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A Study of Tislelizumab Versus Sorafenib in Participants With Unresectable Hepatocellular Carcinoma (HCC)

A Randomized, Open-label, Multicenter Phase 3 Study to Compare the Efficacy and Safety of BGB-A317 Versus Sorafenib as First-Line Treatment in Patients With Unresectable Hepatocellular Carcinoma

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03412773
Enrollment
684
Registered
2018-01-26
Start date
2017-12-18
Completion date
2023-12-14
Last updated
2025-10-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hepatocellular Carcinoma (HCC)

Keywords

Advanced liver cancer, RATIONALE-301

Brief summary

This Phase 3 study was a global, multicenter trial that randomly assigned participants to either tislelizumab or sorafenib as a first-line treatment for adults with advanced liver cancer (hepatocellular carcinoma) that could not be surgically removed. Before enrolling Japanese participants in the main Phase 3 study, a preliminary assessment of safety and tolerability (the Safety Run-In Sub-study) was conducted in Japan.

Interventions

DRUGTislelizumab

Tislelizumab 200 mg intravenously (IV) once every three weeks (Q3W)

DRUGSorafenib

Sorafenib 400 mg orally (PO) twice daily (BID)

Sponsors

BeiGene
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Safety Run-In Sub-study Eligibility Criteria: The study included adult Japanese participants (≥ 20 years) with histologically confirmed hepatocellular carcinoma (HCC) at Barcelona Clinic Liver Cancer (BCLC) Stage C or B. Eligible participants had either received, were ineligible for, or declined standard treatment. Additional requirements were a Child-Pugh A classification within 7 days before enrollment, at least one measurable lesion per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and an Eastern Cooperative Oncology Group (ECOG) Performance Status score of ≤ 1. Main Study Key Inclusion Criteria: 1. Histologically confirmed diagnosis of HCC 2. Barcelona Clinic Liver Cancer (BCLC) Stage B or C disease not amenable to or progressing after loco-regional therapy and not amenable to a curative treatment approach 3. No prior systemic therapy for HCC (with the exception of HCC participants enrolled in the safety run-in substudy \[Japan only\]) 4. Measurable disease 5. Child-Pugh score A 6. Easter Cooperative Oncology Group (ECOG) Performance Status ≤ 1 7. Adequate organ function Main Study Key

Exclusion criteria

1. Known fibrolamellar HCC, sarcomatoid HCC, or mixed cholangiocarcinoma and HCC histology 2. Tumor thrombus involving main trunk of portal vein or inferior vena cava 3. Loco-regional therapy to the liver within 28 days before randomization 4. Clinical evidence of portal hypertension with bleeding esophageal or gastric varices at Screening, or within 6 months before randomization 5. Bleeding or thrombotic disorder or any prescribed anticoagulant requiring therapeutic international normalized ratio monitoring (eg, warfarin or similar agents) at Screening, or within 6 months before randomization/enrollment 6. Presence at Screening of active immune deficiency or autoimmune disease and/or prior history of any immune deficiency or autoimmune disease that may relapse 7. Participant with any condition requiring systemic treatment with either corticosteroids (\> 10 mg daily of prednisone or equivalent) or other immunosuppressive medication within 14 days before randomization 8. History of interstitial lung disease or non-infectious pneumonitis, unless induced by radiation therapy 9. QT interval corrected for heart rate (QTc) (corrected by Fridericia's method) \> 450 msec at Screening NOTE: Other protocol defined Inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Safety Run-in Sub-study: Number of Participants With Treatment-emergent Adverse Events (TEAEs)From the first dose to 30 days after the last dose, new anticancer therapy, or the analysis cutoff of December 14th, 2023 (a maximum of 64 months)An adverse event (AE) is any unfavorable or unintended sign (e.g., abnormal lab result), symptom, or disease temporally associated with study drug use, regardless of causality. A serious adverse event (SAE) is defined as any adverse event that: * Resulted in death * Was life-threatening * Required or prolonged hospitalization * Caused disability/incapacity * Lead to a congenital anomaly/birth defect * Was deemed medically significant by the investigator (e.g., required intervention to prevent severe outcomes).
Safety Run-in Sub-study: Serum Concentration of TislelizumabCycle 1 and Cycle 5 at end of infusion, 24 hand 72 hours post-dose, and 8 days and 15 days post-dose (each cycle was 3 weeks).Serum concentration of tislelizumab was a pre-specified primary endpoint for the sub-study only.
Main Study: Overall Survival (OS)Through the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)Defined as the time from the date of randomization to the date of death due to any cause. Median OS was estimated using Kaplan-Meier methodology. Overall survival was a pre-specified primary endpoint for the main study only.

