原发性肝细胞癌伴VP3/4型门静脉瘤栓靶免联合局部治疗前瞻性、多中心随机对照研究

注册号:

Registration number:

ChiCTR2600124989 

最近更新日期:

Date of Last Refreshed on:

2026-05-20 10:01:34 

注册时间:

Date of Registration:

2026-05-20 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

原发性肝细胞癌伴VP3/4型门静脉瘤栓靶免联合局部治疗前瞻性、多中心随机对照研究

Public title:

Prospective, Multicenter, Randomized Controlled Study of Target-Immunotherapy Combined with Local Treatment for Hepatocellular Carcinoma with VP3/4 Portal Vein Tumor Thrombus

注册题目简写:

English Acronym:

研究课题的正式科学名称:

原发性肝细胞癌伴VP3/4型门静脉瘤栓靶免联合局部治疗前瞻性、多中心随机对照研究

Scientific title:

Prospective, Multicenter, Randomized Controlled Study of Target-Immunotherapy Combined with Local Treatment for Hepatocellular Carcinoma with VP3/4 Portal Vein Tumor Thrombus

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:

张永宏 

研究负责人:

张永宏 

Applicant:

Zhang Yonghong 

Study leader:

Zhang Yonghong 

申请注册联系人电话:

Applicant telephone:

+86 10 83997154

研究负责人电话:

Study leader's
telephone:

+86 10 83997154

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:

13810108505@163.com

研究负责人电子邮件:

Study leader's E-mail:

13810108505@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:

中国北京市丰台区右安门外西头条8号

研究负责人通讯地址:

中国北京市丰台区右安门外西头条8号

Applicant address:

8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, China

Study leader's address:

8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 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:

首都医科大学附属北京佑安医院

Applicant's institution:

Beijing You’an Hospital, Capital Medical University

研究负责人所在单位:

首都医科大学附属北京佑安医院

Affiliation of the Leader:

Beijing Youan Hospital, Capital Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

京佑科伦字[2026]046号

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:

首都医科大学附属北京佑安医院伦理委员会

Name of the ethic committee:

Ethics Committee of Beijing Youan Hospital,Capital Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-04-24 00:00:00

伦理委员会联系人:

盛艾娟

Contact Name of the ethic committee:

Sheng Aijuan

伦理委员会联系地址:

中国北京市丰台区右安门外西头条8号

Contact Address of the ethic committee:

8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 10 83997028

伦理委员会联系人邮箱:

Contact email of the ethic committee:

aijuansheng9696@126.com

研究实施负责(组长)单位:

首都医科大学附属北京佑安医院

Primary sponsor:

Beijing Youan Hospital, Capital Medical University

研究实施负责(组长)单位地址:

中国北京市丰台区右安门外西头条8号

Primary sponsor's address:

8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 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):

北京

市(区县):

Country:

China

Province:

Beijing

City:

单位(医院):

首都医科大学附属北京佑安医院

具体地址:

中国北京市丰台区右安门外西头条8号

Institution
hospital:

Beijing Youan Hospital, Capital Medical University

Address:

8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, China

经费或物资来源:

首都卫生发展科研专项项目

Source(s) of funding:

Beijing Health Development Research and Development Project

研究疾病:

原发性肝细胞癌伴VP3/4型门静脉瘤栓  

Target disease:

Hepatocellular Carcinoma with VP3/4 Portal Vein Tumor Thrombus

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

针对肝癌伴门脉瘤栓患者预后差,尤其是静脉侵犯分型(Venous Invasion Phases,VP)3/4瘤栓患者靶向联合免疫治疗中位生存时间仅为7.6个月的临床难题,通过开展系统治疗联合局部治疗(放疗、介入等)的多中心前瞻性临床研究,获得显著提高VP3/4瘤栓疗效的精准治疗方案和高级别循证医学证据,优化局部治疗关键技术、明确优势人群。  

Objectives of Study:

