A Study of Camrelizumab Combined With Rivoceranib Mesylate Versus Investigator's Choice of Regimen in Treatment of Patients With Advanced Hepatocellular Carcinoma (HCC)

Study Overview
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Brief Summary
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This is a randomized, open-label, international, multi-center, phase III trial to evaluate the efficacy and safety of Camrelizumab Combined with Rivoceranib Mesylate versus Investigator's Choice of Regimen in Treatment of Patients with Hepatocellular Carcinoma (HCC)

Official Title
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A Randomized, Open-Label, Controlled, International Multi-Center Phase III Clinical Study of Camrelizumab Combined With Rivoceranib (Apatinib) Mesylate Versus Investigator's Choice of Regimen in Treatment of Patients With Hepatocellular Carcinoma (HCC) Who Have Been Treated With Immune Checkpoint Inhibitors (ICIs)

Conditions
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Advanced Hepatocellular Carcinoma (HCC)

Intervention / Treatment
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* Drug: camrelizumab；Rivoceranib
* Drug: Rivoceranib
* Drug: Sorafenib
* Drug: Regorafenib


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subject must participate voluntarily and sign the informed consent form; Aged ≥ 18 years old, male or female; Histopathologically confirmed hepatocellular carcinoma; Has PD on treatment with prior anti-PD-1/PD-L1/CTLA-4 monoclonal antibody (mAb) administered either as monotherapy or as combination therapy. No more than 2 lines of previous system treatment; Be able to provide fresh or archived tumor tissue samples; Patient with at least one measurable lesion (for Stage I); Barcelona clinic liver cancer: Stage B or C; Child-Pugh score: ≤ 7; ECOG PS score of 0-1; Life expectancy of ≥ 12 weeks; Adequate organ function Must take one medically approved contraceptive measure Exclusion Criteria: Patients with any active, known or suspected autoimmune disorder; Patients who have used corticosteroids or other immunosuppressive agents for systemic treatment within 1 month prior to randomization; With known severe allergic reactions to any other monoclonal antibodies; Received previous camrelizumab or rivoceranib mesylate treatment; Patients who discontinued ICIs treatment due to immune-related toxicity; Patients with known CNS metastasis or hepatic encephalopathy; Patients with liver tumor burden greater than 50% of total liver in volume, or patients who have previously undergone liver transplantation;; Patients with symptomatic ascites or pleural effusion requiring paracentesis and drainage, or patients who have undergone ascites or pleural effusion drainage within 2 weeks before randomization; Patients with other malignancies currently or within the past 5 years; Patients with hypertension which cannot be well controlled by antihypertensives; history of hypertensive crisis or hypertensive encephalopathy; Uncontrolled cardiac diseases or symptoms； Known hereditary or acquired bleeding disorders; Clinically significant bleeding symptoms or clear bleeding tendency; Patients with gastrointestinal perforation or gastrointestinal fistula; Patients with significant vascular invasions with a high possibility of fatal bleeding; Patients with important arterial/venous thrombosis; Patients experiencing toxicity caused by previous anti-tumor therapy that has not recovered to Grade ≤ 1; Patients with active infection; Patients with congenital or acquired immune deficiency; Patients who received live vaccines within 28 days prior to randomization, or are expect to be vaccinated during the treatment period; Patients with other potential factors that may affect the study results.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized，Open，Controlled, International Multi-Center
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: camrelizumab + Rivoceranib<br> | Drug: camrelizumab；Rivoceranib<br>* Camrelizumab at 200 mg via intravenous administration (IV), once every 2 weeks (Q2W), in combination with 250 mg of rivoceranib mesylate, oral administration, once a day (QD)<br>|
| Active Comparator: Rivoceranib<br> | Drug: Rivoceranib<br>* Rivoceranib mesylate (750 mg, QD, po)<br>|
| Active Comparator: Sorafenib<br> | Drug: Sorafenib<br>* Sorafenib tosylate (400 mg, twice a day (BID), po)<br>|
| Active Comparator: Regorafenib<br> | Drug: Regorafenib<br>* Regorafenib (160 mg, administer for 21 days then stop for 7 days, po)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stage I：Objective Response Rate（ORR） |  | 2.5 years | 
| Stage II：Overall survival （OS） |  | 2.5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stage I：Overall survival （OS） |  | 2.5 years | 
| Adverse Events（AEs） |  | 2.5 years | 
| Stage II：Objective Response Rate（ORR） |  | 2.5 years | 
| Disease Control Rate（DCR） |  | 2.5 years | 
| Duration of Response（DoR） |  | 2.5 years | 
| Progression-Free-Survival （PFS） |  | 2.5 years | 
| time to progression （TTP） |  | 2.5 years | 
| Pharmacokinetics (PK) Ctrough of camrelizumab |  | 2.5 years | 
| Pharmacokinetics (PK) Ctrough of Apatinib |  | 2.5 years | 
| Proportion of anti- camrelizumab antibody (ADA) |  | 2.5 years | 
| Proportion of neutralizing antibody (Nab) |  | 2.5 years |