Secondary

MeasureTime frameDescription
Progression Free Survival (PFS) Assessed by the InvestigatorThrough the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)Defined as the time from randomization to the first objectively documented disease progression, or death from any cause, whichever occurred first, as assessed by the investigator per RECIST v1.1. Kaplan-Meier methodology was used to estimate the median PFS.
Duration of Response (DOR) as Assessed by BIRCThrough the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)Defined as the time from the first occurrence of a documented objective response until the first documentation of progression or death from any cause, whichever occurred first, as determined by the BIRC per RECIST v1.1. Median DOR was estimated using Kaplan-Meier methodology. DOR was not assessed by the BIRC for participants in the sub-study, and this was not a pre-specified sub-study endpoint.
Duration of Response (DOR) Assessed by the InvestigatorThrough the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)Defined as the time from the first occurrence of a documented objective response until the first documentation of progression or death from any cause, whichever occurred first, as assessed by the investigator per RECIST v1.1. Median DOR was estimated using Kaplan-Meier methodology.
Time to Progression (TTP) Assessed by BIRCThrough the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)Defined as the time from the date of randomization to the date of the first objectively documented tumor progression as assessed by the BIRC per RECIST v1.1. Median TTP was estimated using Kaplan-Meier methodology. TTP was not assessed by the BIRC for participants in the sub-study, and this was not a pre-specified sub-study endpoint.
Time to Progression (TTP) as Assessed by the InvestigatorThrough the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)Defined as the time from the date of randomization to the date of the first objectively documented tumor progression as assessed by the investigator per RECIST v1.1. Median TTP was estimated using Kaplan-Meier methodology. TTP was not a pre-specified sub-study endpoint.
Safety Run-in Sub-study: Overall SurvivalUp a to 64 monthsDefined as the time from the date of randomization to the date of death due to any cause. Median OS was estimated using Kaplan-Meier methodology.
Disease Control Rate (DCR) as Assessed by BIRCThrough the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)Defined as the percentage of participants whose best overall response (BOR) was complete response, partial response, or stable disease as assessed by the BIRC per RECIST v1.1. DCR was not a pre-specified endpoint for participants in the sub-study.
Disease Control Rate (DCR) as Assessed by the InvestigatorThrough the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)Defined as the percentage of participants whose best overall response (BOR) was complete response, partial response, or stable disease as assessed by the investigator per RECIST v1.1. DCR was not a pre-specified endpoint for participants in the sub-study.
Clinical Benefit Rate (CBR) as Assessed by BIRCThrough the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)Defined as the percentage of participants whose best overall response (BOR) was complete response, partial response, or stable disease greater than or equal to 24 weeks in duration, as assessed by the BIRC per RECIST v1.1. CBR was not a pre-specified endpoint for participants in the sub-study.
Overall Response Rate (ORR) as Assessed by Blinded Independent Review Committee (BIRC)Through the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)Defined as the percentage of participants who had partial response or complete response as determined by Blinded Independent Review Committee (BIRC) per the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 in all randomized participants with measurable disease at baseline. ORR was not assessed by the BIRC for participants in the sub-study, and this was not a pre-specified sub-study endpoint.
Change From Baseline in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Hepatocellular Carcinoma 18 Questions (EORTC QLQ HCC 18) Index Score at Cycle 4Baseline to Cycle 4 (each cycle was 21 days)The EORTC QLQ-HCC18 is a questionnaire specifically designed to assess health-related quality of life in participants with hepatocellular carcinoma. It includes six symptom scales measuring Fatigue (3 items), Jaundice (2 items), Body Image (2 items), Nutrition (5 items), Pain (2 items), Fever (2 items) and two single items measuring Sex Life and Abdominal Swelling. Participants respond on a scale from 1 = Not at all to 4 = Very Much. Raw scores are transformed into a 0 to 100 scale using linear transformation. The HCC18 Index score is calculated from each of the 6 symptom scales and the 2 single items, and ranges from 0 to 100. Higher scores indicate greater symptom burden or worse quality of life. The EORTC QLQ-HCC18 was not assessed for participants in the sub-study.
Change From Baseline in the European EORTC QLQ HCC 18 Index Score at Cycle 6Baseline to Cycle 6 (Each cycle was 21 days)The EORTC QLQ-HCC18 is a questionnaire specifically designed to assess health-related quality of life in participants with hepatocellular carcinoma. It includes six symptom scales measuring Fatigue (3 items), Jaundice (2 items), Body Image (2 items), Nutrition (5 items), Pain (2 items), Fever (2 items) and two single items measuring Sex Life and Abdominal Swelling. Participants respond on a scale from 1 = Not at all to 4 = Very Much. Raw scores are transformed into a 0 to 100 scale using linear transformation. The HCC18 Index score is calculated from each of the 6 symptom scales and the 2 single items, and ranges from 0 to 100. Higher scores indicate greater symptom burden or worse quality of life. The HEORTC QLQ-HCC18 was not assessed in participants in the sub-study.
Change From Baseline in the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status/Quality of Life Score at Cycle 4Baseline to Cycle 4 (each cycle was 21 days)The EORTC QLQ-C30 v3.0 is a questionnaire that assesses quality of life of participants with cancer. It includes global health status and quality of life questions related to overall health in which participants respond based on a 7-point scale, where 1 is very poor and 7 is excellent. Raw scores are transformed into a 0 to 100 scale via linear transformation. A higher score indicates better health outcomes. The EORTC QLQ-C30 was not assessed in participants in the sub-study.
Change From Baseline in the EORTC QLQ-C30 Global Health Status/Quality of Life Score at Cycle 6Baseline to Cycle 6 (each cycle was 21 days)The EORTC QLQ-C30 v3.0 is a questionnaire that assesses quality of life of participants with cancer. It includes global health status and quality of life questions related to overall health in which participants respond based on a 7-point scale, where 1 is very poor and 7 is excellent. Raw scores are transformed into a 0 to 100 scale via linear transformation. A higher score indicates better health outcomes. The EORTC QLQ-C30 was not assessed in participants in the sub-study.
Change From Baseline in the European Quality of Life 5 Dimensions, 5-level (EQ-5D-5L) Visual Analogue Scale (VAS) at Cycle 4Baseline to Cycle 4 (each cycle was 21 days)The EQ-5D-5L comprises a descriptive module and a Visual Analogue scale (VAS). The EQ-5D-5L VAS measures respondent's self-rated health status on a 0 to 100 scale, with 100 = 'the best health you can imagine' and 0 = 'the worst health you can imagine'. Higher scores on VAS indicate higher health status. The EQ-5D-5L VAS was not assessed in participants in the sub-study.
Change From Baseline in the EQ-5D-5L VAS at Cycle 6Baseline to Cycle 6 (each cycle was 21 days)The EQ-5D-5L comprises a descriptive module and a visual analogue scale (VAS). The EQ-5D-5L VAS measures respondent's self-rated health status on a 0 to 100 scale, with 100 = 'the best health you can imagine' and 0 = 'the worst health you can imagine'. Higher scores on VAS indicate higher health status. The EQ-5D-5L VAS was not assessed in participants in the sub-study.
Main Study: Number of Participants With Treatment-emergent Adverse EventsFrom the first dose to 30 days after the last dose, new anticancer therapy, or the study completion analysis cutoff on December 14th, 2023 (a maximum of 61 months for participants in Arm A and 63 months for participants in Arm B).An adverse event (AE) is any unfavorable or unintended sign (e.g., abnormal lab result), symptom, or disease temporally associated with study drug use, regardless of causality. A serious adverse event (SAE) is defined as any adverse event that: * Resulted in death * Was life-threatening * Required or prolonged hospitalization * Caused disability/incapacity * Lead to a congenital anomaly/birth defect * Was deemed medically significant by the investigator (e.g., required intervention to prevent severe outcomes).
Safety Run-in Sub-study: Number of Participants Who Developed Anti-tislelizumab AntibodiesFrom the first dose to 30 days after the last dose, new anticancer therapy, or the analysis cutoff of December 14th, 2023 (a maximum of 64 months)Treatment-emergent anti-drug antibodies (ADA): participants who were ADA negative at baseline and ADA positive post-baseline. Treatment-boosted ADA: participants who were ADA positive at baseline that was boosted to a 4-fold or higher-level following drug administration. ADA assessments were not performed for participants enrolled in the main study.
Clinical Benefit Rate (CBR) as Assessed by the InvestigatorThrough the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)Defined as the percentage of participants whose best overall response (BOR) is complete response, partial response, or stable disease greater than or equal to 24 weeks in duration, as assessed by the investigator per RECIST v1.1. CBR was not a pre-specified endpoint for participants in the sub-study.
Overall Response Rate (ORR) as Assessed by the InvestigatorThrough the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)Defined as the percentage of participants who had partial response or complete response as determined by the investigator per RECIST v1.1 in all randomized participants with measurable disease at baseline.
Progression Free Survival (PFS) as Assessed by BIRCThrough the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)Defined as the time from randomization to the first objectively documented disease progression, or death from any cause, whichever occurred first, as assessed by the BIRC per RECIST v1.1. Kaplan-Meier methodology was used to estimate the median PFS. PFS was not assessed by the BIRC for participants in the sub-study, and this was not a pre-specified sub-study endpoint.