Given the poor prognosis of hepatocellular carcinoma patients with portal vein tumor thrombus, particularly those with Venous Invasion Phases (VP) 3/4 tumor thrombus, whose median survival time under targeted therapy combined with immunotherapy is only 7.6 months, this clinical challenge is addressed through a multicenter prospective clinical study. The study investigates the combination of systemic therapy and local treatments (such as radiotherapy and interventional therapy) to develop precise treatment regimens that significantly improve outcomes for VP3/4 tumor thrombus patients. The aim is to generate high-level evidence-based medical data, optimize key local treatment techniques, and identify the most suitable patient populations.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1. 患有除HCC之外的其他恶性肿瘤; 2. 严重心、脑、肾、肺疾病或功能障碍; 3. 开始前6个月内有消化道出血病史; 4. 准备或既往接受过器官或骨髓移植患者; 5. 患者正使用免疫抑制剂或全身激素治疗; 6. 已知对研究药物或辅料过敏者。

Exclusion criteria:

1. Presence of malignancies other than HCC; 2. Presence of severe cardiac, cerebral, renal, or pulmonary diseases or dysfunction; 3. History of gastrointestinal bleeding within 6 months prior to initiation; 4. Patients who have received or are scheduled for organ or bone marrow transplantation; 5. Patients currently on immunosuppressive agents or systemic corticosteroid therapy; 6. Patients with known hypersensitivity to the investigational drug or its excipients.

研究实施时间:

Study execute time:

From 2026-04-08 00:00:00 To 2028-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-05-20 00:00:00 To 2027-12-31 00:00:00

干预措施:

Interventions:

组别:

试验组 1

样本量:

36

Group:

Trial group 1

Sample size:

干预措施:

按需-免疫增强型 TACE 治疗(通过微导管超选择插管至肿瘤供血动脉进行精准栓塞患者靶病灶中的 1-3 个目标)联合靶向免疫治疗(卡瑞利珠单抗 200mg Q3W,甲磺酸阿帕替尼片 250mg QD,TACE 治疗前 3 天和术后 3 天暂停甲磺酸阿帕替尼)

干预措施代码:

Intervention:

Demand-based immune-enhanced TACE therapy (precise embolization via microcatheter superselective catheterization into tumor-feeding arteries targeting 1-3 lesions) combined with targeted immunotherapy (camrelizumab 200mg Q3W, apatinib mesylate tablets 250mg QD, apatinib temporarily discontinued 3 days before and 3 days after TACE)

Intervention code:

组别:

试验组 2

样本量:

36

Group:

Trial group 2

Sample size:

干预措施:

精准放疗(4D-MRI 联合腹部加压技术,大分割模式 3Gy×12-15 次)联合靶向免疫治疗(卡瑞利珠单抗 200mg Q3W,甲磺酸阿帕替尼片 250mg QD)

干预措施代码:

Intervention:

Precise radiotherapy (4D-MRI combined with abdominal compression technique, hypofractionated regimen of 3Gy × 12-15 fractions) combined with targeted immunotherapy (camrelizumab 200mg Q3W, apatinib mesylate tablets 250mg QD)

Intervention code:

组别:

对照组

样本量:

36

Group:

Control group

Sample size:

干预措施:

单纯靶向免疫治疗(卡瑞利珠单抗 200mg Q3W,甲磺酸阿帕替尼片 250mg QD)

干预措施代码:

Intervention:

Monotherapy with targeted immunotherapy (camrelizumab 200mg Q3W, apatinib mesylate tablets 250mg QD)

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

首都医科大学附属北京佑安医院 

单位级别:

三级甲等 

Institution
hospital:

Beijing Youan Hospital, Capital Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

北京肿瘤医院(北京大学肿瘤医院) 

单位级别:

三级甲等 

Institution
hospital:

Peking University Cancer Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

江苏恒瑞医药股份有限公司 

单位级别:

无 N/A 

Institution
hospital:

Jiangsu Hengrui Pharmaceuticals Co., Ltd.

Level of the institution:

N/A

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

中国人民解放军总医院第五医学中心 

单位级别:

三级甲等 

Institution
hospital:

Fifth Medical Center of Chinese People's Liberation Army General Hospital?

