ClinicalTrials.gg
CompletedNCT03347292Updated Jul 25, 2023

Regorafenib Plus Pembrolizumab in First Line Systemic Treatment of HCC

A Phase 1 interventional study of Regorafenib(Stivarga, BAY73-4506) and Pembrolizumab in Carcinoma, Hepatocellular, sponsored by Bayer. Completed at 7 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-07-25.

Sponsored by Bayer · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Primary completion was Dec 2020, 5 years 10 months ago, and no results have been posted to the registry.

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Phase
Phase 1
Study type
Interventional
Enrollment
58
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 22 studies testing regorafenib in Carcinoma, Hepatocellular — 7 open to participants now, 9 under way, none of them phase 3. regorafenib · Carcinoma, Hepatocellular.

Enrollment
7th of 22
58 · median 33
Started
2018
with 1 other
Phase 1
Only one
of the 22
Registered
3rd of 22
by date
Lead sponsor
5 of 22
Bayer

Among the 22 studies testing regorafenib in Carcinoma, Hepatocellular, this one is the 7th largest by enrollment, is one of 2 that started in 2018, is the only one in phase 1, and was the 3rd registered.

Carcinoma, Hepatocellular

3,650 studies on the registry are indexed under Carcinoma, Hepatocellular; 1,062 are open to participants now.

Browse Carcinoma, Hepatocellular studies →

Open to participants now

7 of the 22 studies testing regorafenib in Carcinoma, Hepatocellular are open now, in 4 countries. Recruiting first, the newest first:

2 more — sign in →

By country, each count listing its studies:

All 7 open studies →

About regorafenib

regorafenib: first FDA approval 2012 (STIVARGA), first EMA approval 2013. What it is approved for, and how studies give it, is on its page →

Who these studies take

Of the 737 Carcinoma, Hepatocellular studies recruiting now, 382 (52%) set no upper age limit and 249 (34%) stop at 75 or younger; 31 take children under 18; 31 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

The full table on the hub →

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 22 studies testing regorafenib in Carcinoma, Hepatocellular, or all of them as a file.
02

Study summary

This study will determine if the combination of regorafenib and pembrolizumab is safe and tolerated in patients with advanced liver cancer. In addition, the study will explore the anti-tumor activity of this combination as well as potentially identifying blood and tissue biomarkers associated with disease activity, status or response. The study will also investigate how the drugs behave in your body

03

Conditions studied

  • Carcinoma, Hepatocellular

Keywords

  • Liver cell carcinoma
  • Liver cancer
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male or female patients ≥ 18 years of age on day of signing .
  • Histological or cytological confirmation of HCC (hepatocellular carcinoma) or non-invasive diagnosis of HCC as per American Association for the Study of Liver Diseases (AASLD) criteria in patients with a confirmed diagnosis of cirrhosis.
  • Barcelona Clinic Liver Cancer (BCLC) stage B or C that cannot benefit from treatments of established efficacy such as resection, local ablation, chemoembolization.
  • Liver function status (CP) Class A. CP status should be calculated based on clinical findings and laboratory results during the screening period.
  • Any local or loco-regional therapy of intrahepatic tumor lesions (e.g. surgery, radiation therapy, hepatic arterial embolization, chemoembolization, radiofrequency ablation, percutaneous ethanol injection, or cryoablation) must have been completed ≥ 4 weeks before first dose of study medication. Note: patients who received sole intrahepatic intra-arterial chemotherapy, without lipiodol or embolizing agents are not eligible.
  • Performance Status (ECOG PS) of 0 or 1.
  • At least one uni-dimensional by computed tomography (CT) scan or magnetic resonance imaging (MRI) according to (RECIST version 1.1) and no older than 28 days before start of the study treatment. Tumor lesions situated in a previously irradiated area, or in an area subjected to other loco-regional therapy, may be considered measurable if there has been demonstrated progression in the lesion.
  • of at least 3 months.
  • Adequate bone marrow and organ function as assessed by the laboratory tests performed within 7 days before of treatment initiation.
  • For patients recruited in the expansion cohort only, provision of archival (block) or fresh tumor tissue samples at baseline is mandatory. If is not available, patients should be willing to undergo a biopsy for provision of fresh tumor samples

Exclusion criteria

Exclusion Criteria:

  • Prior systemic therapy for HCC; prior exposure to regorafenib.
  • Previous treatment with a programmed death 1 (PD1), programmed death-ligand (), or cytotoxicT-lymphocyte-associated protein 4 (CTLA-4) inhibitors, or any form of immunotherapy for HCC.
  • Previous treatment with within 30 days of planned start of study drugs (seasonal flu vaccines that do not contain a live virus are permitted).
  • Active disease (active defined as having autoimmune disease related symptoms and detectable autoantibodies) that has required systemic treatment in the past 2 years (i.e., with use of diseasemodifying agents, , or drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  • Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drugs. The use of physiologic doses of corticosteroids may be approved after consultation with the Sponsor.
  • Known history of (HIV) infection (HIV 1/2 antibodies).
  • Dual active infection (HBsAg (+) and /or detectable HBV DNA) and infection (anti-HCV Ab(+) and detectable HCV RNA) at study entry.
  • Pleural effusion or ascites that causes respiratory compromise (≥ Grade 2 dyspnea).
  • Known history of brain or meningeal tumors.
  • Significant acute gastrointestinal disorders with diarrhea as a major symptom e.g., Crohn's disease,malabsorption, or CTCAE Grade ≥ 2 diarrhea of any etiology.
Terms in these criteria, in plain language(17)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
58 participants (actual)

