ChiCTR2000039508 版本V1.5 版本创建时间2021/01/31 02:04:42 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2000039508 

最近更新日期:

Date of Last Refreshed on:

2021-01-30 20:12:08 

注册时间:

Date of Registration:

2020-10-30 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

【辑】肝动脉化疗栓塞术联合卡瑞利珠单抗及靶向药物治疗中晚期不可切除的肝细胞癌患者的山东、多中心、 前瞻性、真实世界研究

Public title:

A multi-center among Shandong , prospective, real-world study of Transcatheter Arterial Chemoembolization (TACE)combined with Camrelizumab and targeted drugs for patients with unresectable advanced Hepatocellular Carcinoma

注册题目简写:

English Acronym:

研究课题的正式科学名称:

肝动脉化疗栓塞术联合卡瑞利珠单抗及靶向药物治疗中晚期不可切除的肝细胞癌患者的山东、多中心、 前瞻性、真实世界研究

Scientific title:

A multi-center among Shandong , prospective, real-world study of Transcatheter Arterial Chemoembolization (TACE)combined with Camrelizumab and targeted drugs for patients with unresectable advanced Hepatocellular Carcinoma

研究课题代号(代码):

Study subject ID:

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:

申请注册联系人:

李金鹏 

研究负责人:

宋金龙 

Applicant:

Jinpeng Li 

Study leader:

Song Jinlong 

申请注册联系人电话:

Applicant telephone:

+86 13335195362

研究负责人电话:

Study leader's telephone:

+86 13969080678

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

17865159036@163.com

研究负责人电子邮件:

Study leader's E-mail:

JLS7286@163.com

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):

申请注册联系人通讯地址:

山东省济南市济兖路440号

研究负责人通讯地址:

山东省济南市济兖路440号

Applicant address:

440 Jiyan Road, Huaiyin District, Ji'nan, Shandong, China

Study leader's address:

440 Jiyan Road, Huaiyin District, Ji'nan, Shandong, China

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:

申请人所在单位:

山东省肿瘤医院

Applicant's institution:

Shandong Cancer Hospital

研究负责人所在单位:

山东省肿瘤医院

Affiliation of the Leader:

Shandong Cancer Hospital

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

ChiECRCT20200322

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

中国注册临床试验伦理审查委员会

Name of the ethic committee:

Chinese Ethics Committee of Registering Clinical Trials

伦理委员会批准日期:

Date of approved by ethic committee:

2020-10-22 00:00:00

伦理委员会联系人:

吴泰相

Contact Name of the ethic committee:

Taixiang Wu

伦理委员会联系地址:

成都国学巷37号四川大学华西医院行政楼八角亭2楼2092室

Contact Address of the ethic committee:

Room 2092, Second Floor, Bajiao Pavilion, Administration Building, West China Hospital of Sichuan University, 37 Guoxue Alley, Chengdu, Sichuan, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

山东省肿瘤医院

Primary sponsor:

Shandong Cancer Hospital

研究实施负责(组长)单位地址:

山东省济南市济兖路440号

Primary sponsor's address:

440 Jiyan Road, Huaiyin District, Ji'nan, Shandong, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

山东

市(区县):

济南

Country:

China

Province:

Shandong

City:

Ji'nan

单位(医院):

山东省肿瘤医院

具体地址:

济兖路440号

Institution
hospital:

Shandong Cancer Hospital

Address:

440 Jiyan Road, Huaiyin District

经费或物资来源:

自筹经费

Source(s) of funding:

Self-financing

Target disease:

Hepatocellular Carcinoma

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

单臂 

Study design:

Single arm 

研究目的:

观察和评价肝动脉化疗栓塞术联合卡瑞利珠单抗及靶向药物治疗中晚期不可切除的原发性肝癌患者的在真实世界中的有效性和安全性  

Objectives of Study:

To evaluate the efficacy and safety of treatment of combination TACE with Camrelizumab and targeted drugs for advanced Hepatocellular Carcinoma (HCC) in real-world.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1. 年龄:18-80周岁;
2. 严格符合《原发性肝癌诊疗规范》(2019年版)临床诊断标准:经肝穿刺活检或病理组织学或者诊断性影像学检查(CT或MRI)确诊的不可切除的中晚期HCC患者;
3. Child-Pugh肝功能评级:A级或较好的B级(≤7分);
4. BCLC分期为B期-C期;
5. 预期生存期大于等于12周;
6. 入组前1周内ECOG PS评分:0-1分;KPS评分>80分;
7. 肿瘤情况符合下列条件之一:
① 首选临床分期为IIb期、IIIa期肝癌。
② 可以手术切除,但由于其它原因(如高龄、严重肝硬化等)不能或不愿接受手术、局部消融治疗的Ib期和IIa期肝癌。
③ 部分有肝外转移的IIIb期肝癌,预计通过TACE治疗能控制肝内肿瘤生长而获益者。
④ 巨块型肝癌患者,肿瘤占整个肝脏的比例<70%。
⑤ 门静脉主干未完全阻塞,或虽完全阻塞但门静脉代偿性侧支血管丰富或通过门静脉支架置放可以复通门静脉血流的肝癌。
⑥ 肝癌破裂出血及肝动脉-门脉静分流造成门静脉高压出血。
⑦ 高危因素(包括肿瘤多发、合并肉眼/镜下癌栓、姑息性切除、术后AFP等肿瘤标志物未降至正常范围等)肝癌患者手术切除后,预防性TACE以期早期发现和治疗残癌或复发灶。
⑧ 肝癌手术切除后复发。
⑨ 肝癌手术前的减瘤治疗,以降低肿瘤分期,为II期手术切除或肝移植创造机会。
8. 至少有一个可测量病灶(根据RECIST 1.1版要求该可测量病灶螺旋CT扫描长径≥10mm或肿大淋巴结短径≥15mm);
9. 首次进行TACE前,有足够的器官功能,实验室检查值满足以下条件:
① 血常规(筛查前14天内未输血、未使用造血刺激因子类药物纠正):白细胞计数(white blood cell, WBC)≥3.0 × 109/L;绝对中性粒细胞计数(absolute neutrophil count, ANC)≥1.5 × 109/L;血小板(platelet, PLT)≥100 × 109/L;血红蛋白含量(hemoglobin, HGB)≥9.0 g/dL;
② 肝功能:天门冬氨酸氨基转移酶(aspartate transferase, AST)≤5 x ULN;丙氨酸肝氨基转移酶(alanine aminotransferase, ALT)≤5 x ULN;血清总胆红素(total bilirubin, TBIL)≤1.5 x ULN (Gilbert 综合征例外:总胆红素≤3.0 mg/dL) ;
③ 肾功能:血清肌酐≤1.5 x ULN 或 肌酐清除率 (creatinine clearance rate, CrCl) ≥200 mL/minute;
④ 凝血功能:国际标准化比率(international normalized ratio, INR)≤1.5 x ULN,活化部分凝血活酶时间(activated partial thromboplastin time, APTT)≤1.5 x ULN(仅适用于目前没有接受抗凝治疗的患者,对于目前正在接受抗凝治疗的患者应接受稳定剂量的抗凝剂治疗);
⑤ 其他:脂肪酶≤1.5 x ULN(若脂肪酶>1.5 x ULN无临床或影像学证实胰腺炎的情况可以入组);淀粉酶 ≤1.5 x ULN(若淀粉酶>1.5 x ULN 无临床或影像学证实胰腺炎的情况可以入组);碱性磷酸酶(alkaline phosphatase, ALP)≤2.5′ULN,肝转移或骨转移受试者,ALP≤5′ULN。
10. 受试者自愿加入本研究,签署知情同意书,依从性好,配合随访。

