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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2600127139 |
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最近更新日期: Date of Last Refreshed on: |
2026-06-25 11:56:43 |
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注册时间: Date of Registration: |
2026-06-25 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
仑伐替尼和帕博利珠单抗联合或不联合支链氨基酸联治疗不可切除肝细胞癌的开放标签、随机对照、二期临床研究 |
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Public title: |
A phase II open-label, randomized controlled study of lenvatinib combined with pembrolizumab, with or without branched-chain amino acid combination therapy, for unresectable hepatocellular carcinoma |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
仑伐替尼和帕博利珠单抗联合或不联合支链氨基酸联治疗不可切除肝细胞癌的开放标签、随机对照、二期临床研究 |
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Scientific title: |
A phase II open-label, randomized controlled study of lenvatinib combined with pembrolizumab, with or without branched-chain amino acid combination therapy, for unresectable hepatocellular carcinoma |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
陈进宏 |
研究负责人: |
陈进宏 |
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Applicant: |
Jinhong Chen |
Study leader: |
Jinhong Chen |
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申请注册联系人电话: Applicant telephone: |
+86 21 52889999 |
研究负责人电话:
Study leader's |
+86 21 52887248 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
jinhongch@hotmail.com |
研究负责人电子邮件: Study leader's E-mail: |
jinhongch@hotmail.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
上海市乌鲁木齐中路12号 |
研究负责人通讯地址: |
上海市乌鲁木齐中路12号 |
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Applicant address: |
No. 12, Urumqi Middle Road, Shanghai |
Study leader's address: |
No. 12, Urumqi Middle Road, Shanghai |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
复旦大学附属华山医院 |
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Applicant's institution: |
Huashan Hospital, Affiliated to Fudan University |
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研究负责人所在单位: |
复旦大学附属华山医院 |
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Affiliation of the Leader: |
Huashan Hospital, Fudan University |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
(2025)临审第(1568)号 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
复旦大学附属华山医院伦理审查委员会 |
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Name of the ethic committee: |
Institutional Review Board Huashan Hospital Fudan University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-12-18 00:00:00 | ||
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伦理委员会联系人: |
全菁 |
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Contact Name of the ethic committee: |
Quan Jing |
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伦理委员会联系地址: |
上海市乌鲁木齐中路12号 |
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Contact Address of the ethic committee: |
No. 12, Urumqi Middle Road, Shanghai |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 21 52888921 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
quanjing1975@163.com |
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研究实施负责(组长)单位: |
复旦大学附属华山医院 |
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Primary sponsor: |
Huashan Hospital, Fudan University |
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研究实施负责(组长)单位地址: |
上海市乌鲁木齐中路12号 |
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Primary sponsor's address: |
No. 12, Urumqi Middle Road, Shanghai |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
北京白求恩公益基金会 |
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Source(s) of funding: |
Beijing Bethune Charitable Foundation |
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研究疾病: |
不可切除的肝细胞癌 |
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Target disease: |
