Immunotherapy for Liver Cancer Before Transplant

Not currently recruiting at 3 trial locations
DS
CV
Overseen ByChristine Vollmer, MBA
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial
Breakthrough TherapyThis drug has been fast-tracked for approval by the FDA given its high promise

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether a combination of immunotherapy drugs, Durvalumab (Imfinzi) and Tremelimumab, can effectively control liver cancer and prepare patients for a liver transplant. The treatment aims to shrink the cancer and maintain control, improving outcomes for those with hepatocellular carcinoma (HCC), a type of liver cancer. Patients may qualify if they have liver cancer confined to the liver, have not received previous treatment for HCC, and are already evaluated and listed for a liver transplant. As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group, offering a chance to contribute to significant advancements in liver cancer treatment.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify if you need to stop taking your current medications. However, you cannot use immunosuppressive medications within 14 days before starting the trial drugs, except for certain types like inhaled or topical steroids. It's best to discuss your specific medications with the study team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that the combination of durvalumab and tremelimumab has been tested for safety in people with liver cancer. In one study, most patients tolerated the treatment well, but about 19% experienced liver damage, which could lead to serious issues like tumor growth or even death.

Other studies confirm that while the treatment can be effective, patients should be aware of possible side effects. These may include immune system-related problems because both durvalumab and tremelimumab are immunotherapy drugs that help the body's immune system fight cancer.

Overall, the safety information indicates that although there are risks, many patients manage the treatment well. It's important for anyone considering this option to consult with their healthcare provider to see how it fits their specific needs.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about Durvalumab and Tremelimumab for liver cancer because these treatments harness the power of the immune system to fight cancer cells. Unlike traditional treatments like chemotherapy or targeted therapy, which directly attack cancer cells, these drugs are immune checkpoint inhibitors that help the body's immune cells recognize and destroy cancer more effectively. This combination could potentially offer a more robust and lasting response, particularly when used before a liver transplant, by reducing cancer recurrence and improving overall outcomes for patients.

What evidence suggests that this trial's treatments could be effective for liver cancer?

In this trial, participants will receive a combination of durvalumab and tremelimumab before undergoing a liver transplant. Studies have shown that using these drugs together can effectively treat hepatocellular carcinoma (HCC), a common type of liver cancer. Research indicates that this combination has significantly improved overall survival, with some patients living much longer than expected. Specifically, the HIMALAYA study found that this treatment provided a lasting survival benefit over five years. In previous trials, patients with inoperable liver cancer experienced long-term disease control with these drugs. These findings suggest that this combination could help manage liver cancer more effectively.46789

Who Is on the Research Team?

Expert Profile: Davendra Sohal ...

Davendra P. Sohal

Principal Investigator

University of Cincinnati

Are You a Good Fit for This Trial?

This trial is for adults over 18 with hepatocellular carcinoma (HCC) who haven't had prior HCC therapy, are listed for a liver transplant, and meet specific health criteria including a Child-Pugh Score of 5-7. They must have tumors within certain size limits, no extrahepatic disease or severe autoimmune disorders, and be able to follow the study protocol.

Inclusion Criteria

My organs and bone marrow are working well.
I have at least one measurable cancer lesion that has not been treated with radiation.
My body weight is over 30 kg.
See 8 more

Exclusion Criteria

Judgment by the investigator that the patient is unsuitable to participate in the study and the patient is unlikely to comply with study procedures, restrictions and requirements
I haven't had major surgery in the last 28 days, except for minor procedures to relieve symptoms.
I have or had an autoimmune or inflammatory condition, with some exceptions.
See 17 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive durvalumab and tremelimumab for up to 4 months

16 weeks

Washout

A minimum 28-day washout period before locoregional therapy

4 weeks

Locoregional Therapy

Participants undergo locoregional therapy per institutional standards

Pre-Transplant Washout

A minimum 72-day washout period from the end of immunotherapy before liver transplant

10 weeks

Liver Transplant

Participants undergo liver transplant

Follow-up

Participants are monitored for safety and effectiveness after transplant

30 days

Long-term Follow-up

Survival follow-up will continue for 5 years after the end of treatment

5 years

What Are the Treatments Tested in This Trial?

Interventions

  • Durvalumab
  • Liver Transplant
  • Tremelimumab
Trial Overview The trial tests Durvalumab and Tremelimumab in patients with HCC awaiting liver transplants. It aims to see if immunotherapy can safely reduce tumor size and control the disease long-term to improve outcomes post-transplant.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Durvalumab + Tremelimumab + Liver TransplantExperimental Treatment3 Interventions

Durvalumab is already approved in European Union, United States, Japan for the following indications:

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Approved in European Union as Imfinzi for:
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Approved in United States as Imfinzi for:
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Approved in Japan as Imfinzi for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Davendra Sohal

Lead Sponsor

Trials
1
Recruited
30+

Citations

Study Details | NCT05027425 | Durvalumab (MEDI4736) ...Immunotherapy can safely downstage patients and achieve durable systemic disease control to improve clinical outcomes in HCC patients undergoing liver ...
Durvalumab and tremelimumab for hepatocellular ...This is a single-arm, open-label, Phase II, multicenter study designed to evaluate the safety and efficacy of durvalumab and tremelimumab for the treatment of ...
EfficacyOutcomes by baseline liver function in patients with unresectable hepatocellular carcinoma treated with tremelimumab and durvalumab in the phase 3 HIMALAYA ...
Imfinzi plus Imjudo demonstrated unprecedented overall ...AstraZeneca's Imfinzi (durvalumab) plus Imjudo (tremelimumab) demonstrated a sustained, clinically meaningful overall survival (OS) benefit at five years.
5-YEAR FOLLOW-UP RESULTS - IN uHCCFind the 5-year clinical trial results for IMFINZI® (durvalumab) + IMJUDO® (tremelimumab-actl), a treatment for adults diagnosed with unresectable ...
NCT06911255 | Safety and Efficacy of Tremelimumab ...The purpose of this clinical trial is to evaluate the safety and efficacy of tremelimumab + durvalumab administered concurrently with transarterial ...
NCT06526104 | Study of Tremelimumab and Durvalumab ...It can be used to predict the prognosis of patients with liver cirrhosis and hepatocellular carcinoma, and has been shown to be more accurate than the Child- ...
Safety Profile of IMFINZI® (durvalumab) & IMJUDO® ...Outcomes by baseline liver function in patients with unresectable hepatocellular carcinoma treated with tremelimumab and durvalumab in the phase 3 HIMALAYA ...
Liver injury during durvalumab-based immunotherapy is ...Liver injury was observed in 19% of durvalumab-treated patients and is associated with a greater likelihood of tumor progression and death during follow-up.
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