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

严重不良事件

指标类型:

次要指标

Outcome:

Serious Adverse Event

Type:

Secondary indicator

测量时间点:

在患者接受治疗开始,整个研究期间进行持续性监测与记录。

测量方法:

严重不良事件(需立即报告): a.致命(即,不良事件实际上引起或导致死亡); b.危及生命(即据研究者判断,不良事件会将患者置于立即死亡风险之下,不包括事件恶化后或允许事件继续发展可能会导致死亡的不良事件); c.需要患者住院治疗或延长住院时间; d.导致永久性或严重的残疾/功能丧失(即导致患者行使正常生活功能的能力受到严重破坏的不良事件); e.研究者认为有重要医学意义的事件(例如,可能会危害患

Measure time point of outcome:

Monitoring extends from the initiation of treatment throughout the entire study period.

Measure method:

Serious Adverse Events: a. Fatal; b. Life?threatening; c. Requiring hospitalization or prolongation of existing hospitalization; d. Resulting in persistent or significant disability/incapacity; e. Other medically important events.

指标中文名:

疾病控制率

指标类型:

次要指标

Outcome:

Disease Control Rate

Type:

Secondary indicator

测量时间点:

受试者接受治疗期间前6个月,每6周进行一次影像学检查以评估疗效,6个月之后将每12周进行一次。

测量方法:

采用增强CT/MRI进行肿瘤影像学随访,依据mRECIST和RECIST v1.1标准评估可测量病灶。肿瘤评估应尽可能由同一名有经验的临床医生完成,以确保各访视之间的一致性。评估结果必须由研究者在下个周期给药之前进行审阅。

Measure time point of outcome:

DCR will be assessed every 6 weeks during the initial 6 months, and every 12 weeks thereafter.

Measure method:

Tumor imaging follow-up will be conducted using contrast-enhanced CT/MRI, and measurable lesions will be assessed according to the mRECIST and RECIST v1.1 criteria. Tumor evaluations should ideally be performed by the same experienced clinician across all visits to ensure consistency. The assessment results must be reviewed by the investigator before the administration of the next treatment cycle.

指标中文名:

客观缓解率

指标类型:

次要指标

Outcome:

Objective Response Rate

Type:

Secondary indicator

测量时间点:

受试者接受治疗期间前6个月,每6周进行一次影像学检查以评估疗效,6个月之后将每12周进行一次。

测量方法:

采用增强CT/MRI进行肿瘤影像学随访,依据mRECIST和RECIST v1.1标准评估可测量病灶。肿瘤评估应尽可能由同一名有经验的临床医生完成,以确保各访视之间的一致性。评估结果必须由研究者在下个周期给药之前进行审阅。

Measure time point of outcome:

ORR will be assessed every 6 weeks during the initial 6 months, and every 12 weeks thereafter.

Measure method:

Tumor imaging follow-up will be conducted using contrast-enhanced CT/MRI, and measurable lesions will be assessed according to the mRECIST and RECIST v1.1 criteria. Tumor evaluations should ideally be performed by the same experienced clinician across all visits to ensure consistency. The assessment results must be reviewed by the investigator before the administration of the next treatment cycle.

指标中文名:

总生存期

指标类型:

主要指标

Outcome:

Overall Survival

Type:

Primary indicator

测量时间点:

将在出现疾病进展或治疗终止后每8周进行一次评估。

测量方法:

可通过电话联系受试者、受试者家属,与受试者当前医生联系或查看当地死亡登记,获得生存期信息。

Measure time point of outcome:

OS will be assessed every 8 weeks after disease progression or treatment discontinuation

Measure method:

Survival information can be obtained by contacting the participants or their family members via telephone. Additionally, it could be acquired by reaching out to the participants' current physicians or reviewing local death registries.

指标中文名:

无进展生存期

指标类型:

次要指标

Outcome:

Progression-Free Survival

Type:

Secondary indicator

测量时间点:

受试者接受治疗期间前6个月,每6周进行一次影像学检查以评估疗效,6个月之后将每12周进行一次。

测量方法:

采用增强CT/MRI进行肿瘤影像学随访,依据mRECIST和RECIST v1.1标准评估可测量病灶。肿瘤评估应尽可能由同一名有经验的临床医生完成,以确保各访视之间的一致性。评估结果必须由研究者在下个周期给药之前进行审阅。

Measure time point of outcome:

PFS will be assessed every 6 weeks during the initial 6 months, and every 12 weeks thereafter.

