Clinical Research Directory

Immune-Related Adverse Events and Clinical Outcomes of First-Line Immunotherapy in Egyptian Patients With Unresectable Hepatocellular Carcinoma

The goal of this observational study is to evaluate how well first-line immunotherapy works and investigate its association with immune-related adverse events (irAEs) in Egyptian adults with unresectable hepatocellular carcinoma (HCC), a type of liver cancer that cannot be removed by surgery. The main questions this study aims to answer are: * Are immune-related adverse events (irAEs), which are side effects caused by activation of the immune system, associated with treatment response and survival? * How effective and safe is first-line immunotherapy in Egyptian patients with unresectable HCC? The study will also explore whether routine blood markers, including eosinophil counts and markers of inflammation and nutritional status, are associated with treatment outcomes and the development of immune-related side effects. Changes in liver function and patients' health-related quality of life will also be evaluated. Approximately 294 patients receiving first-line immunotherapy as part of their routine medical care will be included. Patients may receive atezolizumab plus bevacizumab or durvalumab plus tremelimumab, as prescribed by their treating physicians. Researchers will not assign treatments or change patients' medical care. The study will include a review of existing medical records and prospective follow-up of eligible patients. Researchers will: * Review medical records to collect information about treatment, routine blood tests, imaging results, side effects, and clinical outcomes. * Follow eligible patients during routine medical visits to assess treatment response, survival, adverse events, and changes in liver function. * Ask prospectively enrolled participants to complete questionnaires about their health-related quality of life during scheduled follow-up assessments. Researchers will compare treatment outcomes between patients who develop irAEs and those who do not, while taking into account when these side effects occur.

Overcoming Immunotherapy Resistance in Hepatocellular Carcinoma

Each year, approximately 1,000 patients in the Netherlands are diagnosed with liver cancer. When liver cancer can no longer be treated with surgery or thermal ablation, cure is no longer possible. In recent years, immunotherapy has become increasingly important in the treatment of liver cancer. Unfortunately, the combination of immunotherapy (atezolizumab) and an anti-angiogenic agent (bevacizumab) results in a durable response in only 15-20% of patients. The aim of this study is to identify a strategy to enhance the effectiveness of immunotherapy, enabling the patient's immune system to better recognize and attack the cancer. Two recent clinical observations suggested that the immune system may be activated by external radiotherapy or radioembolization. Following these treatments, both patients unexpectedly showed regression of multiple non-irradiated liver metastases. One of these patients had initially experienced disease progression during immunotherapy, but after radiotherapy subsequently demonstrated regression of all metastatic lesions. In this clinical study (16 patients in total), we will investigate whether the immune system can be reactivated after failure of immunotherapy. Patients will be eligible for participation after disease progression during immunotherapy for liver cancer. In Group A, eight patients will receive three fractions of external radiotherapy directed at the most dominant liver lesion or an extrahepatic metastasis. In Group B, eight patients will receive radioembolization of the most dominant liver lesion. There will be no randomization. Group A will be enrolled first, and Group B will open only after completion of enrollment in Group A. The primary outcome measure is the number of patients in each group who achieve disease control at 6 months, defined as stable disease or tumor regression lasting for at least 6 months. During the study, participating patients will undergo extensive blood analyses, tumor biopsies of both treated and untreated lesions, and multiple CT scans. Through these investigations, we aim to characterize the tumor microenvironment in detail, evaluate the role of different immune cell populations, and gain a better understanding of why these treatments administered after immunotherapy failure may still be capable of reactivating the immune system.

Phase 1 Trial of ACE723, A Dual-Payload Antibody Drug Conjugate, in Patients With Advanced HCC Who Have Failed or Progressed on Standard Systemic Therapy Containing ICIs

ACE723 is a dual-payload antibody drug conjugate targeting glypican-3 (GPC-3) that is under investigation for the treatment of unresectable or metastatic hepatocellular carcinoma (HCC).

