RecruitingNot ApplicableNCT06609863

dTACE-HAIC Combined With Bevacizumab and Atezolizumab for Huge Hepatocellular Carcinoma

dTACE-HAIC Combined With Bevacizumab and Atezolizumab for Huge Intermediate and Advanced Hepatocellular Carcinoma: a Prospective Phase II Study

Sponsor

Sun Yat-sen University

Enrollment

27 participants

Start Date

Oct 1, 2024

Study Type

INTERVENTIONAL

Conditions

Chemotherapy Advanced Hepatocellular Carcinoma Atezolizumab Bevacizumab

Summary

This study intends to evaluate the efficacy and safety of drug-eluting transcatheter arterial embolization-hepatic arterial infusion chemotherapy of oxaliplatin, 5-fluorouracil and leucovorin (dTACE-HAIC) plus Bevacizumab and Atezolizumab for patients with intermediate-advanced huge hepatocellular carcinoma.

Eligibility

Min Age: 18 YearsMax Age: 75 Years

Inclusion Criteria10

Clinical diagnosis of HCC.
Age between 18 and 75 years;
The maximum tumor size ≥10 cm;
Intermediate-advanced huge HCC, advanced HCC with PVTT type I-III
limited metastases (≤5).
Child-Pugh class A or B;
Eastern Cooperative Group performance status (ECOG) score of 0-1;
Hemoglobin ≥ 8.5 g/dL Total bilirubin ≤ 30mmol/L Serum albumin ≥ 32 g/L ASL and AST ≤ 5 x upper limit of normal Serum creatinine ≤ 1.5 x upper limit of normal INR ≤ 1.5 or PT/APTT within normal limits Absolute neutrophil count (ANC) \>1,500/mm3
Prothrombin time ≤18s or international normalized ratio \< 1.7.
Ability to understand the protocol and to agree to and sign a written informed consent document.

Exclusion Criteria11

Diffuse HCC;
Extrahepatic metastasis \>5;
Obstructive PVTT involving mesenteric vena cava (PVTT IV).
Serious medical comorbidities.
Evidence of hepatic decompensation including ascites, gastrointestinal bleeding or hepatic encephalopathy
untreated or incompletely treated esophageal or gastric varices (assessed with esophagogastroduodenoscopy) with bleeding or high risk of bleeding.
Eastern Cooperative Group performance status (ECOG) score of ≥2;
Known or suspected allergy to the investigational agents or any agent given in association with this trial.
Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
Evidence of bleeding diathesis.
Patients with clinically significant gastrointestinal bleeding within 30 days prior to study entry.

Interventions

PROCEDUREdTACE-HAIC

dTACE procedure was a 2.8-F microcatheter was super-selectively inserted into the tumor feeding artery using the coaxial technique. Then drug-eluting microspheres were used (100-300um). The microcatheter was reserved at the proper/left/right hepatic artery according tumor location. After the patient returned to the ward, the following FOLFOX-based regime was intra-arterially administered through the microcatheter. The FOLFOX regimen was administered via the hepatic artery as follows: 85 or 135 mg/m2 oxaliplatin from hour 0 to 2 on day 1, and 400 mg/m2 leucovorin from hour 2 to 4 on day 1, and 400 mg/m2 fluorouracil bolus at hour 5 on the day 1; and 2400 mg/m2 fluorouracil over 46 h on days 1 and 2. Hepatic arterial infusion chemotherapy administration of oxaliplatin, fluorouracil, and leucovorin via the tumor feeding arteries every 4 weeks