Study arms

  • Experimental
    Dose escalation

    The regorafenib starting dose will be 120 mg q.d.(once daily) 3 weeks on / 1 week off in combination with the recommended dose of pembrolizumab (200 mg Q3W). Pembrolizumab dose will not be escalated or de-escalated.

    Drug: Regorafenib(Stivarga, BAY73-4506) · Drug: Pembrolizumab

  • Experimental
    Dose expansion

    Dose expansion cohorts will continue to be expanded until the sample size of 30-35 patients per cohort is reached.

    Drug: Regorafenib(Stivarga, BAY73-4506) · Drug: Pembrolizumab

Interventions

  • Regorafenib 80mg/120mg/160mg q.d., 3 weeks on / 1 week off + pembrolizumab 200mg i.v. every 3 weeks

  • 200 mg i.v.(Intravenous(ly)) every 3 weeks (Q3W). This dose will not be escalated or deescalated and the dosing schedule will not be changed

06

What researchers measure

Primary outcomes

  1. Incidence of treatment-emergent adverse event(TEAEs)

    The incidence of treatment-emergent adverse events and treatment-emergent drug-related adverse events summarized in frequency tables using worst CTCAE v4.03 grade.

    Time frame: Up to 30 days after last dose of study drug

  2. Severity of TEAEs

    Time frame: Up to 30 days after last dose of study drug

  3. Dose Limiting Toxicities(DLTs)

    Time frame: Up to 42 days after first treatment administration

Secondary outcomes

  1. Maximum Tolerated Dose (MTD)

    The MTD is defined as the highest dose that can be given so that toxicity probability is below the target toxicity PT =35%.

    Time frame: After approximately 18 months

  2. Progression-free survival (PFS)

    Time frame: After approximately 36 months

  3. Time to progression (TTP)

    Time frame: After approximately 36 months

  4. Overall survival (OS)

    Time frame: After approximately 36 months

  5. Overall response rate (ORR)

    Time frame: After approximately 36 months

  6. Disease control rate (DCR)

    Time frame: After approximately 36 months

  7. Duration of response (DOR)

    Time frame: After approximately 36 months

  8. Duration of stable disease

    Time frame: After approximately 36 months

07

Study locations

7 sites
  • USC Norris Hospital and Clinics
    Los Angeles, California 90033, United States
  • University of Florida Health Sciences Center
    Gainesville, Florida 32608, United States
  • H. Lee Moffitt Cancer Center & Research Institute
    Tampa, Florida 33612, United States
  • Mount Sinai Medical Center
    New York, New York 10029, United States
  • Seattle Cancer Care Alliance
    Seattle, Washington 98109-1023, United States
  • Universitätsklinikum Köln
    Köln, Nordrhein-Westfalen 50937, Germany
  • Universitätsmedizin der Johannes Gutenberg Universität Mainz
    Mainz, Rheinland-Pfalz 55131, Germany
08

References and documents

Individual participant data

Plan to share: No — Availability of this study's data will later be determined according to Bayer's commitment to the EFPIA/PhRMA "Principles for responsible clinical trial data sharing". This pertains to scope, timepoint and process of data access. As such, Bayer commits to sharing upon request from qualified researchers patient-level clinical trial data, study-level clinical trial data, and protocols from clinical trials in patients for medicines and indications approved in the US and EU as necessary for conducting legitimate research. This applies to data on new medicines and indications that have been approved by the EU and US regulatory agencies on or after January 01, 2014. Interested researchers can use www.vivli.org to request access to anonymized patient-level data and supporting documents from clinical studies to conduct research. Information on the Bayer criteria for listing studies and other relevant information is provided in the member section of the portal.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jun 2018 to primary completion in Dec 2020, 29 months.

Of 103 industry-sponsored phase 1 interventional studies under Carcinoma, Hepatocellular, half reached primary completion within 47 months of starting (the median), counting those still running; a quarter within 29 and three quarters within 65. This study's 29 months is below that.

Counting every sponsor, half of 248 studies reached it within 49 months; a quarter within 32 and three quarters within 77.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 16, 2017
First posted
Nov 20, 2017
StartActual
Jun 18, 2018
Primary completionActual
Dec 17, 2020
CompletionActual
Sep 6, 2022
Last update
Jul 25, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 25, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03347292
Lead sponsor
Bayer
Responsible party
Sponsor
First posted
Nov 20, 2017
Start date
Jun 18, 2018
Primary completion
Dec 17, 2020
Completion
Sep 6, 2022
Last update
Jul 25, 2023

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jul 2023. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Regorafenib

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