Hepatocellular Carcinoma (HCC)
Conditions
Keywords
HCC, VETC, Recurrence, PD-1, Lenvatinib
Brief summary
Vessels that encapsulate tumor clusters (VETC) are a novel invasive metastatic factor in hepatocellular carcinoma (HCC), operating independently of the epithelial-mesenchyme transition (EMT). The presence of VETC is associated with a higher rate of postoperative recurrence in HCC patients, indicating a more aggressive biological behavior.Improving the prognosis for VETC-positive patients is a critical issue in clinical oncology.
Detailed description
Previous studies have established that VETC is a novel mode of metastasis, independent of EMT, and may be associated with immune suppression and poor prognosis. Numerous retrospective studies have found that patients with VETC positivity have higher rates of postoperative recurrence and distant metastasis. How to improve the surgical prognosis for VETC-positive patients remains to be explored. Currently, there are no published studies on how to improve the prognosis for this group of individuals. One of our unpublished retrospective studies found that treatment with PD-1 monoclonal antibodies does not effectively improve the prognosis for VETC-positive patients. However, the combination of PD-1 monoclonal antibodies with lenvatinib can effectively reduce postoperative recurrence and improve prognosis in VETC-positive patients. Therefore, we have designed this multicenter, randomized controlled trial to explore the efficacy and safety of lenvatinib in combination with sintilimab in VETC-positive HCC.
Interventions
DRUGSintilimab
Patient receives first adjuvant sintilimab 2-4 weeks postoperatively, 200 mg IV, every 21 days for a total of 8 cycles
DRUGLenvatinib
lenvatinib is initiated orally(12 mg for body weight >= 60kg, 8 mg for body weight < 60kg daily), 2-4 weeks postoperatively for 6 months.
Sponsors
Wan-Guang Zhang
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-75 years; * No previous local or systemic treatment for hepatocellular carcinoma; * Child-Pugh liver function score ≤ 7; ④ECOG PS 0-1; ⑤BCLC stage 0-C, underwent R0 resection and confirmed by pathology as hepatocellular carcinoma; ⑥No major systemic diseases, immunodeficiency diseases, etc.; ⑦CD34 immunohistochemical staining confirms the presence of VETC in the intratumoral vascular pattern (part or all of the field of view)
Exclusion criteria
* Pregnant or breastfeeding women; * Recurrent HCC, distant metastasis or other systemic tumors; * Vascular invasion involving the mesenteric vein, main portal vein, hepatic vein or inferior vena cava; * History of gastrointestinal bleeding within the past 4 weeks; * Active infection; ⑥Other significant clinical and laboratory abnormalities that affect safety evaluation; ⑦Inability to follow the study protocol, receive treatment or follow-up as scheduled
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Disease-free survival | From date of include in this research until the date of first documented recurrence or date of death from any cause, whichever came first, assessed up to 60 months | DFS defined as time to recurrence or death after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival | From date of include in this research until the date of death from any cause, whichever came first, assessed up to 60 months | OS defined as time to death from any cause after surgery. |
| Adverse events | Baseline up to 60 months | The incidence and severity of adverse events (AEs) and serious adverse events (SAEs) as assessed by CTCAE v5.0 |
Contacts
Primary ContactWanguang Zhang
Outcome results
None listed