Hepatocellular Carcinoma (HCC), IrAE
Conditions
Brief summary
This study is a prospective, randomized, single-center randomized controlled clinical trial to investigate the safety and efficacy of ondansetron in reducing the toxicity associated with immune checkpoint inhibitor treatment. This study plans to enroll 134 patients with hepatocellular carcinoma who are scheduled to receive standard ICI treatment. This study will adopt the 2023 CSCO Guidelines for the Management of Immune checkpoint inhibitor-related toxicity as the main assessment criterion, and take the incidence and severity of irAEs as the main observation indicators to evaluate the effectiveness of ondansetron in reducing the toxicity related to immune checkpoint inhibitor treatment in patients with hepatocellular carcinoma.
Interventions
DRUGondansetron
Ondansetron: Maintained at 8mg/qd, orally, until disease progression or intolerance.
Sponsors
First Affiliated Hospital of Wenzhou Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Age: 18 to 80 years old, both male and female are acceptable. 2. The imaging or pathological diagnosis is hepatocellular carcinoma; 3. It is planned to carry out standard treatment for liver cancer, specifically including lenvatinib + tislelizumab or lenvatinib + pembrolizumab or atezolizumab + bevacizumab. 4. ECOG score: 0 to 2 points; 5. Expected survival period ≥12 weeks; 6. Baseline blood cell count tests and blood biochemistry must meet the following standards: White blood cell count ≥3.0×10\^9/L; Hemoglobin ≥90 g/L; The absolute neutrophil count is ≥1.5×10\^9/L; Platelet count ≥100×10\^9/L; Alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤ 2.5 times the upper limit of normal (ULN). Total bilirubin ≤ twice ULN; Serum creatinine ≤ 1.5 times ULN; Albumin ≥30 g/L; 7. The subjects voluntarily joined this study, signed the informed consent form, had good compliance and cooperated with the follow-up.
Exclusion criteria
1. Those who have received treatment with ondansetron within 14 days; 2. Patients with autoimmune diseases; 3. Use of systemic glucocorticoids or other immunosuppressants within 14 days; 4. Those who have previously discontinued ICI treatment due to irAEs; 5. Those with severe liver dysfunction (Child-Pugh grade C); 6. Those with contraindications to ondansetron such as serotonin syndrome or phenylketonuria; 7. Patients allergic to ondansetron; 8. Those who are currently using drugs that may have serious interactions with ondansetron, such as apopmorphine; 9. The researcher evaluated that the patient was unable or unwilling to comply with the requirements of the research protocol.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence rate of irAEs | through study completion, an average of 1 year | To evaluate whether the prophylactic use of ondansetron can reduce the incidence of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitors (ICI). The evaluation criteria mainly refer to the "2023 CSCO Guidelines for the Management of Toxicity Related to Immune Checkpoint Inhibitors", with a focus on the incidence of all grades of irAEs and the incidence of severe irAEs at grade 3 and above. The monitoring scope covers liver and kidney functions, blood routine, cardiac function (electrocardiogram, myocardial injury markers), endocrine function (thyroid function, etc.) and imaging manifestations of pneumonia. |
| The Severity of irAEs | through study completion, an average of 1 year | To evaluate whether the prophylactic use of ondansetron can reduce the severity of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitors (ICI). The evaluation criteria mainly refer to the "2023 CSCO Guidelines for the Management of Toxicity Related to Immune Checkpoint Inhibitors", with a focus on the incidence of all grades of irAEs and the incidence of severe irAEs at grade 3 and above. The monitoring scope covers liver and kidney functions, blood routine, cardiac function (electrocardiogram, myocardial injury markers), endocrine function (thyroid function, etc.) and imaging manifestations of pneumonia. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ORR | through study completion, an average of 1 year | Objective Response Rate，according to RECIST v1.1 |
| DCR | through study completion, an average of 1 year | Disease Control Rate, according to RECIST v1.1 |
Countries
China
Outcome results
None listed