Phase 3 Study of Pembrolizumab and Lenvatinib in Combination with TACE for Incurable/Non-metastatic Hepatocellular Carcinoma

Recruitment & Eligibility

Status: Authorised-recruitment may be ongoing or finished

Sex: All

Target Recruitment: 950

Inclusion Criteria

1.Has a diagnosis of HCC confirmed by radiology, histology, or cytology.
Has a radiologic diagnosis of HCC as per the AASLD guidelines, which requires:
-liver cirrhosis and a liver mass confirmed by BICR that shows arterial phase hyperenhancement on triphasic CT or MRI, AND EITHER:
Is =20 mm with either non-peripheral portal washout or an enhancing capsule OR
Is 10-19 mm with non-peripheral portal venous washout AND an enhancing capsule.
2.Has HCC localized to the liver without portal vein thrombosis, and not amenable to curative treatment such as resection, ablation, or liver transplant. No extrahepatic HCC is permitted, confirmed by BICR.
3.Has at least one measurable HCC lesion based on RECIST 1.1, confirmed by BICR.
4.Has all lesions treatable with TACE in 1 or 2 sessions.
5.Is amenable, without any contraindications, to the TACE procedure and chemotherapy agent pre specified at the study site.
6.Has a CP class A liver score within 7 days prior to first dose of study intervention.
7.Has a predicted life expectancy of >3 months.
8.Has an ECOG PS of 0 to 1 within 7 days prior to first dose of study intervention.
9.Is male or female = 18 years of age at the time of signing the informed consent.
10.Male participants are eligible to participate if they agree to the following during the intervention period and for at least the time needed to eliminate each study intervention after the last dose of study intervention. The length of time required to continue contraception for each study intervention is as follows:
- Lenvatinib 7 days
- TACE 95 days
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 570
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 380

Exclusion Criteria

1.Has HCC lesion(s) measuring =10 cm in any dimension, has more than 10 lesions on radiographic evaluation or has HCC lesions occupying =50% of the liver volume, confirmed by BICR.
2.Has had esophageal or gastric variceal bleeding within the last 6 months.
3.Has bleeding or thrombotic disorders or is using factor X inhibitors or anticoagulants requiring therapeutic INR monitoring, eg, warfarin or similar agents. Treatment with antiplatelet agents and low molecular weight heparin is permitted.
4.Has clinically apparent ascites on physical examination that is not controlled with medication. Ascites detectable on imaging studies only is allowed.
5.Has any macrovascular tumor thrombosis in the portal veins, confirmed by BICR. Microvascular tumor thrombosis detected on biopsy, but not radiographic scan, is permitted.
6.Has had clinically diagnosed hepatic encephalopathy in the last 6 months unresponsive to therapy. Participants on rifaximin or lactulose during screening to control their hepatic encephalopathy are excluded.
7.Has received any systemic chemotherapy, including anti-VEGF therapy, or any systemic investigational anticancer agents for HCC.
8. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX-40, CD137).

Study & Design

Study Type: Interventional clinical trial of medicinal product

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method

Secondary Outcome Measures

Name	Time	Method

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