Countries

China, Czechia, France, Germany, Italy, Japan, Poland, Spain, Taiwan, United Kingdom, United States

Participant flow

Recruitment details

The main study enrolled participants across centers in Asia, Europe, and the U.S. The first participant consented on December 18, 2017, and the study concluded on December 14, 2023. In Japan, a safety run-in sub-study was conducted to evaluate tislelizumab's safety and tolerability in Japanese patients with hepatocellular carcinoma (HCC). Sub-study participants were not assessed for the same primary and secondary endpoints specified for the main study.

Pre-assignment details

The main study had 4 phases: Screening, Treatment, Safety Follow-up (up to 30 days post-treatment or 90 days post-tislelizumab for immune events); and Survival Follow-up (duration varied). Randomization in the main study was stratified by macrovascular invasion (present vs absent), extrahepatic spread (present vs absent), etiology (hepatitis C virus vs other), Eastern Cooperative Oncology Group Performance Status (0 vs 1) and geography (Asia \[excluding Japan\] vs Japan vs Rest of World).

Participants by arm

ArmCount
Safety Run-In Sub-study
Japanese participants received 200 mg intravenous tislelizumab every 3 weeks to assess preliminary safety and tolerability.
10
Arm A: Tislelizumab
Participants received 200 mg of intravenous tislelizumab every 3 weeks until intolerable toxicity, withdrawal of consent, or the investigator determined no further benefit from the therapy.
342
Arm B: Sorafenib
Participants received 400 mg of oral sorafenib twice daily until intolerable toxicity, consent withdrawal, or the investigator deemed no further benefit.
332
Total684

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyDeath7259273
Overall StudyLost to Follow-up076
Overall StudyPhysician Decision001
Overall StudyStudy Closed By Sponsor34633
Overall StudyTransfer to Long Term Extension (BGB-A317-290-LTE1) or Post Trial Supply (PTS)0150
Overall StudyWithdrawal by Subject01519

