Spots Global Cancer Trial Database for Combination of Sintilimab and Stereotactic Body Radiotherapy in Hepatocellular Carcinoma (ISBRT01)

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Trial Identification

Brief Title: Combination of Sintilimab and Stereotactic Body Radiotherapy in Hepatocellular Carcinoma (ISBRT01)

Official Title: Effect of Stereotactic Body Radiotherapy Followed by Sintilimab Versus Stereotactic Body Radiotherapy Alone for Hepatocellular Carcinoma With Portal Vein Invasion After Arterially Directed Therapy: A Randomized Clinical Trial

Study ID: NCT04167293

Conditions

Hepatocellular Carcinoma

Interventions

stereotactic body radiotherapy

Sintilimab

Study Description

Brief Summary: Although sorafenib is the standard treatment for hepatocellular carcinoma with portal vein invasion, the outcome of these patients remains very poor, with a median survival time of 5.5 to 7.2 months. It has been demonstrated that first-line treatment with transarterial chemoembolization plus radiotherapy could provide more favorable survival than sorafenib alone. However, intrahepatic dissemination and distant metastasis remains the major recurrence pattern after treatment in these patients; therefore, searching for new strategies to improve efficacy is necessary. Immunotherapy targeting the PD-1/PD-L1 checkpoints has demonstrated promising activity in advanced HCC. Combining radiotherapy with immune checkpoints showed promising response rates and improved survival in several solid tumor types. The aim of this randomized study was to investigate the efficacy and safety of stereotactic body radiotherapy followed by sintilimab (an anti-PD-1 antibody) compared with stereotactic body radiotherapy alone for hepatocellular carcinoma with portal vein invasion after arterially directed therapy.

Detailed Description: A total of 116 HCC patients with portal vein invasion after arterially directed therapy (transarterial chemoembolization or hepatic arterial infusion chemotherapy) will be randomized to two treatment arms using a 1:1 ratio: SBRT + PD-1 arm or SBRT alone arm. Patients in both arms will receive stereotactic body radiotherapy (SBRT) using volumetric arc therapy. The prescribed dose is 30-54 Gy in 3-6 fractions over 1-2 weeks. In the SBRT + PD-1 arm, sintilimab is administered intravenously at 200 mg every 3 weeks for up to 1 year. The first course of sintilimab will be given within 4-6 weeks after completion of SBRT.