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Hepatic arterial infusion chemotherapy (HAIC) deliver high concentration of chemotherapeutic agents directly to the liver tumor, was proved to be effective for intrahepatic and perihilar cholangiocarcinoma. Based on the potential synergistic effect of bevacizumab, chemotherapy and PD-1 inhibitor, this phase II clinical study want to test the efficacy and safety using intra-arterial infusion of oxaliplatin, 5-fluorouracil and bevacizumab combined with intravenous infusion of PD-1 inhibitor (Toripalimab) in the treatment of unresectable biliary malignant tumors.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| OXA, 5-FU and Bev plus Toripalimab | Experimental | the patients enrolled in this arm would receive hepatic arterial infusion chemotherapy with oxaliplatin, 5-fluorouracil and bevacizumab plus intravenous Toripalimab |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| OXA, 5-FU and bevacizumab plus Toripalimab | Drug |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall response rate | CR plus PR according to imRECIST | From the start of treatment until the end of treatment, up to approximately 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival | date from the start of treatment until death or lost to follow-up, whichever happen first, assessed at least 6 months | From the start of treatment until death or lost to follow-up, up to approximately 3 years |
| Adverse events |
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Inclusion Criteria:
Biliary tract cancer proved by histology or cytology
Metastatic advanced or locally advanced unresectable biliary tract cancer, including gallbladder cancer, intrahepatic cholangiocarcinoma and perihilar cholangiocarcinoma, decided by hepatobiliary doctor and radiologist.
At least one measurable lesion within liver;
No prior intra-arterial/systemic chemotherapy or other systemic therapies
Prior resection, TACE or ablation will be allowed.
Age from 18 years old to 80 years old.
the performance of Eastern Cooperative Oncology Group (ECOG) <2
Child-Pugh A or Child-Pugh B (≤ score 7).
Expectant survival time ≥ 3 months.
Baseline blood count test and blood biochemical must meet following criteria:
Patients sign informed consent.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Xiaodong Wang, MD | Department of Interventional Therapy, Peking University Cancer Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University Cancer Hospital | Beijing | Beijing Municipality | 100142 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20431764 | Background | Park J, Kim MH, Kim KP, Park DH, Moon SH, Song TJ, Eum J, Lee SS, Seo DW, Lee SK. Natural History and Prognostic Factors of Advanced Cholangiocarcinoma without Surgery, Chemotherapy, or Radiotherapy: A Large-Scale Observational Study. Gut Liver. 2009 Dec;3(4):298-305. doi: 10.5009/gnl.2009.3.4.298. Epub 2009 Dec 31. | |
| 20375404 |
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signed informed consent with patients
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| ID | Term |
|---|---|
| D005472 | Fluorouracil |
| D000068258 | Bevacizumab |
| C000656314 | toripalimab |
| C410216 | Folfox protocol |
| ID | Term |
|---|---|
| D014498 | Uracil |
| D011744 | Pyrimidinones |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
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|
|
type and incidence of adverse events
| From the start of treatment until the end of treatment, up to approximately 3 years |
| Progression-free survival | date from the first treatment to the date of disease progression, lost to follow-up or death, whichever happen first | From the start of the treatment until first documented progression or death from any cause, whichever came first, assessed up to approximately 3 yearsse date of disease progression |
| Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A, Madhusudan S, Iveson T, Hughes S, Pereira SP, Roughton M, Bridgewater J; ABC-02 Trial Investigators. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010 Apr 8;362(14):1273-81. doi: 10.1056/NEJMoa0908721. |
| 25176325 | Background | Boehm LM, Jayakrishnan TT, Miura JT, Zacharias AJ, Johnston FM, Turaga KK, Gamblin TC. Comparative effectiveness of hepatic artery based therapies for unresectable intrahepatic cholangiocarcinoma. J Surg Oncol. 2015 Feb;111(2):213-20. doi: 10.1002/jso.23781. Epub 2014 Sep 1. |
| 27820684 | Background | Wang X, Hu J, Cao G, Zhu X, Cui Y, Ji X, Li X, Yang R, Chen H, Xu H, Liu P, Li J, Li J, Hao C, Xing B, Shen L. Phase II Study of Hepatic Arterial Infusion Chemotherapy with Oxaliplatin and 5-Fluorouracil for Advanced Perihilar Cholangiocarcinoma. Radiology. 2017 May;283(2):580-589. doi: 10.1148/radiol.2016160572. Epub 2016 Nov 7. |
| 31729943 | Background | Gao F, Yang C. Anti-VEGF/VEGFR2 Monoclonal Antibodies and their Combinations with PD-1/PD-L1 Inhibitors in Clinic. Curr Cancer Drug Targets. 2020;20(1):3-18. doi: 10.2174/1568009619666191114110359. |
| 29229461 | Background | Hegde PS, Wallin JJ, Mancao C. Predictive markers of anti-VEGF and emerging role of angiogenesis inhibitors as immunotherapeutics. Semin Cancer Biol. 2018 Oct;52(Pt 2):117-124. doi: 10.1016/j.semcancer.2017.12.002. Epub 2017 Dec 8. |
| 29352857 | Background | Mathew M, Enzler T, Shu CA, Rizvi NA. Combining chemotherapy with PD-1 blockade in NSCLC. Pharmacol Ther. 2018 Jun;186:130-137. doi: 10.1016/j.pharmthera.2018.01.003. Epub 2018 Jan 31. |
| 25804482 | Background | Dalgleish AG. Rationale for combining immunotherapy with chemotherapy. Immunotherapy. 2015;7(3):309-16. doi: 10.2217/imt.14.111. |
| 30991686 | Background | Longo V, Brunetti O, Azzariti A, Galetta D, Nardulli P, Leonetti F, Silvestris N. Strategies to Improve Cancer Immune Checkpoint Inhibitors Efficacy, Other Than Abscopal Effect: A Systematic Review. Cancers (Basel). 2019 Apr 15;11(4):539. doi: 10.3390/cancers11040539. |
| 41983220 | Derived | Zheng K, Fu S, Zhu X, Cao G, Xu L, Liu P, Gao S, Xu H, Guo J, Chen H, Liu W, Xu D, Wang L, Yan X, Bao Q, Wu J, Wang K, Zhou J, Hao C, Xing B, Shen L, Yang R, Wang X. Phase II trial of hepatic arterial infusion chemotherapy plus bevacizumab and toripalimab for advanced biliary tract cancers: efficacy, safety, and exploratory analysis. Hepatobiliary Surg Nutr. 2026 Apr 1;15(2):37. doi: 10.21037/hbsn-24-463. Epub 2025 Feb 20. |
| D006571 |
| Heterocyclic Compounds |
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |