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Promising immunotherapy combo takes on advanced liver cancer

NCT ID NCT04523493

What the study statuses mean

This study's is highlighted.

Recruitment status, easiest to join first

Recruiting now
This trial is taking on new participants right now.
Not yet recruiting
Registered, but not yet taking participants.
By invitation only
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing This study
Running, but no longer taking on new participants.
Completed
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Jun 27, 2026 · Last updated Jul 07, 2026 · Updated 2 times

Summary

This Phase 3 trial tests whether adding the immunotherapy drug toripalimab to the standard targeted therapy lenvatinib helps people with advanced liver cancer live longer. About 530 participants will receive either the combination or a placebo plus lenvatinib. The study is double-blind, meaning neither patients nor doctors know who gets the extra drug.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance
Toripalimab (an immunotherapy drug) combined with lenvatinib (a targeted therapy drug)
What this could lead to
If successful, this combination could become a new standard first-line treatment for advanced liver cancer, potentially extending survival.
What could go wrong
This is an early-stage Phase 3 trial; results may not confirm benefit. Immunotherapy can cause serious immune-related side effects.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Phase 3

Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.

Participants

530 people

The number who actually took part.

Started

Jun 2020

Expected to finish

Mar 2027

An estimate. End dates often move.

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 to 75 years

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion criteria: 1. Age of 18-75 full years (inclusive), male or female. 2. Histopathologically or cytologically confirmed HCC or participants with liver cirrhosis meet the clinical diagnostic criteria for HCC of the American Association for the Study of Liver Diseases (AASLD). 3. Stage B (intermediate stage) or C (advanced stage) HCC determined in accordance with Barcelona Clinic Liver Cancer staging system (BCLC stage), be unsuitable for surgery and/or local therapy, or have progression of disease after surgery and/or local therapy. 4. No previous use of any systemic therapy for HCC (mainly including systemic chemotherapy, antiangiogenic drugs or other molecular targeted therapy, immunotherapy containing CTLA-4, PD 1/PD-L1 monoclonal antibody). 5. Having ≥ 1 measurable lesion in accordance with RECIST v1.1. Requirement: the selected target lesion has not been treated locally before, or is located in the area of previous local therapy and subsequently determined as PD through radiological examination and in accordance with RECIST v1.1. 6. Child-Pugh class A or ≤7 class B, with no history of hepatic encephalopathy. 7. Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score 0-1. 8. Expected survival ≥12 weeks. 9. Main organ function meets the following requirements: no blood transfusion within 14 days prior to screening, no use of hematopoietic stimulating factor (including G-CSF, GM-CSF, EPO and TPO etc.) or human albumin preparation. 10. In case of HBsAg (+) and/or HBcAb (+), HBV DNA is required to be \< 1000 IU/mL (if the lowest detectable value at the local center is higher than 1000IU/mL, enrollment can be determined based on the specific condition after discussed with sponsor), and it is required to continue original anti-HBV therapy in the full course, or start to use Entecavir or tenofovir in the full course after screening during the study. 11. Female patients at childbearing age must receive serum pregnancy test within 7 days before randomization, have negative result, and are willing to use reliable and effective contraceptive methods during the trial and within 5 months after last administration. Male patients whose partners are women of childbearing potential must agree to use reliable and effective contraceptive methods during the trial and within 5 months after last administration. 12. Being voluntary to participate in the study, sufficiently informed consent and sign the written informed consent form, with good compliance. Exclusion criteria: 1. Known cholangiocellular carcinoma (ICC) or mixed hepatocellular carcinoma, sarcomatoid hepatocellular carcinoma and hepatic fibrolamellar carcinoma. 2. Malignant tumor except HCC within 5 years: however, localized tumor cured in the study is excluded,including cervical carcinoma in situ, skin basal cell carcinoma and carcinoma in situ of prostate. 3. Hepatic surgery and/or local therapy or treatment with investigational product for HCC within 4 weeks prior to randomization; palliative radiation therapy for bone metastatic lesion within 2 weeks prior to randomization; use of Chinese medicine preparations with anti-liver cancer effect within two weeks prior to randomization. Toxicity induced by previous therapy (except alopecia) not recovered to ≤ grade 1 (NCI-CTCAE v5.0). 4. Prior use of other anti-PD-1 antibody or other immunotherapy targeting PD-1/PD-L1. 5. Uncontrolled pericardial effusion, uncontrolled pleural effusion or clinically obvious moderate or severe peritoneal effusion at screening, defined as reaching the following criteria: having clinical symptoms and pleural and peritoneal effusion detected in physical examination at screening; or puncture for drainage required for pleural and peritoneal effusion and/or intracavitary administration during screening. 6. History of gastrointestinal hemorrhage within 6 months prior to randomization or clear tendency of gastrointestinal hemorrhage (including severe esophageal-gastric varices with hemorrhagic risk, locally active peptic ulcer, persistent fecal occult blood (+)). 7. Having ≥ grade 3 (NCI-CTCAE v5.0) gastrointestinal or non-gastrointestinal fistula at present. 8. Cancer thrombus invasion in the main trunk of portal vein (Vp4) (more than 1/2 of the lumen), inferior vena cava cancer thrombus or cardiac involvement in accordance with CT/MRI. 9. Serious cardiovascular and cerebrovascular diseases: 10. Other obvious hemorrhagic tendency or evidence on important coagulation disorder: 11. Medium to large surgical treatment within 4 weeks prior to randomization, not including diagnostic biopsy. 12. Know central nervous system metastasis; cranial and/or spinal MRI is needed for exclusion if central nervous system metastasis is suspected. 13. Serious, uncured wound, active ulcer or untreated bone fracture. 14. Vaccination of live vaccine within 30 days prior to randomization. 15. Presence of immunodeficiency or receiving long-term systemic steroid therapy within 7 days prior to randomization (daily dose \>10mg Prednisone or other equivalent glucocorticoid), or other immunosuppressive therapy. 16. Active autoimmune diseases requiring systemic treatment (i.e., immunomodulatory drug, corticosteroid or immunosuppressant) in the past two years; however, replacement therapy (e.g., thyroxine, insulin or physiological corticosteroid replacement therapy for renal or pituitary insufficiency) will not be considered as systemic therapy and is allowed to be used. 17. History of clear interstitial lung disease or non-infectious pneumonia, unless induced by local radiotherapy. 18. Active tuberculosis or received antituberculosis therapy within 1 year prior to randomization. 19. Any serious acute and chronic infection requiring systemic antibacterial, antifungal or antiviral therapy at screening, not including viral hepatitis. 20. Known history of human immunodeficiency virus (HIV) infection. 21. Previously receiving allogeneic stem cell or solid organ transplantation. 22. Inability to swallow tablets, malabsorption syndrome or any other condition that affects gastrointestinal absorption. 23. Known history of serious allergy to any monoclonal antibody, anti-angiogenesis drug. 24. Other participants who are unsuitable for inclusion as judged by the investigator."

