The purpose of this study is to evaluate the efficacy and safety of lenvatinib and pembrolizumab in combination with TACE versus TACE plus oral and intravenous (IV) placebos in participants with incurable, non-metastatic hepatocellular carcinoma (HCC). The primary hypotheses are that pembrolizumab plus lenvatinib in combination with TACE is superior to placebo plus TACE with respect to progression-free survival (PFS) and overall survival (OS).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
480
Administered at a dose of 12 mg (for participants with screening body weight ≥60 kg) or 8 mg (for participants with screening body weight \<60 kg) via oral capsules once a day during each 21-day cycle.
Administered via IV infusion at a dose of 400 mg once every 6 weeks (Q6W).
Lenvatinib-matching placebo administered via oral capsules once a day during each 21-day cycle.
Pembrolizumab-matching placebo administered via IV infusion once every 6 weeks (Q6W).
Conducted as a background procedure of chemotherapeutic and embolic agent(s).
Arizona Oncology Associates PC- HOPE ( Site 0770)
Tucson, Arizona, United States
Scripps Clinic Torrey Pines ( Site 0714)
La Jolla, California, United States
USC Norris Comprehensive Cancer Center ( Site 0717)
Los Angeles, California, United States
UCLA Hematology/Oncology - Santa Monica ( Site 0720)
Los Angeles, California, United States
UC Irvine Health ( Site 0718)
Orange, California, United States
Progression-free Survival (PFS) per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)
PFS is defined as the time from randomization to the first documented progressive disease or death due to any cause, whichever occurs first. Responses are according to RECIST 1.1 as assessed by blinded independent central review (BICR).
Time frame: Up to ~43 months
Overall Survival (OS)
OS is defined as the time from randomization to death due to any cause.
Time frame: Up to ~95 months
PFS per Modified Response Evaluation Criteria in Solid Tumors (mRECIST)
PFS is defined as the time from randomization to the first documented progressive disease or death due to any cause, whichever occurs first. Responses are according to mRECIST as assessed by BICR.
Time frame: Up to ~43 months
Objective Response Rate (ORR) per mRECIST
ORR is defined as the percentage of participants who have a confirmed complete response (CR: disappearance of any intratumoral arterial enhancement in all target lesions) or partial response (PR: at least a 30% decrease in the sum of diameters of viable \[enhancement in the arterial phase\] target lesions, taking as reference the baseline sum of the diameters of target lesions). Responses are according to mRECIST as assessed by BICR.
Time frame: Up to ~95 months
Disease Control Rate (DCR) per mRECIST
DCR is defined as the percentage of participants who have a best overall response of CR (disappearance of any intratumoral arterial enhancement in all target lesions), PR (at least a 30% decrease in the sum of diameters of viable \[enhancement in the arterial phase\] target lesions, taking as reference the baseline sum of the diameters of target lesions), or stable disease (SD). Responses are according to mRECIST as assessed by BICR.
Time frame: Up to ~95 months
Duration of Response (DOR) per mRECIST
DOR is determined by disease assessment and is defined as the time from the first documented evidence of a response of CR (disappearance of any intratumoral arterial enhancement in all target lesions) or PR (at least a 30% decrease in the sum of diameters of viable \[enhancement in the arterial phase\] target lesions, taking as reference the baseline sum of the diameters of target lesions) until the first documented disease progression or death due to any cause, whichever occurs first. Responses are according to mRECIST as assessed by BICR.
Time frame: Up to ~95 months
Time to Progression (TTP) per mRECIST
TTP is defined as the time from randomization to the first documented disease progression. Responses are according to mRECIST as assessed by BICR.
Time frame: Up to ~95 months
Percentage of Participants Who Experience At Least One Adverse Event (AE)
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The percentage of participants who experience at least one AE will be reported.
Time frame: Up to ~95 months
Percentage of Participants Who Experience At Least One Serious Adverse Event (SAE)
An SAE is an AE that results in death, is life threatening, requires or prolongs a hospitalization, results in persistent or significant disability or incapacity, is a congenital anomaly or birth defect, is a cancer, is associated with an overdose, or is another important medical event. The percentage of participants who experience at least one SAE will be reported.
Time frame: Up to ~95 months
Percentage of Participants Who Experience At Least One Hepatic Event of Clinical Interest (ECI)
Percentage of participants with Hepatic ECIs not due to disease progression or TACE as assessed by the investigator will be reported.
Time frame: Up to ~95 months
Percentage of Participants Who Discontinue Study Drug Due to an AE
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The percentage of participants who discontinue study drug due to an AE will be reported.
Time frame: Up to ~95 months
ORR per RESCIST 1.1
ORR is defined as the percentage of participants who have a confirmed complete response (CR: disappearance of all target lesions) or partial response (PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters). Responses are according to RECIST 1.1 as assessed by BICR.
Time frame: Up to ~95 months
DCR per RECIST 1.1
DCR is defined as the percentage of participants who have a best overall response of CR (disappearance of all target lesions), PR (at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters), or SD. Responses are according to RECIST 1.1 as assessed by BICR.
Time frame: Up to ~95 months
DOR per RECIST 1.1
DOR is determined by disease assessment and is defined as the time from the first documented evidence of a response of CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters) until the first documented disease progression or death due to any cause, whichever occurs first. Responses are according to RECIST 1.1 as assessed by BICR.
Time frame: Up to ~95 months
TTP per RECIST 1.1
TTP is defined as the time from randomization to the first documented disease progression. Responses are according to RECIST 1.1 as assessed by BICR.
Time frame: Up to ~95 months
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Yale Cancer Center ( Site 0724)
New Haven, Connecticut, United States
Tampa General Hospital ( Site 0764)
Tampa, Florida, United States
Mountain States Tumor Institute ( Site 0773)
Boise, Idaho, United States
University of Iowa Hospital and Clinics ( Site 0729)
Iowa City, Iowa, United States
University of Kansas Cancer Center ( Site 0731)
Westwood, Kansas, United States
...and 195 more locations