Measure method:

Tumor imaging follow-up will be conducted using contrast-enhanced CT/MRI, and measurable lesions will be assessed according to the mRECIST and RECIST v1.1 criteria. Tumor evaluations should ideally be performed by the same experienced clinician across all visits to ensure consistency. The assessment results must be reviewed by the investigator before the administration of the next treatment cycle.

指标中文名:

不良事件

指标类型:

次要指标

Outcome:

Adverse Event

Type:

Secondary indicator

测量时间点:

在患者接受治疗开始,整个研究期间进行持续性监测与记录。

测量方法:

依据CTCAE v6.0标准判断不良事件严重程度。试验期间应如实填写不良事件记录表,包括不良事件的发生时间、严重程度、与研究治疗的相关性、持续时间、采取的措施和转归等。

Measure time point of outcome:

Monitoring extends from the initiation of treatment throughout the entire study period.

Measure method:

The severity of adverse events will be assessed according to the CTCAE v6.0 criteria. During the trial, the adverse event record form must be completed accurately, including the onset time, severity, relationship to the study treatment, duration, measures taken, and outcome of the event.

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

粪便样本

组织:

Sample Name:

Feces

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

血清样本

组织:

Sample Name:

Serum

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

血块样本

组织:

Sample Name:

Blood Clot

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

尿液样本

组织:

Sample Name:

Urine

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

外周血单个核细胞样本

组织:

Sample Name:

Peripheral Blood Mononuclear Cells

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 85 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):

本试验采用中央随机分组系统,受试者按照1:1:1随机分组,各中心竞争入组。随机编号表由随机化专员提供,利用SAS软件产生。

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

This trial employed a central randomization system. Participants were randomly assigned in a 1:1:1 ratio with competitive enrollment across all centers. The randomization schedule was generated using SAS software and provided by the randomization specialist.

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:

开放标签

Blinding:

Open-label study

是否共享原始数据:

IPD sharing

否No

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):

本研究的原始数据仅限于合作机构内部使用

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

The raw data of this study are limited to internal use within the collaborating institutions

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:

1.数据质量保证 受托研究机构(CRO)负责本研究的数据管理,包括数据质量核查。对于人工录入的数据,将通过EDC系统采用eCRF进行收集。由研究中心负责数据录入至EDC系统中。若数据有疑义,CRO将要求研究中心澄清数据,研究中心将在EDC系统中用电子化方式解决。申请人将监督本试验的数据管理。CRO将制定数据质量计划,描述对数据将进行的质量核查。 EDC系统的稳定性和法规合规会保留eCRF及修改文档。按标准规程,对保存的数据进行系统备份,并记录保留研究数据。 2.电子病例报告表 使用申报单位指定的EDC系统来完成电子病例报告表(eCRF)。研究中心将接受培训,并给予登录eCRF的权限。研究者需按照申办方的操作指示操作并电子提交eCRF。 所有eCRF应由接受过培训的指定研究人员填写。研究者或指定人员审核eCRF,并进行电子签名和署名日期。 研究结束时,研究者将收到其研究中心患者的只读数据(必须与研究记录一起保存)。需要确认收到数据。 3.源数据文件 研究监察员会进行源数据核查和审阅以确认由研究中心授权人员输入到eCRF的关键方案数据(即源数据)是准确、完整的,并能通过源文件进行验证。 源文件(纸质版或电子版)是首次记录并存档患者数据的文件。其中包括但不限于医院记录、临床和诊室图表、实验室记录、备忘录、患者自报结果、评价分类名录、药房配药记录、自动仪器记录的数据、验证后认证为准确完整的转录副本、缩微胶片、照片底片、缩微胶卷、磁性介质、X射线、患者档案和与临床试验有关的药房、实验室、医学技术科室记录。 研究开始前,在试验监察计划中明确规定将要产生的源文件的类型。其中包括将要直接记录在eCRF中的任何方案数据(即不是以前的书面或电子记录的数据)和认可的源数据。为了实现源数据核查和审评,研究者和机构应提供审阅源文件和报告的权限,用于试验相关监察,稽查和IRB/EC审查。研究中心还应允许相关卫生管理当局进行检查。 4.计算机系统 若将临床观察结果录入到研究中心的计算机医疗记录系统(即代替原先的书面记录本中),如果已根据卫生监督机构对临床研究用途的计算机系统的要求对该系统进行了验证,则电子记录可以作为源文件。可接受的计算机数据采集系统允许保存原始录入数据。如果要对原始数据进行修改,计算机系统应保存直观的稽查轨迹,即显示原始数据、修改原因、修改人姓名以及修改日期。 5.记录保留 与本研究实施相关的记录和文件,包括eCRF、纸质PRO数据、知情同意书、实验室检查结果和药物库存记录,必须由主要研究者保存直到研究结束或终止后15年,或按相关国家或当地卫生部门要求的时间保存,以较长者为准。期满后可按当地规定进行销毁。

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

1. Data Quality Assurance The Contract Research Organization (CRO) is responsible for data management in this study, including data quality checks. Manually entered data will be collected via Electronic Case Report Forms (eCRFs) through the Electronic Data Capture (EDC) system. The study sites are responsible for entering data into the EDC system. If data discrepancies are identified, the CRO will request clarification from the site, and the site will resolve them electronically within the EDC system. The Sponsor will oversee the data management of this trial. The CRO will develop a Data Quality Plan outlining the quality checks to be performed on the data. The stability and regulatory compliance of the EDC system will ensure the retention of eCRFs and any amendment documentation. System backups of stored data will be performed according to standard procedures, and the retention of study data will be documented. 2. Electronic Case Report Form Electronic Case Report Forms (eCRFs) will be completed using the EDC system designated by the Sponsor. Study sites will receive training and be granted access to the eCRF system. Investigators must operate according to the Sponsor’s instructions and submit eCRFs electronically. All eCRFs must be completed by trained designated study staff. The investigator or an authorized delegate will review the eCRF, and provide an electronic signature with the date of signing. At the end of the study, the investigator will receive read-only data for patients enrolled at their site (which must be kept together with the study records). Acknowledgment of data receipt is required. 3. Source Documents The study monitor will perform source data verification and review to confirm that key protocol data entered into the eCRF by authorized site personnel (i.e., source data) are accurate, complete, and verifiable against source documents. Source documents (paper or electronic) are the original records where patient data are first recorded and archived. These include, but are not limited to, hospital records, clinical and office charts, laboratory records, memos, patient-reported outcomes, evaluation checklists, pharmacy dispensing records, data recorded by automated instruments, certified true copies of transcribed records, microfilms, photographic negatives, microfiches, magnetic media, X-rays, patient files, and records from pharmacies, laboratories, and medical technical departments related to the clinical trial. Before the study begins, the types of source documents to be generated will be specified in the monitoring plan. This includes any protocol data to be recorded directly into the eCRF (i.e., not previously documented in written or electronic form) and accepted source data. To facilitate source data verification and review, the investigator and institution must provide access to source documents and reports for trial-related monitoring, auditing, and IRB/EC review. The study site must also permit inspection by relevant health authorities. 4. Computer Systems If clinical observations are entered directly into the site’s computerized medical record system (replacing original paper records), the electronic record may serve as the source document, provided the system has been validated in accordance with health authority requirements for computerized systems used in clinical research. Acceptable computerized data capture systems must allow retention of the original entered data. If modifications are made to original data, the system must maintain a visible audit trail that shows the original data, reason for change, name of person making the change, and date of change. 5. Record Retention Records and documents related to the conduct of this study, including eCRFs, paper-based PRO data, informed consent forms, laboratory test results, and drug accountability records, must be retained by the principal investigator until 15 years after study completion or termination, or as required by relevant national or local health authorities—whichever is longer. After this period, they may be destroyed in accordance with local regulations.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-05-20 10:01:29