Inclusion criteria

1. Subjects aged 18-80 years old;
2. Patients in strict accordance with the clinical diagnostic criteria of the code for diagnosis and treatment of primary liver cancer (2019 Edition): unresectable patients with advanced HCC confirmed by liver biopsy or histopathology or diagnostic imaging examination (CT or MRI);
3. Child Pugh liver function rating: Grade A or better grade B (≤ 7 points);
4. Patients with BCLC stage b-c;
5. Patients whose expected survival time is more than or equal to 12 weeks;
6. ECoG PS score: 0-1; KPS score > 80 in the first week;
7. Patients whose tumor condition meets one of the following conditions:
(1) The first choice for clinical staging is stage IIB and IIIA.
(2) Stage IB and IIA HCC can be resected, but can't or won't accept surgery or local ablation due to other reasons (such as advanced age, severe liver cirrhosis, etc.).
(3) Some stage IIIB HCC patients with extrahepatic metastasis are expected to benefit from TACE treatment to control the growth of intrahepatic tumor.
(4) In patients with massive liver cancer, the proportion of tumor in the whole liver is less than 70%.
(5) Liver cancer whose main portal vein is not completely blocked, or whose portal vein has abundant compensatory collateral vessels, or whose portal vein can be recanalized by stent placement.
(6) Portal hypertensive bleeding was caused by rupture of liver cancer and hepatic artery portal shunt.
(7) High risk factors (including multiple tumors, combined with macroscopic / microscopic tumor thrombus, palliative resection, postoperative AFP and other tumor markers did not fall to the normal range, etc.) after hepatectomy, preventive TACE should be carried out in order to early detect and treat residual cancer or recurrence.
(8) Liver cancer recurred after operation.
(9) In order to reduce the tumor stage and create the opportunity for stage II resection or liver transplantation, the preoperative tumor reduction therapy should be performed.
8. Patients with at least one measurable lesion (according to the requirements of RECIST version 1.1, the long diameter of the measurable lesion is ≥ 10 mm or the short diameter of the enlarged lymph node is ≥ 15 mm);
9. Before TACE for the first time, patients with sufficient organ function should meet the following conditions:
(1) Routine blood test (no blood transfusion and no use of hematopoiesis stimulating factor drugs within 14 days before screening): white blood cell count (WBC) ≥ 3.0 × 109 / L; absolute neutrophil count (ANC) ≥ 1.5 × 109 / L; platelet (PLT) ≥ 100 × 109 / L; hemoglobin (Hgb) ≥ 9.0 g / dl;
(2) Liver function: aspartate aminotransferase (AST) ≤ 5 x ULN; alanine aminotransferase (ALT) ≤ 5 x ULN; total bilirubin (TBIL) ≤ 1.5 x ULN (except for Gilbert syndrome: total bilirubin ≤ 3.0 mg / dl);
(3) Renal function: serum creatinine ≤ 1.5 x ULN or creatinine clearance rate (CrCl) ≥ 200 ml / min;
(4) Coagulation function: international normalized ratio (INR) ≤ 1.5 x ULN, activated partial thromboplastin time (APTT) ≤ 1.5 x ULN (only applicable to patients who have not received anticoagulant therapy at present, and patients who are currently receiving anticoagulant therapy should receive stable dose of anticoagulant therapy);
(5) Others: lipase ≤ 1.5 x ULN (if lipase > 1.5 x ULN has no clinical or imaging confirmed pancreatitis can be included); amylase ≤ 1.5 x ULN (if amylase > 1.5 x ULN has no clinical or imaging confirmed pancreatitis can be included); alkaline phosphatase (ALP) ≤ 2.5 ′ ULN, liver metastasis or bone metastasis subjects, ALP ≤ 5 ′ ULN.
10. The subjects voluntarily joined the study, signed informed consent, good compliance, and cooperated with the follow-up.

排除标准:

