🇸

Los Angeles, California, United States

Stanford Cancer Center

🇺🇸

Palo Alto, California, United States

Va Palo Alto Health Care System

🇺🇸

Palo Alto, California, United States

UCLA Cancer Center

🇺🇸

Santa Monica, California, United States

Hartford Healthcare Cancer Institute at Hartford Hospital

🇺🇸

Hartford, Connecticut, United States

MedStar Washington Hosp Center

🇺🇸

Washington, District of Columbia, United States

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Genesis Cancer Center
🇺🇸Hot Springs, Arkansas, United States

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