Baseline characteristics

CharacteristicTotalArm B: SorafenibArm A: TislelizumabSafety Run-In Sub-study
Age, Continuous60.15 years
STANDARD_DEVIATION 12.652
59.51 years
STANDARD_DEVIATION 12.737
60.45 years
STANDARD_DEVIATION 12.528
71.70 years
STANDARD_DEVIATION 8.247
Eastern Cooperative Oncology Group (ECOG) Performance Status
0 (Fully active)
371 Participants180 Participants182 Participants9 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Status
1 (Restricted but ambulatory)
313 Participants152 Participants160 Participants1 Participants
Etiology
Hepatitis C Virus
89 Participants39 Participants46 Participants4 Participants
Etiology
Other
595 Participants293 Participants296 Participants6 Participants
Extrahepatic Spread
Absent
263 Participants134 Participants123 Participants6 Participants
Extrahepatic Spread
Present
421 Participants198 Participants219 Participants4 Participants
Geographic Region
Asia (excluding Japan)
425 participants210 participants215 participants0 participants
Geographic Region
European Union (EU)/United States (US)
172 participants83 participants89 participants0 participants
Geographic Region
Japan
87 participants39 participants38 participants10 participants
Macrovascular Invasion
Absent
585 Participants284 Participants291 Participants10 Participants
Macrovascular Invasion
Present
99 Participants48 Participants51 Participants0 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Asian
515 Participants250 Participants255 Participants10 Participants
Race/Ethnicity, Customized
Black or African American
5 Participants2 Participants3 Participants0 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Not Reported
15 Participants6 Participants9 Participants0 Participants
Race/Ethnicity, Customized
Other
0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Unknown
5 Participants1 Participants4 Participants0 Participants
Race/Ethnicity, Customized
White
144 Participants73 Participants71 Participants0 Participants
Sex: Female, Male
Female
107 Participants51 Participants53 Participants3 Participants
Sex: Female, Male
Male
577 Participants281 Participants289 Participants7 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
7 / 10258 / 338273 / 3241 / 684
other
Total, other adverse events
8 / 10313 / 338318 / 3240 / 0
serious
Total, serious adverse events
1 / 10104 / 33891 / 3247 / 684

Outcome results

Primary

Main Study: Overall Survival (OS)

Defined as the time from the date of randomization to the date of death due to any cause. Median OS was estimated using Kaplan-Meier methodology. Overall survival was a pre-specified primary endpoint for the main study only.

Time frame: Through the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)

Population: The Intent-To-Treat (ITT) analysis set included all randomized participants in the main study.

ArmMeasureValue (MEDIAN)
Safety Run-In Sub-studyMain Study: Overall Survival (OS)15.9 Months
Arm B: SorafenibMain Study: Overall Survival (OS)14.1 Months
95.003% CI: [0.712, 1.019]
p-value: 0.039895% CI: [0.712, 1.019]Log Rank
Primary

Safety Run-in Sub-study: Number of Participants With Treatment-emergent Adverse Events (TEAEs)

An adverse event (AE) is any unfavorable or unintended sign (e.g., abnormal lab result), symptom, or disease temporally associated with study drug use, regardless of causality. A serious adverse event (SAE) is defined as any adverse event that: * Resulted in death * Was life-threatening * Required or prolonged hospitalization * Caused disability/incapacity * Lead to a congenital anomaly/birth defect * Was deemed medically significant by the investigator (e.g., required intervention to prevent severe outcomes).

Time frame: From the first dose to 30 days after the last dose, new anticancer therapy, or the analysis cutoff of December 14th, 2023 (a maximum of 64 months)

Population: The Sub-study Safety Analysis Set includes all participants in the safety run-in sub-study who received at least one dose of any study drug.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Safety Run-In Sub-studySafety Run-in Sub-study: Number of Participants With Treatment-emergent Adverse Events (TEAEs)TEAEs8 Participants
Safety Run-In Sub-studySafety Run-in Sub-study: Number of Participants With Treatment-emergent Adverse Events (TEAEs)SAEs1 Participants
Primary

Safety Run-in Sub-study: Serum Concentration of Tislelizumab

Serum concentration of tislelizumab was a pre-specified primary endpoint for the sub-study only.

Time frame: Cycle 1 and Cycle 5 at end of infusion, 24 hand 72 hours post-dose, and 8 days and 15 days post-dose (each cycle was 3 weeks).

Population: The Sub-study Pharmacokinetic (PK) Analysis Set includes all participants in the safety run-in sub-study who received at least 1 dose of tislelizumab per the protocol, for whom any post-dose PK data were available at each time point.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 1 End of Infusion63.21 µg/mLGeometric Coefficient of Variation 22.304
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 1: 24 Hours Post Dose53.04 µg/mLGeometric Coefficient of Variation 20.901
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 1: 72 Hours Post Dose42.06 µg/mLGeometric Coefficient of Variation 23.649
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 1: 8 Days Post Dose32.61 µg/mLGeometric Coefficient of Variation 16.92
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 1: 15 Days Post Dose23.74 µg/mLGeometric Coefficient of Variation 18.328
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 5 Day 1: Predose27.17 µg/mLGeometric Coefficient of Variation 34.436
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 5 Day 1: End of Infusion87.54 µg/mLGeometric Coefficient of Variation 27.508
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 5: 24 Hours Post Dose80.54 µg/mLGeometric Coefficient of Variation 27.006
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 5: 72 Hours Post Dose64.80 µg/mLGeometric Coefficient of Variation 23.837
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 5: 8 Days Post Dose52.65 µg/mLGeometric Coefficient of Variation 26.759
Safety Run-In Sub-studySafety Run-in Sub-study: Serum Concentration of TislelizumabCycle 5: 15 Days Post Dose37.57 µg/mLGeometric Coefficient of Variation 24.982
Secondary