1. 曾患或正在并发其他恶性肿瘤,以下情况除外:
(1) 已治愈的低复发率的早期癌症,例如子宫颈原位癌,基底细胞癌,浅表膀胱肿瘤或早期胃癌。
(2)在进入研究之前已治愈3年以上的恶性肿瘤,此后一直未复发。
2. 既往治疗史包括:
(1)晚期肝癌的全身化疗或靶向治疗;
(2)前4周内出现≥CTCAE 3级任何部位出血事件、存在未愈合伤口、溃疡或骨折,4周内行侵入性手术;
(3)异体移植,骨髓移植或造血干细胞移植;
(4)接受过抗PD-1,抗PD-L1,抗CD137或抗细胞毒性T淋巴细胞相关抗原-4(CTLA-4)抗体(包括ipilimumab或任何其他特异性靶向T细胞共刺激或检查点途径的抗体或药物)治疗。
3. HBsAg阳性且HBV DNA拷贝数大于所在研究中心检验科正常值上限(1000拷贝数/ml或500IU/ml );已知HIV阳性病史或已知的获得性免疫缺陷综合征(Acquired Immune Deficiency Syndrome, AIDS);
4. 患有高血压且经降压药物治疗无法降至正常范围者(收缩压>140 mmHg,舒张压>90 mmHg),患有I级以上冠心病、I级心律失常(包括QTc间期延长男性>450 ms,女性>470 ms)及I级心功能不全;尿蛋白阳性的患者;
5. 具有影响口服药物的多种因素(比如无法吞咽、恶心、呕吐、慢性腹泻和肠梗阻等);
6. 已知对药物或辅料过敏;
7. 肝癌合并门静脉癌栓(PVTT)IV 型;
8. 既往和目前有肺纤维化史、间质性肺炎、尘肺、放射性肺炎、药物相关肺炎、肺功能严重受损等的客观证据的患者;
9. 具有明确的出血倾向的患者,包括下列情况:有局部活动性溃疡病灶,且大便潜血(++);2个月内有黑便、呕血病史者;
10. 活动性、已知或怀疑自身免疫性疾病。允许白癜风、I 型糖尿病、仅需要激素替代疗法治疗的因自身免疫性甲状腺炎导致的残留甲状腺功能减退,或缺乏外因刺激的情况下预期不会复发的情况可以入组;
11. 首剂研究药物前≤14 天内使用皮质类固醇激素(>10 mg/天强的松或等效剂量)或其他免疫抑制剂。没有活动性自身免疫疾病的情况下允许吸入或局部使用类固醇和肾上腺替代类固醇;
12. 有未能良好控制的心脏临床症状或疾病,如:(1)纽约心脏病协会(New York Heart Association, NYHA)2 级以上心力衰竭;(2)不稳定型心绞痛;(3)24 周内发生过心肌梗死;(4)有临床意义的室上性或室性心律失常需要治疗或干预;
13. 怀孕或哺乳期妇女;可能怀孕或计划怀孕的患者;
14. 4周内参加过其他临床研究方案;
15. 研究者判断,受试者有其他可能导致本研究被迫中途终止的因素,如,不依从方案、其他的严重疾病(含精神疾病)需要合并治疗,有严重的实验室检查异常,伴有家庭或社会等因素,会影响到受试者的安全或资料及样品的收集

Exclusion criteria:

1. Patients who have suffered from or are complicated with other malignant tumors, except for the following cases:
(1) Cured early cancers with low recurrence rate, such as cervical carcinoma in situ, basal cell carcinoma, superficial bladder tumor or early gastric cancer.
(2) The patients who had been cured for more than 3 years before entering the study had no recurrence since then.
2. Past treatment history includes:
(1) Systemic chemotherapy or targeted therapy for advanced liver cancer;
(2) In the first 4 weeks, there were bleeding events in any part with grade ≥ CTCAE 3, unhealed wounds, ulcers or fractures, and invasive surgery was performed within 4 weeks;
(3) Allogeneic transplantation, bone marrow transplantation or hematopoietic stem cell transplantation;
(4) Have received anti-PD-1, anti-PD-L1, anti-CD137 or anti cytotoxic T lymphocyte associated antigen-4 (CTLA-4) antibodies (including ipilimumab or any other antibodies or drugs specifically targeting T cell costimulation or checkpoint pathway).
3. HBsAg positive and HBV DNA copy number higher than the upper limit of normal value (1000 copies / ml or 500 IU / ml) in the laboratory of the research center; known history of HIV positive or known acquired immune deficiency syndrome (AIDS);
4. Patients with hypertension (systolic blood pressure > 140 mmHg, diastolic blood pressure > 90 mmHg), grade I coronary heart disease, grade I arrhythmia (including QTc interval prolongation > 450 ms for men and > 470 MS for women) and grade I cardiac insufficiency; patients with positive urine protein; patients with hypertension and hypertension who can not be reduced to normal range after antihypertensive drug treatment;
5. Patients with multiple factors affecting oral medication (such as inability to swallow, nausea, vomiting, chronic diarrhea and intestinal obstruction, etc.);
6. Patients with known allergy to drugs or excipients;
7. Patients with hepatocellular carcinoma and portal vein tumor thrombus (PVTT) type IV;
8. Patients with previous or current objective evidence of pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, radiation pneumonia, drug-related pneumonia, and severe impairment of pulmonary function;
9. Patients with definite bleeding tendency include the following situations: Patients with local active ulcer lesions and occult blood in stool (+ +); patients with history of black stool and hematemesis within 2 months; patients with history of bleeding in stool (+ +);
10. Patients with active, known or suspected autoimmune diseases. Patients with vitiligo, type I diabetes, residual hypothyroidism due to autoimmune thyroiditis requiring hormone replacement therapy only, or those who are not expected to relapse in the absence of external stimulation can be enrolled;
11. Patients who used corticosteroids (> 10 mg / day prednisone or equivalent) or other immunosuppressants within 14 days before the first dose of study drug. Inhaled or topical steroids and adrenal replacement steroids are permitted in the absence of active autoimmune diseases;
12. Patients with uncontrolled clinical cardiac symptoms or diseases, such as:
(1) New York Heart Association (NYHA) grade 2 or above heart failure;
(2) Unstable angina pectoris;
(3) Myocardial infarction occurred within 24 weeks;
(4) Supraventricular or ventricular arrhythmias with clinical significance need treatment or intervention;
13. Pregnant or lactating women; patients who may be pregnant or plan to be pregnant;
14. Patients who participated in other clinical research protocols within 4 weeks;
15. The researcher judged that there are other factors that may lead to the termination of the study, such as non-compliance with the protocol, other serious diseases (including mental illness) requiring combined treatment, serious laboratory abnormalities, family or social factors, which will affect the safety of the subjects or the collection of data and samples

