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This Phase 2a trial will evaluate the safety and efficacy of NK cell therapy combined with the hepatic artery infusion chemotherapy (HAIC) in patients with intermediate and/or locally advanced hepatocellular carcinoma (HCC). We hypothesized that 5-fluorouracil (FU) with immunomodulatory functions would relieve the immunosuppressive microenvironment from the myeloid-derived suppressor cells (MDSCs), thereby enhancing the anti-tumor activity of NK cells. Thus, the subsequent infusion of autologous NK cells (VAX-NK/HCC) following HAIC treatment may further improve the anti-tumor activity in patients with advanced HCC.
Primary Objective I. To assess the objective response rate (ORR) of administering VAX-NK/HCC, autologous NK cells combined with HAIC in patients with locally advanced HCC.
Secondary Objectives I. To assess the efficacy of administering VAX-NK/HCC combined with HAIC. II. To assess the safety of administering VAX-NK/HCC combined with HAIC. III. To assess the immune responses of administering VAX-NK/HCC combined with HAIC.
OUTLINE: This is a Phase 2a study. Patients receive HAIC treatment every 4 week for up to 4 cycles followed by ex-vivo expanded autologous NK cell infusions. The NK cell treatment repeats every 4 weeks for up to 2 cycles in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients will be followed until the disease progression.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Autologous NK cell infusion combined with HAIC | Experimental | HAIC of 5-FU (500 mg/m2, Q4W) and cisplatin (15 mg/m2, Q4W) will be administered for up to 4 cycles to patients with locally advanced HCC. Subjects who achieved sustained SD or better based on the mRECIST criteria after 2nd cycle of HAIC will be enrolled to receive 1x10^9 cells VAX-NK/HCC infusion. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vax-NK/HCC | Biological | autologous NK cells expanded ex vivo. |
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| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) of administering VAX-NK/HCC combined with HAIC | ORR will be measured as the proportion of patients with a best overall response of complete response (CR) and partial response (PR) of administering VAX-NK/HCC combined with HAIC. | average 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Disease control rate (DCR) of administering VAX-NK/HCC combined with HAIC | ORR will be measured as the proportion of patients with a best overall response of complete response (CR), partial response (PR), and stable disease (SD) of administering VAX-NK/HCC combined with HAIC. | average 6 months |
| Time to progression (TTP) of administering VAX-NK/HCC combined with HAIC |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Seon-Ah Ha, Ph.D. | VaxCell Biotherapeutics Co., Ltd. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seon-Ah Ha | Hwasun | Jeollanam-do | 58141 | South Korea |
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TTP will be measured by time to progression, defined as time from enrollment to disease progression. |
| average 6 months |
| Overall survival (OS) of administering VAX-NK/HCC combined with HAIC | OS will be measured as time from enrollment to death due to any cause. | average 12 months |
| Quality of Life of administering VAX-NK/HCC combined with HAIC | The assessment will be performed using the Korean versions of European Organization for Research and Treatment of Cancer (EORTC) Questionnaire 30 (QLQ-C30) consisting of 30 items. Total score: Range 0-100. | average 6 months |
| Adverse Events (AEs) and Serious Adverse Events (SAEs) of administering VAX-NK/HCC combined with HAIC | The assessment will be measured by determining the number of patients that experience AEs and SAEs graded according to the NCI-CTCAE (Version 4.0) | average 6 months |
| The proportions of T and NK cells | This will be measured by determining the relative percentages of CD4+CD8+ T cells and CD3- CD56+ NK cells in patients' peripheral blood. | average 6 months |
| The lymphocyte/monocyte ratio (LMR) | LMR will be calculated by dividing the absolute lymphocyte count by the absolute monocyte count in patients' peripheral blood. | average 6 months |
| The NK cell cytotoxicity | This will be measured by determining percent cell lysis of target cells (K562) in patients' peripheral blood. | average 6 months |
| The serum cytokine levels | The serum concentrations of IFN-γ, IL-10, and TGF-β will be measured in patients' serum using the Enzyme-Linked immunosorbent assays. | average 6 months |