Change From Baseline in the EORTC QLQ-C30 Global Health Status/Quality of Life Score at Cycle 6

The EORTC QLQ-C30 v3.0 is a questionnaire that assesses quality of life of participants with cancer. It includes global health status and quality of life questions related to overall health in which participants respond based on a 7-point scale, where 1 is very poor and 7 is excellent. Raw scores are transformed into a 0 to 100 scale via linear transformation. A higher score indicates better health outcomes. The EORTC QLQ-C30 was not assessed in participants in the sub-study.

Time frame: Baseline to Cycle 6 (each cycle was 21 days)

Population: ITT Analysis Set. Only participants with data at both Baseline and Cycle 6 are included.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Safety Run-In Sub-studyChange From Baseline in the EORTC QLQ-C30 Global Health Status/Quality of Life Score at Cycle 6-0.9 score on a scale
Arm B: SorafenibChange From Baseline in the EORTC QLQ-C30 Global Health Status/Quality of Life Score at Cycle 6-5.9 score on a scale
Comparison: Between-arm differences in the change from Baseline were assessed using a mixed model for repeated measures. The model included Baseline scores, stratification factors, treatment arms, visits, and treatment arm by visit interaction as fixed effects and visit as a repeated measure with an unstructured covariance matrix based on the missing at random assumption.p-value: 0.002295% CI: [1.8, 8.2]Mixed Models Analysis
Secondary

Change From Baseline in the EQ-5D-5L VAS at Cycle 6

The EQ-5D-5L comprises a descriptive module and a visual analogue scale (VAS). The EQ-5D-5L VAS measures respondent's self-rated health status on a 0 to 100 scale, with 100 = 'the best health you can imagine' and 0 = 'the worst health you can imagine'. Higher scores on VAS indicate higher health status. The EQ-5D-5L VAS was not assessed in participants in the sub-study.

Time frame: Baseline to Cycle 6 (each cycle was 21 days)

Population: ITT Analysis Set. Only participants with data at both Baseline and Cycle 6 are included in the analysis.

ArmMeasureValue (MEAN)Dispersion
Safety Run-In Sub-studyChange From Baseline in the EQ-5D-5L VAS at Cycle 6-0.2 score on a scaleStandard Deviation 17.03
Arm B: SorafenibChange From Baseline in the EQ-5D-5L VAS at Cycle 6-5.4 score on a scaleStandard Deviation 13.09
Secondary

Change From Baseline in the European EORTC QLQ HCC 18 Index Score at Cycle 6

The EORTC QLQ-HCC18 is a questionnaire specifically designed to assess health-related quality of life in participants with hepatocellular carcinoma. It includes six symptom scales measuring Fatigue (3 items), Jaundice (2 items), Body Image (2 items), Nutrition (5 items), Pain (2 items), Fever (2 items) and two single items measuring Sex Life and Abdominal Swelling. Participants respond on a scale from 1 = Not at all to 4 = Very Much. Raw scores are transformed into a 0 to 100 scale using linear transformation. The HCC18 Index score is calculated from each of the 6 symptom scales and the 2 single items, and ranges from 0 to 100. Higher scores indicate greater symptom burden or worse quality of life. The HEORTC QLQ-HCC18 was not assessed in participants in the sub-study.

Time frame: Baseline to Cycle 6 (Each cycle was 21 days)

Population: ITT Analysis Set. Only participants with data at both baseline and Cycle 6 are included

ArmMeasureValue (LEAST_SQUARES_MEAN)
Safety Run-In Sub-studyChange From Baseline in the European EORTC QLQ HCC 18 Index Score at Cycle 62.2 score on a scale
Arm B: SorafenibChange From Baseline in the European EORTC QLQ HCC 18 Index Score at Cycle 64.9 score on a scale
Comparison: Between-arm differences in the change from Baseline were assessed using a mixed model for repeated measures. The model included Baseline scores, stratification factors, treatment arms, visits, and treatment arm by visit interaction as fixed effects and visit as a repeated measure with an unstructured covariance matrix based on the missing at random assumption.p-value: 0.009695% CI: [-4.7, -0.7]Mixed Models Analysis
Secondary

Change From Baseline in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Hepatocellular Carcinoma 18 Questions (EORTC QLQ HCC 18) Index Score at Cycle 4

The EORTC QLQ-HCC18 is a questionnaire specifically designed to assess health-related quality of life in participants with hepatocellular carcinoma. It includes six symptom scales measuring Fatigue (3 items), Jaundice (2 items), Body Image (2 items), Nutrition (5 items), Pain (2 items), Fever (2 items) and two single items measuring Sex Life and Abdominal Swelling. Participants respond on a scale from 1 = Not at all to 4 = Very Much. Raw scores are transformed into a 0 to 100 scale using linear transformation. The HCC18 Index score is calculated from each of the 6 symptom scales and the 2 single items, and ranges from 0 to 100. Higher scores indicate greater symptom burden or worse quality of life. The EORTC QLQ-HCC18 was not assessed for participants in the sub-study.

Time frame: Baseline to Cycle 4 (each cycle was 21 days)

Population: ITT Analysis Set. Only participants with data at both Baseline and Cycle 4 are included

ArmMeasureValue (LEAST_SQUARES_MEAN)
Safety Run-In Sub-studyChange From Baseline in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Hepatocellular Carcinoma 18 Questions (EORTC QLQ HCC 18) Index Score at Cycle 41.6 score on a scale
Arm B: SorafenibChange From Baseline in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Hepatocellular Carcinoma 18 Questions (EORTC QLQ HCC 18) Index Score at Cycle 43.9 score on a scale
Comparison: Between-arm differences in the change from Baseline were assessed using a mixed model for repeated measures. The model included Baseline scores, stratification factors, treatment arms, visits, and treatment arm by visit interaction as fixed effects and visit as a repeated measure with an unstructured covariance matrix based on the missing at random assumption.p-value: 0.003395% CI: [-3.8, -0.8]Mixed Models Analysis
Secondary

Change From Baseline in the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status/Quality of Life Score at Cycle 4

The EORTC QLQ-C30 v3.0 is a questionnaire that assesses quality of life of participants with cancer. It includes global health status and quality of life questions related to overall health in which participants respond based on a 7-point scale, where 1 is very poor and 7 is excellent. Raw scores are transformed into a 0 to 100 scale via linear transformation. A higher score indicates better health outcomes. The EORTC QLQ-C30 was not assessed in participants in the sub-study.

Time frame: Baseline to Cycle 4 (each cycle was 21 days)

Population: ITT Analysis Set. Only participants with data at both Baseline and Cycle 4 are included.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Safety Run-In Sub-studyChange From Baseline in the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status/Quality of Life Score at Cycle 4-0.7 score on a scale
Arm B: SorafenibChange From Baseline in the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Global Health Status/Quality of Life Score at Cycle 4-5.1 score on a scale
Comparison: Between-arm differences in the change from Baseline were assessed using a mixed model for repeated measures. The model included Baseline scores, stratification factors, treatment arms, visits, and treatment arm by visit interaction as fixed effects and visit as a repeated measure with an unstructured covariance matrix based on the missing at random assumption.p-value: 0.003795% CI: [1.4, 7.3]Mixed Models Analysis
Secondary

Change From Baseline in the European Quality of Life 5 Dimensions, 5-level (EQ-5D-5L) Visual Analogue Scale (VAS) at Cycle 4

The EQ-5D-5L comprises a descriptive module and a Visual Analogue scale (VAS). The EQ-5D-5L VAS measures respondent's self-rated health status on a 0 to 100 scale, with 100 = 'the best health you can imagine' and 0 = 'the worst health you can imagine'. Higher scores on VAS indicate higher health status. The EQ-5D-5L VAS was not assessed in participants in the sub-study.

Time frame: Baseline to Cycle 4 (each cycle was 21 days)

Population: ITT Analysis Set. Only participants with data at both Baseline and Cycle 4 are included in the analysis.

ArmMeasureValue (MEAN)Dispersion
Safety Run-In Sub-studyChange From Baseline in the European Quality of Life 5 Dimensions, 5-level (EQ-5D-5L) Visual Analogue Scale (VAS) at Cycle 4-0.4 score on a scaleStandard Deviation 14.52
Arm B: SorafenibChange From Baseline in the European Quality of Life 5 Dimensions, 5-level (EQ-5D-5L) Visual Analogue Scale (VAS) at Cycle 4-4.3 score on a scaleStandard Deviation 12.92
Secondary

Clinical Benefit Rate (CBR) as Assessed by BIRC

Defined as the percentage of participants whose best overall response (BOR) was complete response, partial response, or stable disease greater than or equal to 24 weeks in duration, as assessed by the BIRC per RECIST v1.1. CBR was not a pre-specified endpoint for participants in the sub-study.

Time frame: Through the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)

Population: ITT Analysis Set

ArmMeasureValue (NUMBER)
Safety Run-In Sub-studyClinical Benefit Rate (CBR) as Assessed by BIRC25.4 percentage of participants
Arm B: SorafenibClinical Benefit Rate (CBR) as Assessed by BIRC24.4 percentage of participants
Secondary

Clinical Benefit Rate (CBR) as Assessed by the Investigator

Defined as the percentage of participants whose best overall response (BOR) is complete response, partial response, or stable disease greater than or equal to 24 weeks in duration, as assessed by the investigator per RECIST v1.1. CBR was not a pre-specified endpoint for participants in the sub-study.

Time frame: Through the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)

Population: ITT Analysis Set

ArmMeasureValue (NUMBER)
Safety Run-In Sub-studyClinical Benefit Rate (CBR) as Assessed by the Investigator25.7 percentage of participants
Arm B: SorafenibClinical Benefit Rate (CBR) as Assessed by the Investigator28.9 percentage of participants
Secondary

Disease Control Rate (DCR) as Assessed by BIRC

Defined as the percentage of participants whose best overall response (BOR) was complete response, partial response, or stable disease as assessed by the BIRC per RECIST v1.1. DCR was not a pre-specified endpoint for participants in the sub-study.

