Hepatocellular carcinoma (HCC) is a common cancer worldwide and a leading cause of cancer-related death. The majority of participants first presenting with HCC have advanced unresectable or metastatic disease. The purpose of this study is to evaluate the optimized dose, adverse events, and efficacy of livmoniplimab in combination with budigalimab. Livmoniplimab is an investigational drug being developed for the treatment of HCC. There are 2 stages to this study. In Stage 1, there are 3 treatment arms and participants will be randomized in a 1:1:1 ratio. Participants will either receive livmoniplimab (at different doses) in combination with budigalimab (another investigational drug), atezolizumab in combination with bevacizumab, or tremelimumab in combination with durvalumab. In Stage 2, there are 2 treatments arms and participants will be randomized in a 1:1 ratio. Participants will either receive livmoniplimab (optimized dose) in combination with budigalimab or tremelimumab in combination with durvalumab. Approximately 660 adult participants will be enrolled in the study across 185 sites worldwide. Stage 1: In arm 1, participants will receive intravenously (IV) infused livmoniplimab (Dose 1) in combination with IV infused budigalimab, every 3 weeks. In arm 2, participants will receive IV infused livmoniplimab (Dose 2) in combination with IV infused budigalimab, every 3 weeks. In Arm 3 (control), participants will receive the investigator's choice: IV atezolizumab in combination with IV bevacizumab every 3 weeks or single dose IV tremelimumab in combination with IV durvalumab every 4 weeks. Stage 2: In arm 1, participants will receive IV infused livmoniplimab (optimized dose) in combination with IV infused budigalimab, every 3 weeks. In Arm 2 (control), participants will receive single dose IV tremelimumab in combination with IV durvalumab every 4 weeks. All participants will continue treatment until disease progression or discontinuation criteria are met, whichever occurs first. The estimated duration of this study is about 56 months. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic and may require frequent medical assessments, blood tests, questionnaires, and scans.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
660
Intravenous (IV) Solution
Intravenous (IV) Solution
Intravenous (IV) Solution
Intravenous (IV) Solution
Intravenous (IV) Solution
Intravenous (IV) Solution
City of Hope /ID# 261468
Duarte, California, United States
RECRUITINGCity of Hope at Orange County Lennar Foundation Cancer Center /ID# 261669
Irvine, California, United States
RECRUITINGUC Irvine /ID# 255673
Orange, California, United States
RECRUITINGThe University of Chicago Medical Center /ID# 255674
Chicago, Illinois, United States
Stage 1: Best Overall Response (BOR) per Investigator
BOR is defined as a participant achieving confirmed complete response (CR) or confirmed partial response (PR) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as determined by investigators at any time prior to subsequent anticancer therapy.
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 2: Overall Survival (OS)
OS is defined as the time from randomization until death from any cause
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 1: Number of Participants with Progression-Free Survival (PFS)
PFS is defined as the time from randomization until the first documentation of progressive disease according to RECIST 1.1 as determined by investigators or death from any cause, whichever occurs first.
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 1: Duration of Response (DOR) per Investigator
DOR is defined as the time from first confirmed CR or PR until the first documentation of progressive disease according to RECIST 1.1 as determined by investigators or death from any cause, whichever occurs first.
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 1: Overall Survival (OS)
OS is defined as the time from randomization until death from any cause.
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 1: Number of Participants with Adverse Events (AEs)
An AE is defined as any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment.
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 1: Maximum Plasma Concentration (Cmax) of Livmoniplimab and Budigalimab
Cmax of livmoniplimab and budigalimab.
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 1: Time to Cmax (Tmax) of Livmoniplimab and Budigalimab
Tmax of livmoniplimab and budigalimab.
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 1: Area Under the Serum Concentration Versus Time Curve (AUC) of Livmoniplimab and Budigalimab
AUC of livmoniplimab and budigalimab.
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 2: Number of Participants with Progression-Free Survival (PFS)
PFS is defined as the time from randomization until the first documentation of progressive disease according to RECIST 1.1 as determined blinded independent central review (BICR) or death from any cause, whichever occurs first.
Time frame: Through Study Completion, Up to Approximately 56 Months
Stage 2: Best Overall Response (BOR) of Complete Response (CR)/Partial Response (PR) per BICR
BOR is defined as a participant achieving confirmed CR/PR per RECIST 1.1 as determined by BICR at any time prior to subsequent anticancer therapy.
Time frame: Through Study Completion, Up to Approximately 56 Months
Change from Baseline in the Pain Domain of the European Organization for Research Treatment of Cancer Quality of Life Questionnaire Hepatocellular Carcinoma 18-Question Module (EORTC QLQ-HCC18)
The EORTC QLQ-HCC18 is an 18-item scale that measures hepatocellular carcinoma (HCC)-specific symptoms and health-related quality of life (HRQoL). The Pain Domain contains 2 items where scores are based on a 4-point Likert scale (with 1 = 'not at all' to 4 = 'very much'); scaled scores for each domain ranged from 0-100 with a higher score indicating worse symptoms.
Time frame: Baseline to Week 12
Change from Baseline in the Fatigue Domain of the EORTC QLQ-HCC18
The EORTC QLQ-HCC18 is an 18-item scale that measures HCC-specific symptoms and HRQoL. The Fatigue Domain contains 3 items where scores are based on a 4-point Likert scale (with 1 = 'not at all' to 4 = 'very much'); scaled scores for each domain ranged from 0-100 with a higher score indicating worse symptoms.
Time frame: Baseline to Week 12
Change from Baseline in Physical Function (PF) Domain of the European Organization for Research Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30)
The EORTC QLQ-C30 is an 30-item patient-reported questionnaire that measures symptoms and HRQoL. The PF Domain is a functional scale where participants rate items on a 4-point scale (with 1 = 'not at all' to 4 = 'very much'). A change of 5 to 10 points is considered a small change and the lower bound (5) will be used to define the minimum important difference. A change of \>= 10 to \< 20 points is considered a moderate change.
Time frame: Baseline to Week 12
Change from Baseline in Global Health Status (GHS)/Quality of Life (QoL) Domain as Measured by the GHS/QoL Domain of the EORTC QLQ-C30
The EORTC QLQ-C30 is an 30-item patient-reported questionnaire that measures symptoms and HRQoL. The GHS/QoL Domain is a scale where participants rate items on a 4-point scale (with 1 = 'not at all' to 4 = 'very much'). A change of 5 to 10 points is considered a small change and the lower bound (5) will be used to define the minimum important difference. A change of ≥ 10 to \< 20 points is considered a moderate change.
Time frame: Baseline to Week 12
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Alliance for Multispecialty Research LLC Kansas City Oncology /ID# 256830
Merriam, Kansas, United States
COMPLETEDNorton Cancer Institute /ID# 260775
Louisville, Kentucky, United States
RECRUITINGHenry Ford Hospital /ID# 255803
Detroit, Michigan, United States
RECRUITINGMetro Minnesota Community Oncology Research Consortium (MMCORC) /ID# 256041
Saint Louis Park, Minnesota, United States
RECRUITINGWashington University-School of Medicine /ID# 255720
St Louis, Missouri, United States
RECRUITINGTexas Oncology - Abilene - Antilley Road /ID# 265820
Abilene, Texas, United States
RECRUITING...and 27 more locations