Unresectable hepatocellular carcinoma. |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
II期临床试验 | ||||||||||||||||||||||
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Study phase: |
2 |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
观察并仑伐替尼和帕博利珠单抗联合或不联合支链氨基酸治疗不可切除肝细胞癌的安全性和有效性,并探索疗效相关的生物标志物。 |
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Objectives of Study: |
To evaluate the safety and efficacy of lenvatinib and pembrolizumab with or without branched-chain amino acids in the treatment of unresectable hepatocellular carcinoma, and to explore biomarkers associated with treatment response and prognosis. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1.年龄≥18周岁或小于75岁; 2.美国东部肿瘤合作组体力状况评分(ECOG)0或1分; 3.组织学或细胞学证实的肝细胞癌(HCC),不包括纤维板层、肉瘤样和混合胆管的肝细胞癌。或根据美国肝病研究协会标准临床诊断的肝癌; 4.经研究者评估为不可切除的BCLC B期或者C期的患者; 5.至少有1个可通过RECIST1.1标准测量评估的病灶; 6.肝功能储备根据Child-Pugh评级为A级(5-6分); 7.血常规:中性粒细胞绝对值>=1.5×10^9/L,血红蛋白>=9.0 g/dL,血小板>=100×10^9/L; 8.肝肾功能:总胆红素<= 1.5 倍正常值上限;AST、ALT <= 5 倍正常值上限;肌酐 <= 1.5 倍正常值上限; 9.凝血功能:国际标准比率(INR)和部分凝血活酶时间<= 1.5 倍正常值上限; 10.有生育能力的患者必须愿意在研究期间以及末次给药后>=120 天采取高效避孕措施;女性患者在研究药物首次给药前<=3 天内尿液或血清妊娠试验结果呈阴性; 11.理解并签署知情同意书。 |
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Inclusion criteria |
1.Age >=18 years and <75 years; 2.Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; 3.Histologically or cytologically confirmed hepatocellular carcinoma (HCC), excluding fibrolamellar, sarcomatoid, and mixed hepatocellular-cholangiocarcinoma subtypes; or clinically diagnosed HCC according to the American Association for the Study of Liver Diseases (AASLD) criteria; 4.Assessed by the investigator as unresectable Barcelona Clinic Liver Cancer (BCLC) stage B or C; 5.At least one measurable lesion according to RECIST version 1.1; 6.Liver function classified as Child-Pugh class A (score 5–6); 7. Blood tests: Absolute neutrophil count >= 1.5×10^9/L, hemoglobin >= 9.0 g/dL, platelets >= 100×10^9/L; 8. Liver and kidney function: Total bilirubin <= 1.5 times the upper limit of normal; AST and ALT <= 5 times the upper limit of normal; creatinine <= 1.5 times the upper limit of normal; 9. Coagulation function: International Normalized Ratio (INR) and activated partial thromboplastin time <= 1.5 times the upper limit of normal; 10. Patients of childbearing potential must be willing to use highly effective contraception during the study and for at least 120 days after the last dose; female patients must have a negative urine or serum pregnancy test within 3 days before the first dose of the study drug; 11. Understand and sign the informed consent form. |
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排除标准: |
1.孕期或哺乳期妇女; 2.既往使用过索拉非尼、仑伐替尼等靶向治疗,或任何免疫检查点抑制剂,包括PD-1、抗PD-L1、抗CTLA-4,或任何细胞免疫治疗; 3.过去2年内需要系统性治疗的活动性自身免疫性疾病(如使用改善病情药物,皮质类固醇,免疫抑制剂治疗),替代治疗(如甲状腺素、胰岛素、或针对肾上腺或垂体功能不全的生理性皮质类固醇治疗)不认为是一种系统性治疗; 4.活动性、未控制的感染:包括但不限于未控制的 HBV/HCV 急性发作,活动性结核,HIV 感染且 CD4 计数明显降低者,或需要静脉抗生素治疗的严重细菌/真菌/病毒感染。 5.研究参与者在入组前3年内患有其他恶性肿瘤,除外已治愈的局部肿瘤(如基底细胞皮肤癌、鳞状细胞皮肤癌、浅表性膀胱癌、宫颈原位癌等); 6.存在严重的心理或精神异常; 7.明显的心血管疾病或心功能不全,包括但不限于: (1)NYHA III–IV 级心衰; (2)近 6 个月内发生心肌梗死、严重心绞痛、冠脉支架植入或冠脉旁路移植术; (3)临床意义的室性心律失常或持续性心房颤动; (4)不可控制的高血压(尽管充分药物治疗,血压仍 ≥150/90 mmHg)。 8.严重肺部疾病: (1)需长期氧疗的严重 COPD 或肺间质病变; (2)活动性严重肺部感染)。 9.肾功能明显受损:急性及慢性肾功能衰竭(eGFR < 30 mL/min/1.73m^2)或需透析治疗。 10.既往或当前有明显出血倾向,包括但不限于: (1)近 6 个月内有消化道大出血史; (2)未经充分处理的高危食管或胃静脉曲张; (3)凝血功能严重异常(如 INR > 2.0,除非因维持抗凝治疗)。 11.同时入组另一项临床研究,除非其为观察性、非干预性的临床研究或干预性研究的随访期; 12.既往肝性脑病、难治性腹水或肝静脉/门静脉血栓形成导致严重门脉高压综合征,经研究者评估不适宜接受试验治疗者。 13.对仑伐替尼、帕博利珠单抗、支链氨基酸制剂或其任何辅料有已知严重过敏反应史。 14.预计生存期小于3个月的患者; 15.在入组前 4 周内参与其他干预性临床试验(给药期),或目前仍处于其他干预性研究的治疗期;已进入其他临床试验的随访期且不影响本试验评估者可入组。 16.研究者认为其他任何影响患者安全或疗效评估的情况。 |
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Exclusion criteria: |