Chemotherapy With the Ralox Regimen Combined With Anlotinib and Penpulimab for Unresectable Hepatocellular Carcinoma

The objective of this clinical trial study is to determine whether intravenous chemotherapy with the Ralox regimen in combination with Anlotinib and Penpulimab has certain efficacy and high safety for patients with unresectable hepatocellular carcinoma. Overall design: This clinical study is a single - center, single - arm, prospective clinical study. In this single - arm study, randomization grouping is not involved. Sample size estimation: According to previous research reports, the objective response rate (ORR0) of targeted immunotherapy for literature unresectable HCC is 30%. If α = 0.05 and 1 - β = 0.80 are set, and assuming that the ORR1 of systemic chemotherapy combined with targeted immunotherapy for unresectable HCC is 59.2%, at least 21 patients need to be enrolled as calculated by the PASS15.0 software. Considering a 10% dropout rate, 24 patients need to be enrolled. It is planned to enroll a total of 30 patients. Subjects will receive systemic intravenous chemotherapy combined with immune checkpoint inhibitors and targeted drug therapy: The intravenous chemotherapy regimen is as follows: Oxaliplatin 100 mg/m², intravenous infusion for 3 hours on Day 1, once every 3 weeks; Raltitrexed 3 mg/m², intravenous infusion for 15 minutes on Day 1. Penpulimab 200 mg, once every 3 weeks. Anlotinib 12 mg, taken orally once a day, with 2 weeks of administration followed by 1 week of discontinuation. Each cycle is 21 days. The combined medication will be continued for 3 cycles, or until obvious disease progression, patient intolerance, or until the researcher deems it necessary to stop the medication (whichever occurs first). After that, subsequent treatment will be carried out according to the clinical diagnosis and treatment routine based on the tumor situation. For each subject, safety assessment and research compliance assessment will be conducted at the first dose and at Weeks 1, 2, and 3 of treatment, and the researcher will medication provide guidance. An examination will be conducted once at the screening visit, every 6 weeks during the treatment phase, and at each research visit during the follow - up period. Throughout the entire research process, its toxicity and safety will be monitored.

Y-90 SIRT for Unresectable HCC Larger Than 7cm

This is a phase II clinical study to evaluate the efficacy and safety of SIRT in patients with HCC greater than 7 cm. After enrollment, patients received yttrium-90 selective internal radiation therapy. The primary endpoint of the study is objective reponse rate (ORR) as assessed by mRECIST. Secondary endpoints were: objective response rate (ORR) as assessed by RECIST 1.1, disease control rate (DCR), progression-free survival (PFS), time to response (TTR), duration of response (DOR), overall survival (OS), and safety (incidence and severity of adverse events).

A Clinical Trial Assessing the Safety and Efficacy of Biodegradable Magnesium Embolic Microspheres for Primary Hepatocellular Carcinoma

The goal of this clinical trial is to determine if the addition of biodegradable magnesium metal microspheres to traditional TACE (Transarterial Chemoembolization) is effective in treating hepatocellular carcinoma, and to assess the safety of these microspheres. The main questions it aims to answer are: * Is the treatment more effective than traditional TACE alone? * What additional medical issues arise when using the microspheres? Researchers will compare TACE with magnesium microspheres to traditional TACE without microspheres to see if the addition of the microspheres improves treatment outcomes. Participants will: * Receive up to 3 treatments of TACE with or without microspheres * Undergo checkups and tests every 30 days * Keep records of tumor size and other safety issues

Observational Study for SIR-Spheres Therapy for the Treatment of HCC Patients in China

Yttrium-90 (y90) Microsphere Injection Solution was approved by the NMPA in 2022. Currently, there is a lack of summary of real-world data in China. Therefore, this retrospective real-world study is intented to explore the characteristics and efficacy of HCC patients treated with y90 in China, aiming to provide reference for guiding and optimizing clinical practices and subsequent confirmatory clinical studies for the treatment of HCC patients in China.