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RecruitingNCT06265350Updated Feb 20, 2024

Cryoablation Combined With Cardonilizumab and Bevacizumab in Hepatocellular Carcinoma With Pulmonary Metastases

An interventional study of Cadonilimab and Bevacizumab in Hepatocellular Carcinoma, Liver Cancer Stage IV and Pulmonary Metastases, sponsored by Sun Yat-sen University. Recruiting at 2 sites in China. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2024-02-20.

Sponsored by Sun Yat-sen University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jan 2026, 8 months ago, but the record still lists the study as recruiting.
  • Started Feb 2024; still recruiting 2 years 8 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

This study intends to evaluate the efficacy and safety of cryoablation combined with Cardonilizumab and Bevacizumab in hepatocellular carcinoma with pulmonary metastases.

Read the detailed description

For advanced hepatocellular carcinoma (HCC), the lung is the most common metastatic organ, accounting for 30-50% of extrahepatic diseases. The standard therapy for advanced HCC with lung metastases according to the Barcelona Clinic Liver Cancer (BCLC) criteria is system therapy.

However, studies have proven that palliative ablation could improve the tumor controlling effect and the outcomes.

Cryoablation is a treatment method that involves freezing tumors at extremely low temperatures to destroy and eliminate them. This therapeutic approach can result in the death of tumor cells through necrosis and also stimulate immune targeting of tumor cells. These immune responses occur as a result of tumor cell death caused by the ablation procedure. In comparison to conventional cancer therapies, cryoablation has minimal adverse reactions and has the potential to promote a more extensive and effective release of self-generated antigens into the bloodstream.

Targeting vascular endothelial growth factor (VEGF) could reduce VEGF-mediated immunosuppression within the tumor. The IMbrave150 study of atezolizumab and bevacizumab versus sorafenib demonstrated response rates of 29.8% vs 12%, respectively, and median overall survival of 19.8 months in the combination arm versus 13.4 months in the sorafenib (P \<0.001). Bevacizumab could enhance anti-PD-1 and anti-programmed death ligand 1 (PD-L1) efficacy by reversing VEGF-mediated immunosuppression and promoting T-cell infiltration in tumors (2).

Cadonilimab is a first-in-class bispecific, humanized IgG1 antibody targeting PD-1 and CTLA-4, which has the potential to boost immune surveillance in tumors. Preclinical studies have shown that its tetravalent design enhances its high binding activity in the tumor microenvironment. With no Fc binding, Cadonilimab could eliminate a series of functions mediated by the Fc receptor, which contribute to a poor safety profile in clinical settings.

02

Conditions studied

  • Hepatocellular Carcinoma
  • Liver Cancer Stage IV
  • Pulmonary Metastases
  • Cadonilimab
  • Bevacizumab
  • Cryoablation
03

In context

Carcinoma

6,741 studies on the registry are indexed under Carcinoma; 1,161 are open to participants now.

This study's planned enrollment of 80 is above the median of 45 across 5,170 interventional studies indexed under Carcinoma.

Browse Carcinoma studies →

Lead sponsor

Sun Yat-sen University is the lead sponsor of 1,644 studies on the registry; 602 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. primary or recurrent HCC;
  2. synchronous metastases (within one month after diagnosing of HCC) or asynchronous metastases (more than one month after diagnosis of HCC);
  3. pulmonary-only metastases >5 and ≤10;
  4. metastases diameter ≤ 5 cm;
  5. intrahepatic tumors ≤5, and tumor burden ≤1/2 liver volume;
  6. PVTT type Vp≤3;
  7. patients underwent first-line system therapy failure, the first-line system included tyrosine kinase inhibitor (TKI), such as Sorafenib or Lenvatinib, with or without PD-1 or PDL1 inhibitor;
  8. the intrahepatic tumors were effectively controlled and pulmonary metastases were no progression, and the controlled intrahepatic tumors were defined as partial or stable response according to modified Response Evaluation Criteria in Solid Tumors (mRECIST);
  9. locoregional therapy (including TACE or HAIC) were also included;
  10. Child-Pugh class A or B;
  11. PS 0 or 1;
  12. no history of other malignancies.

Exclusion criteria

Exclusion Criteria:

  1. under 18 years or over 75 years;
  2. metastases >10
  3. non-lung metastases;
  4. incomplete clinical data;
  5. metastases diameter > 5 cm;
  6. intrahepatic tumors > 5, and tumor burden > 1/2 liver volume;
  7. PVTT type Vp 4;
  8. lost to follow-up within 3 months.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
80 participants (estimated)

Study arms

  • Active comparator
    Bevacizumab+Cadonilimab group

    Patients accepted Bevacizumab (7.5mg/kg,Q3W, IV) plus Cadonilimab (375mg,Q3W, IV)

    Drug: Cadonilimab · Drug: Bevacizumab

  • Experimental
    Cryoablation+Bevacizumab+Cadonilimab

    Patients accepted Cryoablation of pulmanary metastases combined with Bevacizumab (7.5mg/kg,Q3W, IV) and Cadonilimab (375mg,Q3W, IV)

    Drug: Cadonilimab · Drug: Bevacizumab · Procedure: Cryoablation

Interventions

  • DrugCadonilimab

    Cadonilimab, 375mg,Q3W, IV

  • DrugBevacizumab

    Bevacizumab, 7.5mg/kg,Q3W, IV

  • ProcedureCryoablation

    Patients accepted Cryoablation of pulmanary metastases

06

What researchers measure

Primary outcomes

  1. Objective response rate (ORR)

    ORR, as determined based on tumor response according to RECIST 1.1, is defined as partial response and complete response.

    Time frame: 6 months

Secondary outcomes

  1. Progression free survival (PFS)

    PFS is defined as the time from the date of inclusion to the date of the first objectively documented tumor progression or death due to any cause.

    Time frame: 6 months

  2. Overall survival (OS)

    OS is the length of time from the date of inclusion until death from any cause.

    Time frame: 12 months

07

Study locations

2 of 2 sites recruiting
  • Sun Yat-sen University Cancer Center
    Guanzhou, Guangdong 510000, China
    Recruiting
  • Sun Yat-sen University Cancer Center
    Guanzhou, Guangdong 510000, China
    Recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 20, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06265350
Lead sponsor
Sun Yat-sen University
Responsible party
Zhou Qunfang (Clinical Professor, Sun Yat-sen University) — Principal investigator
First posted
Feb 20, 2024
Start date
Feb 2, 2024
Primary completion
Jan 30, 2026 (estimated)
Completion
Jan 30, 2027 (estimated)
Last update
Feb 20, 2024

Study contacts

Qunfang Zhou, MD
Contact
zhouqun988509@163.com
86 19868000115
Zhimei Hunag, MD
study director · Sun Yat-sen University
Jinhua Huang, MD
study director · Sun Yat-sen University

Oversight

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

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