研究实施时间:

Study execute time:

From 2020-11-01 00:00:00 To 2023-10-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2020-11-01 00:00:00 To 2021-10-31 00:00:00  

干预措施:

Interventions:

组别:

试验组

样本量:

100

Group:

Experimental group

Sample size:

干预措施:

TACE+卡瑞利珠单抗+靶向药

干预措施代码:

Intervention:

TACE+Camrelizumab +TKI drug

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

山东 

市(区县):

济南 

Country:

China 

Province:

Shandong 

City:

Ji'nan 

单位(医院):

山东省肿瘤医院 

单位级别:

三甲 

Institution
hospital:

Shandong Cancer Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

潍坊 

Country:

China 

Province:

Shandong 

City:

Weifang 

单位(医院):

潍坊市人民医院 

单位级别:

三甲 

Institution
hospital:

Weifang People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

济宁 

Country:

China 

Province:

Shandong 

City:

Jining 

单位(医院):

济宁医学院附属医院 

单位级别:

三甲 

Institution
hospital:

Affiliated Hospital of Jining Medical College

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

济南 

Country:

China 

Province:

Shandong 

City:

Ji'nan 

单位(医院):

济南市传染病医院 

单位级别:

三甲 

Institution
hospital:

Ji'nan Infectious Disease Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

青岛 

Country:

China 

Province:

Shandong 

City:

Qingdao 

单位(医院):

青岛大学医学院附属医院 

单位级别:

三甲 

Institution
hospital:

Affiliated Hospital of Qingdao University School of Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

临沂 

Country:

China 

Province:

Shandong 

City:

Linyi 

单位(医院):

临沂市肿瘤医院 

单位级别:

三甲 

Institution
hospital:

Linyi Tumor Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

聊城 

Country:

China 

Province:

Shandong 

City:

Liaocheng 

单位(医院):

聊城市人民医院 

单位级别:

三甲 

Institution
hospital:

Liaocheng People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

烟台 

Country:

China 

Province:

Shandong 

City:

Yantai 

单位(医院):

烟台市毓璜顶医院 

单位级别:

三甲 

Institution
hospital:

Yuhuangding Hospital of Yantai City

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

无进展生存期

指标类型:

主要指标

Outcome:

progression-free survival rate (PFS)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

疾病控制率

指标类型:

次要指标

Outcome:

Disease Control Rate (DCR)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

缓解持续时间

指标类型:

次要指标

Outcome:

Duration of responce

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

客观缓解率

指标类型:

主要指标

Outcome:

Objective response rate

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

至疾病进展时间

指标类型:

次要指标

Outcome:

Time to Progression

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 80 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

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

盲法:

Blinding:

是否共享原始数据:

IPD sharing

Yes

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):

电子病历

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Electronic medical record

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:

电子采集和管理系统

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Electronic Data Capture, EDC

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2020-10-30 18:03:29