SIRT for Potentially Resectable HCC

Study Overview
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Brief Summary
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This study is conducted to evaluate the efficacy and safety of Y-90 selective internal radiation therapy (SIRT) in patients with potentially resectable hepatocellular carcinoma (HCC).

Detailed Description
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This is a bi-center, prospective study to evaluate the efficacy and safety of SIRT in patient with potentially resectable HCC. 35 patients with potentially resectable (initially unresectable) HCC will be enrolled in this study. The patients will receive 1-2 sessions of SIRT. If the patients have invasive tumors, extensive liver involvement or vascular invasion, systematic treatment will be added. If the patients are evaluated as resectable during follw-up, liver resection will be recommended. The primary end point of this study is success rate of conversion to resection. The secondary endpoints are objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), time to progression (TTP), duration of response (DOR), overall survival (OS) and adverse events (AEs).

Official Title
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Y-90 Selective Internal Radiation Therapy for Potentially Resectable Hepatocellular Carcinoma: a Prospective, Single Arm Trial

Conditions
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Hepatocellular Carcinoma

Intervention / Treatment
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* Procedure: SIRT


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: HCC with diagnosis confirmed pathologically or clinically No pervious treatment for HCC At least one measurable intrahepatic target lesion Potentially resectable HCC: tumor(s) confined to the left/right hemiliver, with/without invasion to the unilateral branch of the portal vein and/or hepatic vein Disease amenable to SIRT (after evaluation) Child-Pugh Class A or without cirrhosis Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1 Patients with active hepatitis B are allowed, but they need to receive antiviral treatment to achieve a HBV DNA<10^3 IU/mL Patients with hepatitis C need to finish the anti-HCV treatment Adequate organ and bone marrow function; the blood biochemical examination: platelet count ≥75×10^9/L, white blood cell count >3.0×10^9/L, absolute value of neutrophils >1.5×10^9/L, hemoglobin ≥85 g/L, ASL and AST≤5×ULN, creatinine≤1.5×ULN, INR<1.5 or PT/APTT normal range Life expectancy of at least 6 months Exclusion Criteria: Tumor involving main portal vein, bilateral branches of portal vein, or vena cava tumor extention beyond one lobe of the liver Bilobar tumor distribution Extrahepatic metastasis Decompensated liver function, including ascites, bleeding from esophageal and gastric varices, and/or hepatic encephalopathy Organ (heart, kidney) dysfunction HBsAg and anti-HCV antibody positive concurrently History of malignancy other than HCC Uncontrolled infection History of HIV History of organ and cell transplantation Patients with bleeding tendency

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SIRT<br>Treatment with SIRT. | Procedure: SIRT<br>* The patients will receive 1-2 sessions of SIRT. If the patients have invasive tumors, extensive liver involvement or vascular invasion, systematic treatment will be added.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success rate of conversion to resection | The proportion of patients with initially unresectable HCC who were evaluated by the surgical team as suitable for second-stage surgical resection after SIRT | 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Objective response rate (ORR) | The percentage of patients who have a best overall tumor response rating of complete response (CR) or partial response (PR) | 3 years | 
| Disease control rate (DCR) | The percentage of patients who have a tumor response rating of CR, PR, or stable disease (SD) | 3 years | 
| Progression-free survival (PFS) | The time between the first treatment and the first occurrence of disease progression (PD) or death from any cause, whichever occurs first | 3 years | 
| Time to progression (TTP) | the time interval from first treatment to the first occurrence of disease progression | 3 years | 
| Duration of response (DOR) | the time from initial objective response (CR or PR) until PD or death, whichever occurs first | 3 years | 
| Overall survival (OS) | The time from initiation of treatment until the date of death from any cause | 3 years | 
| Adverse Events (AEs) | Number of patients with AEs assessed by NCI CTCAE v5.0. | 3 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hepatocellular Carcinoma, unresectable, selective internal radiation therapy