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Tyrosine Kinase Inhibitor

Lenvatinib + Pembrolizumab + TACE for Liver Cancer

Phase 3

Waitlist Available

Research Sponsored by Merck Sharp & Dohme LLC

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Has HCC localized to the liver and not amenable to curative treatment

Has a diagnosis of HCC confirmed by radiology, histology, or cytology

Must not have

Has a serious nonhealing wound, ulcer, or bone fracture

Has significant cardiovascular impairment within 12 months of the first dose of study intervention such as congestive heart failure

Timeline

Screening 3 weeks

Treatment Varies

Follow Up up to ~95 months

Awards & highlights

Pivotal Trial

Summary

This trial is testing a combo of two drugs vs TACE (a cancer treatment) plus placebos to see if it prolongs PFS and OS in people with incurable HCC.

Who is the study for?

This trial is for adults with non-metastatic, incurable liver cancer (HCC) confirmed by radiology or pathology. Eligible participants may have had Hepatitis B or C if treated properly. They must have stable blood pressure and organ function, and their cancer should be limited to the liver but not suitable for curative treatment.

What is being tested?

The study tests the effectiveness of lenvatinib plus pembrolizumab with TACE against placebo plus TACE in improving survival without cancer progression in patients with HCC. The goal is to see if combining these drugs with TACE leads to better outcomes than TACE alone.

What are the potential side effects?

Possible side effects include high blood pressure, fatigue, loss of appetite, weight loss, nausea, inflammation of organs due to immune response from pembrolizumab and potential complications from the TACE procedure like abdominal pain or fever.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below

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My liver cancer cannot be cured with surgery or other treatments.

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My liver cancer diagnosis was confirmed through imaging or lab tests.

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I have Hepatitis B.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:

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I have a serious wound or broken bone that isn't healing.

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I haven't had major heart problems like heart failure in the last year.

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I have had treatment directly on liver tumors.

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I have fluid buildup in my abdomen not managed by medication.

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I have had stomach bleeding in the past 6 months.

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I am eligible for a liver transplant.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ up to ~95 months

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~up to ~95 months

This trial's timeline: 3 weeks for screening, Varies for treatment, and up to ~95 months for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Overall Survival (OS)

Progression-free Survival (PFS) per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)

Secondary study objectives

DCR per RECIST 1.1

DOR per RECIST 1.1

Disease Control Rate (DCR) per mRECIST

+10 more

Side effects data

From 2024 Phase 3 trial • 804 Patients • NCT03040999

64%

Radiation skin injury

63%

Stomatitis

58%

Anaemia

56%

Nausea

48%

Dry mouth

45%

Constipation

45%

Weight decreased

44%

Dysphagia

42%

Neutrophil count decreased

33%

Dysgeusia

33%

Vomiting

32%

Fatigue

31%

White blood cell count decreased

28%

Hypomagnesaemia

26%

Decreased appetite

25%

Hypothyroidism

25%

Hypokalaemia

24%

Lymphocyte count decreased

24%

Platelet count decreased

23%

Oropharyngeal pain

23%

Blood creatinine increased

22%

Diarrhoea

22%

Odynophagia

20%

Hypoacusis

20%

Alanine aminotransferase increased

20%

Hyponatraemia

19%

Tinnitus

19%

Oral candidiasis

19%

Asthenia

16%

Pyrexia

16%

Cough

15%

Aspartate aminotransferase increased

15%

Rash

14%

Insomnia

13%

Acute kidney injury

13%

Pharyngeal inflammation

13%

Pruritus

12%

Dysphonia

12%

Gamma-glutamyltransferase increased

11%

Pneumonia

11%

Dehydration

10%

Hyperthyroidism

10%

Hypoalbuminaemia

10%

Hypocalcaemia

10%

Headache

10%

Productive cough

Neck pain

Peripheral sensory neuropathy

Gastrooesophageal reflux disease

Hiccups

Hyperglycaemia

Hyperuricaemia

Dizziness

Hypophosphataemia

Urinary tract infection

Ear pain

Localised oedema

Hyperkalaemia

Erythema

Oral pain

Abdominal pain upper

Arthralgia

Anxiety

Febrile neutropenia

Dyspepsia

Saliva altered

Back pain

Oedema peripheral

Hypertension

Dyspnoea

Nasopharyngitis

Alopecia

Dry skin

Sepsis

Pneumonia aspiration

Trismus

Pneumonitis

Laryngeal oedema

Malnutrition

Pharyngeal haemorrhage

Cellulitis

Septic shock

Systemic infection

Clostridium difficile colitis

Cardiac arrest

Death

Bronchitis

Hepatitis

Immune-mediated hepatitis

Oesophagitis

General physical health deterioration

Hypophagia

Tumour haemorrhage

Cerebrovascular accident

Syncope

Acute respiratory failure

Aspiration

Colitis

Mouth haemorrhage

Hypersensitivity

Acute myocardial infarction

Abscess neck

Device related infection

Stoma site infection

Vascular device infection

Wound infection

Hypercalcaemia

Pulmonary embolism

Respiratory failure

100%

80%

60%

40%

20%

Study treatment Arm

Pembrolizumab + CRT Followed by Pembrolizumab

Placebo + CRT Followed by Placebo

Awards & Highlights

Pivotal Trial

The final step before approval, pivotal trials feature drugs that have already shown basic safety & efficacy.

Trial Design

2Treatment groups

Experimental Treatment

Active Control

Group I: Lenvatinib plus Pembrolizumab plus TACEExperimental Treatment3 Interventions

Participants will receive a combination of lenvatinib, pembrolizumab, and TACE. Lenvatinib will be 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) orally once a day during each 21-day cycle until progressive disease or unacceptable toxicity (up to 2 years \[\~35 cycles\] or longer with Sponsor approval). Pembrolizumab will be administered via IV infusion at a dose of 400 mg once every 6 weeks (Q6W) for up to 2 years (\~17 doses). Participants will undergo TACE as a background procedure of chemotherapeutic and embolic agent(s).

Group II: Oral Placebo plus IV Placebo plus TACEActive Control3 Interventions

Participants will receive a combination of lenvatinib-matching oral placebo, pembrolizumab-matching IV placebo, and TACE. Lenvatinib-matching oral placebo will be administered once a day during each 21-day cycle for up to 2 years (\~35 cycles) or longer with Sponsor approval and pembrolizumab-matching IV placebo will be administered once every 6 weeks (Q6W) for up to 2 years (\~17 doses). Participants will undergo TACE as a background procedure of chemotherapeutic and embolic agent(s).

Treatment

First Studied

Drug Approval Stage

How many patients have taken this drug

Lenvatinib

2017

Completed Phase 4

~2070

Pembrolizumab

2017

Completed Phase 3

~3150