1.Pregnant or breastfeeding women; 2.Prior treatment with targeted therapies such as sorafenib or lenvatinib, or any immune checkpoint inhibitors including anti–PD-1, anti–PD-L1, anti–CTLA-4 agents, or any form of cellular immunotherapy; 3.Active autoimmune disease requiring systemic treatment within the past 2 years (e.g., use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement for adrenal or pituitary insufficiency) is not considered systemic treatment; 4.Active, uncontrolled infection, including but not limited to uncontrolled acute exacerbation of HBV/HCV, active tuberculosis, HIV infection with significantly reduced CD4 count, or severe bacterial, fungal, or viral infection requiring intravenous antibiotics; 5.History of other malignancies within 3 years prior to enrollment, except for adequately treated localized tumors (e.g., basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial bladder cancer, carcinoma in situ of the cervix, etc.); 6.Severe psychiatric or mental disorders; 7. Significant cardiovascular disease or heart dysfunction, including but not limited to: (1) NYHA class III–IV heart failure; (2) Myocardial infarction, severe angina, coronary stent placement, or coronary artery bypass surgery within the past 6 months; (3) Clinically significant ventricular arrhythmias or persistent atrial fibrillation; (4) Uncontrolled hypertension (blood pressure still ≥150/90 mmHg despite adequate medication). 8. Severe lung disease: (1) Severe COPD or interstitial lung disease requiring long-term oxygen therapy; (2) Active severe lung infection. 9. Significant kidney impairment: acute or chronic renal failure (eGFR < 30 mL/min/1.73m^2) or requiring dialysis. 10. Past or current significant bleeding tendency, including but not limited to: (1) History of major gastrointestinal bleeding within the past 6 months; (2) High-risk esophageal or gastric varices not adequately treated; (3) Severe coagulation abnormalities (e.g., INR > 2.0, unless for maintenance anticoagulation). 11.Concurrent participation in another clinical trial, unless it is an observational, non-interventional study or the follow-up phase of an interventional study; 12.History of hepatic encephalopathy, refractory ascites, or hepatic/portal vein thrombosis leading to severe portal hypertension syndrome, deemed unsuitable for study treatment by the investigator; 13.Known history of severe hypersensitivity to lenvatinib, pembrolizumab, branched-chain amino acid preparations, or any of their excipients; 14.Estimated life expectancy of less than 3 months; 15.Participation in another interventional clinical trial (during the treatment phase) within 4 weeks prior to enrollment, or currently receiving treatment in another interventional study. Participants who are in the follow-up phase of another clinical trial and whose participation does not interfere with this study evaluation may be enrolled; 16.Any other condition that, in the investigator’s judgment, may compromise patient safety or interfere with the evaluation of study efficacy. |
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研究实施时间: Study execute time: |
从 From 2026-06-30 00:00:00至 To 2027-06-30 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2026-06-30 00:00:00 至 To 2027-06-30 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
中央随机化系统 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Central Randomization System |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
对评估者设盲 |
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Blinding: |
Blinding the evaluators |
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是否共享原始数据: IPD sharing |
否No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
无 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
None |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
EDC |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
EDC |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |