Advanced HCC Treated by Systemic Immunotherapy
Conditions
Keywords
HCC Organoids, HCC PBMCs
Brief summary
The study aims to analyze blood samples from patients with advanced hepatocellular carcinoma who are receiving systemic treatment with immunotherapy. The objective is to determine whether treatment exposure leads to changes in the transcriptomic patterns of peripheral blood mononuclear cells (PBMCs), if these changes are associated with treatment response, and whether certain pre-treatment transcriptomic signatures can predict response to treatment. As an exploratory objective, PBMCs derived from patients exposed to immune checkpoint inhibitors will be co-cultured with their paired tumor cells in organoid cultures. This aims to assess whether these preclinical 3D models correlate with clinical outcomes.
Detailed description
The primary pivotal objective of the study is to analyse the single cell transcriptome of peripheral blood mononuclear cells (PBMCs) in patients with HCC treated with immunotherapy to define if treatment exposure determines transcriptomic pattern changes and if some of these changes are associated with treatment response. The secondary objective of the study is to investigate if some pre-treatment transcriptome signature of PBMCs is predictive of response and long-lasting response to treatment. As an exploratory objective, the study investigators will analyse the interaction between patients' peripheral immune cells previously exposed to immune check-point inhibitors and their paired tumour cells in the organoid cultures.
Interventions
None listed
Sponsors
Fondazione IRCCS Policlinico San Matteo di Pavia
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
1. diagnosis of advanced HCC treated with atezolizumab plus bevacizumab or tremelimumab single dose plus durvalumab (STRIDE regimen) as first-line treament 2. age ≥18 and \<90 years at time of signing informed consent 3. Signed Informed Consent Form
Exclusion criteria
1. Life expectancy of \<12 months due to concomitant diseases 2. Active or history of autoimmune disease or immune deficiency on inflammatory chronic diseases 3. Ongoing drug abuse 4. History of malignancy other than HCC within 3 years prior to study entry with the following exception: 1. Completely resected malignancies with a negligible risk of metastasis or death (e.g., 5-year OS rate 90%) and without evidence of recurrence for \> 3 years prior to study entry 2. adequately treated non-melanoma skin carcinoma or lentigo maligna without evidence of metastases. 3. adequately treated carcinoma in situ of the cervix without evidence of recurrence 4. localised prostate cancer 5. adequately treated non invasive or in situ urothelial cancers 5. evidence or history of positive HIV test 6. inability to comply with the study protocol, in the investigator's judgment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Analysis of the single cell profiling of peripheral blood mononuclear cells in patients with HCC treated with immunotherapy pre-therapy (T0) and the 3 months post-therapy (T3) to define if a difference between the two time points exists. | From enrollment untill 3 months after treatment start, (up to 120 days from study inclusion) | The single cell profiling of peripheral blood mononuclear cells in patients with HCC treated with immunotherapy will be analised at two type points: before starting therapy(T0), and the 3 months post-therapy (T3). The difference of single cell profiling of the two paired time-points will be analysed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation between transcriptome signature at baseline and treatment outcomes. | From enrollment to the time of best response to treatment, up to 24 months from enrollement | To define if there is a correlation between baseline transcriptome signatures and treatment outcomes (duration of response, median progression-free survival, median overall survival) |
| Correlation between baseline gene clusters and treatment responses | From enrollment to the time of best response, up to 24 months from enrollment | To identify baseline gene clusters that correlats with higher respose rates |
Other
| Measure | Time frame | Description |
|---|---|---|
| Exploring the interacton between PBMCs and tumor tissue in 3D culture system. | From enrollment untill 3 months after treatment start, (up to 120 days from study inclusion) | To compare the percentage of apoptosis in tumor cells from patient-derived 3D culture systems of HCC, co-cultured with PBMC harvested after treatment with immune checkpoint inhibitors (ICIs), versus those co-cultured with baseline PBMCs collected at T0. |
Countries
Italy
Contacts
Primary ContactSalvatore Corallo
Outcome results
None listed