Time frame: Through the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)

Population: ITT Analysis Set

ArmMeasureValue (NUMBER)
Safety Run-In Sub-studyDisease Control Rate (DCR) as Assessed by BIRC44.2 percentage of participants
Arm B: SorafenibDisease Control Rate (DCR) as Assessed by BIRC50.3 percentage of participants
Secondary

Disease Control Rate (DCR) as Assessed by the Investigator

Defined as the percentage of participants whose best overall response (BOR) was complete response, partial response, or stable disease as assessed by the investigator per RECIST v1.1. DCR was not a pre-specified endpoint for participants in the sub-study.

Time frame: Through the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)

Population: ITT Analysis Set

ArmMeasureValue (NUMBER)
Safety Run-In Sub-studyDisease Control Rate (DCR) as Assessed by the Investigator44.2 percentage of participants
Arm B: SorafenibDisease Control Rate (DCR) as Assessed by the Investigator52.4 percentage of participants
Secondary

Duration of Response (DOR) as Assessed by BIRC

Defined as the time from the first occurrence of a documented objective response until the first documentation of progression or death from any cause, whichever occurred first, as determined by the BIRC per RECIST v1.1. Median DOR was estimated using Kaplan-Meier methodology. DOR was not assessed by the BIRC for participants in the sub-study, and this was not a pre-specified sub-study endpoint.

Time frame: Through the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)

Population: ITT Analysis Set. Only participants with best overall response of complete response or partial response confirmed per RECIST v1.1 were included in the analysis, and percentages were based on the number of responders.

ArmMeasureValue (MEDIAN)
Safety Run-In Sub-studyDuration of Response (DOR) as Assessed by BIRC36.1 months
Arm B: SorafenibDuration of Response (DOR) as Assessed by BIRC11.0 months
Secondary

Duration of Response (DOR) Assessed by the Investigator

Defined as the time from the first occurrence of a documented objective response until the first documentation of progression or death from any cause, whichever occurred first, as assessed by the investigator per RECIST v1.1. Median DOR was estimated using Kaplan-Meier methodology.

Time frame: Through the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)

Population: Sub-study Safety Analysis Set; Main study ITT Analysis Set; Only participants with best overall response of complete response or partial response per investigator assessment were included in the analysis.

ArmMeasureValue (MEDIAN)
Safety Run-In Sub-studyDuration of Response (DOR) Assessed by the InvestigatorNA Months
Arm B: SorafenibDuration of Response (DOR) Assessed by the Investigator25.2 Months
Arm B: SorafenibDuration of Response (DOR) Assessed by the Investigator13.8 Months
Secondary

Main Study: Number of Participants With Treatment-emergent Adverse Events

An adverse event (AE) is any unfavorable or unintended sign (e.g., abnormal lab result), symptom, or disease temporally associated with study drug use, regardless of causality. A serious adverse event (SAE) is defined as any adverse event that: * Resulted in death * Was life-threatening * Required or prolonged hospitalization * Caused disability/incapacity * Lead to a congenital anomaly/birth defect * Was deemed medically significant by the investigator (e.g., required intervention to prevent severe outcomes).

Time frame: From the first dose to 30 days after the last dose, new anticancer therapy, or the study completion analysis cutoff on December 14th, 2023 (a maximum of 61 months for participants in Arm A and 63 months for participants in Arm B).

Population: The Safety Analysis Set includes all randomized participants who received at least one dose of any study drug.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Safety Run-In Sub-studyMain Study: Number of Participants With Treatment-emergent Adverse EventsTEAEs325 Participants
Safety Run-In Sub-studyMain Study: Number of Participants With Treatment-emergent Adverse EventsSAEs104 Participants
Arm B: SorafenibMain Study: Number of Participants With Treatment-emergent Adverse EventsTEAEs324 Participants
Arm B: SorafenibMain Study: Number of Participants With Treatment-emergent Adverse EventsSAEs91 Participants
Secondary

Overall Response Rate (ORR) as Assessed by Blinded Independent Review Committee (BIRC)

Defined as the percentage of participants who had partial response or complete response as determined by Blinded Independent Review Committee (BIRC) per the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 in all randomized participants with measurable disease at baseline. ORR was not assessed by the BIRC for participants in the sub-study, and this was not a pre-specified sub-study endpoint.

Time frame: Through the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)

Population: ITT Analysis Set

ArmMeasureValue (NUMBER)
Safety Run-In Sub-studyOverall Response Rate (ORR) as Assessed by Blinded Independent Review Committee (BIRC)14.3 percentage of participants
Arm B: SorafenibOverall Response Rate (ORR) as Assessed by Blinded Independent Review Committee (BIRC)5.4 percentage of participants
Comparison: The null hypothesis assumed that ORR is equal in both groups, while the alternative hypothesis assumed ORR is higher in the tislelizumab group (Arm A).p-value: 0.000395% CI: [3.85, 12.7]Cochran-Mantel-Haenszel
Secondary

Overall Response Rate (ORR) as Assessed by the Investigator

Defined as the percentage of participants who had partial response or complete response as determined by the investigator per RECIST v1.1 in all randomized participants with measurable disease at baseline.