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Conditions

The condition(s) this trial relates to.

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Contacts and locations

Locations

  • A.O.U. Citta della Salute e della Scienza di Torino

    Tortona, Italy

  • AOUI Verona - Policlinico "G.B. Rossi" di Borgo Roma

    Verona, 37134, Italy

  • Azienda Ospedaliero Universitaria Pisana

    Pisa, 56126, Italy

  • Centrum Medyczne Pratia Poznań

    Skórzewo, 60-185, Poland

  • Communal Enterprise Volyn Regional Clinical Hospital of Volyn Regional Council

    Lutsk, 43018, Ukraine

  • Communal Non-Profit Institution of Kharkiv Regional Council Regional Clinical Specialized Dispensary of Radiation Protection of Population

    Kharkiv, 61166, Ukraine

  • Communal Non-commercial Enterprise City Clinical Hospital #4 of Dnipro City Council, Department of Chemotherapy

    Dnipro, 49102, Ukraine

  • Communal Non-commercial Enterprise Odesa Regional Clinical Hospital of Odesa Regional Council, Department of General Surgery

    Odesa, 65025, Ukraine

  • Communal Non-commercial Enterprise Zaporizhzhia Regional Antitumor Center of Zaporizhzhia Regional Council

    Zaporizhzhia, 69040, Ukraine

  • Communal Non-commercial Enterprise of Sumy Regional Council, Sumy Regional Clinical Oncological Dispensar

    Sumy, 40022, Ukraine

  • Communal Non-profit Enterprise "Regional Center of Oncology", Department of Abdominal Organs Oncosurgery

    Kharkiv, 61070, Ukraine

  • Copernicus Podmiot Leczniczy sp. z o.o., Wojewodzkie Centrum Onkologii, Oddzial Onkologii Klinicznej/Chemioterapii

    Gdansk, 80-219, Poland

  • Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico,Oncologia Medica

    Milan, 20122, Italy

  • ID Clinic

    Mysłowice, 41-400, Poland

  • IRCCS Fondazione Giovanni Pascale, Istituto Nazionale Dei Tumori

    Naples, 80131, Italy

  • Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie - Państwowy Instytut Badawczy, Klinika Onkologii i Radioterapii

    Warsaw, 02-034, Poland

  • National Cancer Centre Singapore

    Singapore, 168583, Singapore

  • PRATIA MCM Kraków, ul. Pana Tadeusza 2,

    Krakow, 30-727, Poland

  • Qinhuai Medical Area, General Hospital of PLA Eastern Theater Command

    Nanjing, Jiangsu, 21000, China

  • State Inst. O.O.Shalimov Nat. scientific certer of Surgery and Transplantology of Nat. Academy of Med.Sciences of Ukraine, Dep.of Oncology

    Kyiv, 03126, Ukraine

  • Szpital Wojewódzki im. Mikołaja Kopernika w Koszalinie, Oddzial Dzienny Chemioterapii

    Koszalin, 75-581, Poland

  • Wielkopolskie Centrum Onkologii, Oddział Onkologii Klinicznej i Immunoonkologii z Pododdziałem Dziennym i Izbą Przyjęć

    Poznan, 61-866, Poland

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