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When multi-kinase inhibitors based therapies (sorafenib and regorafenib) are limited in late-stage liver cancer patients, there is no alternative options. PD-1 blockade has became a promising immunotherapeutic strategy in many cancers. While it showed limited efficacy in liver cancer. Polyinosinic-polycytidylic acid (PolyIC) has been widely studied as a new anti-tumor drug and recent study showed that polyIC and PD-L1 mAb has a quite synergetic effect on the hepatocellular carcinoma (HCC). This study is aimed to evaluate the safety and efficacy of the combination of PolyIC and PD-1 mAb in unresectable late-stage HCC patients.
Nowadays, primary liver cancer, especially hepatocellular carcinoma (HCC) has become the second leading cause of cancer-related death. Unfortunately, the therapeutic strategies are still limited for HCC. For HCC patients at advanced stage, up to now, sorafenib and regorafenib are applied for palliative therapy to prolong the patients' life. PD-1 blockade has became a promising immunotherapeutic strategy in many cancers. While it showed limited efficacy in liver cancer. Polyinosinic-polycytidylic acid (PolyIC) has been widely studied as a new anti-tumor drug and recent study showed that polyIC and PD-L1 mAb has a quite synergetic effect on the treatment of HCC. This study is aimed to evaluate the safety and efficacy of the combination of PolyIC and PD-1 mAb in unresectable late-stage HCC patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 'PolyIC plus PD-1 mAb' and 'PD-1 mAb' | Experimental | 'PolyIC plus PD-1 mAb' group: PolyIC, 2mg, i.m., every other day, for three weeks. PD-1 mAb, 200mg, i.v., every three weeks. 'PD-1 mAb' group: PD-1 mAb, 200mg, i.v., every three weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PD-1 mAb | Drug | Intravenous infusion of PD-1 mAb, 200mg, once a time, every three weeks. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Objective response rate (ORR) | Percentage of patients whose cancer shrinks or disappears after treatment | Up to approximately 5 years |
| Measure | Description | Time Frame |
|---|---|---|
| Disease control rate (DCR) | Percentage of patients whose cancer doesn't progress after treatment | Up to approximately 5 years |
| Progression free survival (PFS) | The percentage of people does not get worse for a period of time after diagnosis |
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Inclusion Criteria:
Hepatocellular carcinoma with imaging diagnosis, in barcelona stage C, or stage B but resistant/recurrent to prior local treatment (e.g., TACE).
Eastern cooperative oncology group physical fitness score: 0-2.
Predicted survival time≥3 months.
Liver function of Child-Pugh A-B, no hepatic encephalopathy or physical examined ascites.
Routine blood tests were in accordance with the following criteria:
White blood cell (WBC)≥2.0x10^9/L, Neutrophil≥1.0x10^9/L, platelet (PLT)≥50x10^9/L, hemoglobin (HB)≥80 g/dL, creatinine≤1.5xULN (upper limit of normal value), Alanine transaminase (ALT) and aspartate aminotransferase (AST)≤5xULN, total bilirubin (TB)≤51.3umol/L, international normalized ratio (INR) or prothrombin time (PT)≤1.7xULN, activated partial thromboplastin time (APTT)≤1.5xULN, serum albumin≥28g/L
Patients will be informed consent, and understand and are willing to cooperate with the trial and sign related documents.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tingbo Liang, MD PhD | Contact | +8615088682641 | liangtingbo@zju.edu.cn | |
| Liang Wen, MD PhD | Contact | +8619967413613 | 11518214@zju.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Tingbo Liang, MD PhD | second affiliated hospital, Zhejiang University School of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The second affiliated hospital of Zhejiang University | Recruiting | Hangzhou | Zhejiang | 310000 | China |
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| ID | Term |
|---|---|
| D006528 | Carcinoma, Hepatocellular |
| ID | Term |
|---|---|
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
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| ID | Term |
|---|---|
| D011070 | Poly I-C |
| ID | Term |
|---|---|
| D011066 | Poly C |
| D011131 | Polyribonucleotides |
| D011119 | Polynucleotides |
| D009711 | Nucleotides |
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| PolyIC | Drug | Intramuscular injection of polyIC, 2mg, every other day, for three weeks. |
|
|
| Up to approximately 5 years |
| Overall survival (OS) | The percentage of people still alive for a given period of time after diagnosis | Up to approximately 5 years |
| Number of participants with treatment-related adverse events | Number of participants with treatment-related adverse events after drug initiation, as assessed by CTCAE v4.0 | Up to approximately 5 years |
| Percentage of participants with a better life quality | The percentage of participants with a better life quality after treatment, assessed by the questionnaires of European Organization for Research and Treatment of Cancer Quality of Life | Up to approximately 5 years |
| Level of alpha-fetoprotein (AFP) | The percentage of participants with a decreased serum level of alpha-fetoprotein (AFP) after treatment | Up to approximately 5 years |
| D009369 | Neoplasms |
| D008113 | Liver Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
| D008107 | Liver Diseases |
| D009706 |
| Nucleic Acids, Nucleotides, and Nucleosides |
| D011069 | Poly I |