Time frame: Through the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)

Population: Sub-study Safety Analysis Set; Main study ITT Analysis Set

ArmMeasureValue (NUMBER)
Safety Run-In Sub-studyOverall Response Rate (ORR) as Assessed by the Investigator20 percentage of participants
Arm B: SorafenibOverall Response Rate (ORR) as Assessed by the Investigator15.5 percentage of participants
Arm B: SorafenibOverall Response Rate (ORR) as Assessed by the Investigator5.7 percentage of participants
p-value: <0.000195% CI: [4.71, 13.78]Cochran-Mantel-Haenszel
Secondary

Progression Free Survival (PFS) as Assessed by BIRC

Defined as the time from randomization to the first objectively documented disease progression, or death from any cause, whichever occurred first, as assessed by the BIRC per RECIST v1.1. Kaplan-Meier methodology was used to estimate the median PFS. PFS was not assessed by the BIRC for participants in the sub-study, and this was not a pre-specified sub-study endpoint.

Time frame: Through the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)

Population: ITT Analysis Set

ArmMeasureValue (MEDIAN)
Safety Run-In Sub-studyProgression Free Survival (PFS) as Assessed by BIRC2.1 months
Arm B: SorafenibProgression Free Survival (PFS) as Assessed by BIRC3.4 months
p-value: 0.136495% CI: [0.92, 1.33]One-sided log-rank test
Secondary

Progression Free Survival (PFS) Assessed by the Investigator

Defined as the time from randomization to the first objectively documented disease progression, or death from any cause, whichever occurred first, as assessed by the investigator per RECIST v1.1. Kaplan-Meier methodology was used to estimate the median PFS.

Time frame: Through the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)

Population: Sub-study Safety Analysis Set; Main study ITT Analysis Set

ArmMeasureValue (MEDIAN)
Safety Run-In Sub-studyProgression Free Survival (PFS) Assessed by the Investigator2.1 Months
Arm B: SorafenibProgression Free Survival (PFS) Assessed by the Investigator2.1 Months
Arm B: SorafenibProgression Free Survival (PFS) Assessed by the Investigator4.0 Months
p-value: 0.262295% CI: [0.9, 1.26]One-sided log-rank test
Secondary

Safety Run-in Sub-study: Number of Participants Who Developed Anti-tislelizumab Antibodies

Treatment-emergent anti-drug antibodies (ADA): participants who were ADA negative at baseline and ADA positive post-baseline. Treatment-boosted ADA: participants who were ADA positive at baseline that was boosted to a 4-fold or higher-level following drug administration. ADA assessments were not performed for participants enrolled in the main study.

Time frame: From the first dose to 30 days after the last dose, new anticancer therapy, or the analysis cutoff of December 14th, 2023 (a maximum of 64 months)

Population: The Sub-study Antidrug antibody (ADA) Analysis Set includes all participants enrolled in the sub-study who received at least one dose of tislelizumab for whom both baseline ADA and at least one postbaseline ADA results were available.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Safety Run-In Sub-studySafety Run-in Sub-study: Number of Participants Who Developed Anti-tislelizumab AntibodiesTreatment-Emergent ADA1 Participants
Safety Run-In Sub-studySafety Run-in Sub-study: Number of Participants Who Developed Anti-tislelizumab AntibodiesTreatment-Boosted ADA0 Participants
Secondary

Safety Run-in Sub-study: Overall Survival

Defined as the time from the date of randomization to the date of death due to any cause. Median OS was estimated using Kaplan-Meier methodology.

Time frame: Up a to 64 months

Population: Sub-study Safety Analysis Set

ArmMeasureValue (MEDIAN)
Safety Run-In Sub-studySafety Run-in Sub-study: Overall Survival29.7 months
Secondary

Time to Progression (TTP) as Assessed by the Investigator

Defined as the time from the date of randomization to the date of the first objectively documented tumor progression as assessed by the investigator per RECIST v1.1. Median TTP was estimated using Kaplan-Meier methodology. TTP was not a pre-specified sub-study endpoint.

Time frame: Through the study completion data cut-off date of December 14th, 2023 (up to approximately 65 months)

Population: ITT Analysis Set

ArmMeasureValue (MEDIAN)
Safety Run-In Sub-studyTime to Progression (TTP) as Assessed by the Investigator2.1 months
Arm B: SorafenibTime to Progression (TTP) as Assessed by the Investigator4.1 months
p-value: 0.118295% CI: [0.94, 1.34]One-sided log-rank test
Secondary

Time to Progression (TTP) Assessed by BIRC

Defined as the time from the date of randomization to the date of the first objectively documented tumor progression as assessed by the BIRC per RECIST v1.1. Median TTP was estimated using Kaplan-Meier methodology. TTP was not assessed by the BIRC for participants in the sub-study, and this was not a pre-specified sub-study endpoint.

Time frame: Through the primary analysis data cut-off date of July 11th, 2022 (up to approximately 55 months)

Population: ITT Analysis Set

ArmMeasureValue (MEDIAN)
Safety Run-In Sub-studyTime to Progression (TTP) Assessed by BIRC2.2 Months
Arm B: SorafenibTime to Progression (TTP) Assessed by BIRC4.1 Months
p-value: 0.085995% CI: [0.94, 1.38]One-sided log-rank test

Source: ClinicalTrials.gov · Data processed: Feb 24, 2026