ClinicalTrials.gg
RecruitingNCT06828380IOPTUpdated Dec 26, 2025

A Study Comparing Immunotherapy Alone Versus Immunotherapy Combined With Radiotherapy in Patients With Hepatocellular Carcinoma (HCC) With Vascular Invasion

A Phase 2 interventional study of Particle beam radiation therapy in Advanced Hepatocellular Carcinoma (HCC), sponsored by National Cancer Center, Korea. Recruiting at 2 sites in South Korea. Open to participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2025-12-26.

Sponsored by National Cancer Center, Korea · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2025; still recruiting 1 year 6 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
128
Allocation
Randomized
Ages
19 Years and older
Sex
All
01

Study summary

In the present study, we aim to investigate the efficacy and safety of concurrent therapy of Immunotherapy based combination therapy and Radiotherapy in patients with advanced HCC showing macrovascular invasion.

02

Conditions studied

  • Advanced Hepatocellular Carcinoma (HCC)
03

In context

Carcinoma, Hepatocellular

3,648 studies on the registry are indexed under Carcinoma, Hepatocellular; 1,061 are open to participants now.

This study's planned enrollment of 128 is above the median of 54 across 2,618 interventional studies indexed under Carcinoma, Hepatocellular.

Browse Carcinoma, Hepatocellular studies →

Lead sponsor

National Cancer Center, Korea is the lead sponsor of 204 studies on the registry; 36 are open to participants now.

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

04

Who can participate

Ages eligible
19 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

  1. Signed form
  2. Age >= 19 at the time of signing Informed consent form
  3. Histological or clinical diagnosis of HCC based on the guidelines of the Korean Liver Cancer Association -National Cancer Center
  4. Unresectable and/or locally advanced or disease showing major vascular invasion

    a. Presence of major vascular invasion on dynamic CT or dynamic MRI (1+2)

    • an intraluminal filling defect adjacent to the primary tumor in portal vein, hepatic vein, and/or inferior vena cava
    • an enhancement of the filling defect on arterial phase and a on portal/delayed phases
  5. Having at least one measurable target lesion (per v1.1)

    a. Participants who received prior locoregional therapy (e.g., radiofrequency ablation, microwave ablation, transarterial chemoembolization, transarterial radioembolization, transarterial embolization, radiation therapy etc.) are eligible provided that other target lesion(s) have not been previously treated with locoregional therapy or the target lesion(s) within the field of locoregional therapy have subsequently progressed in accordance with RECIST v1.1.

  6. class A
  7. (ECOG) performance status (PS) of 0-1
  8. Adequate hematologic and end-organ function, defined by the following laboratory test results, obtained within 28 days prior to screening:

    1. ≥ 8.0 g/dL
    2. (ANC) ≥ 1,000/mm3
    3. count ≥ 50,000/μL
    4. Total \< 3.0 mg/dL
    5. Serum albumin ≥ 2.8 g/dL
    6. (ALT) and aspartate aminotransferase (AST) ≤ 5 × the (ULN)
    7. in INR ≤ 1.8 × ULN
    8. Serum creatinine ≤ 2.0 × ULN or calculated ≥ 40 mL/min (using the Cockcroft-Gault equation)
  9. Documented virology status of hepatitis, as confirmed by screening tests for and

    a. Participants with HBV or HCV infection must be treated with antiviral therapy as per institutional practice.

  10. Female participants of must agree to either remain abstinent or use effective (with a failure rate of \<1% per year) since signing of the informed consent form until at least 6 months after the last study drug administration.
  11. Male participants must agree to remain abstinent or use a condom and refrain from donating sperm since signing of the informed consent form until at least 6 months after the last study drug administration.

Exclusion criteria

Exclusion Criteria:

  1. Fibrolamellar carcinoma or sarcomatoid carcinoma
  2. Receipt of 2 or more prior systemic therapy for advanced HCC. Additional prior systemic therapies used as or local therapy are allowed.
  3. Receipt of other systemic therapy than -based regimen
  4. Receipt of prior radiation therapy to liver

    a. Participants are excluded if the potential radiation field overlaps with a previously irradiated area.

  5. Receipt of locoregional therapy for HCC within 28 days prior to initiation of study treatment or non-recovery from complications due to the procedure (radiofrequency ablation, microwave ablation, cryoablation, trans-arterial embolization including chemo- and radio-embolization, or radiation therapy).

    a. A 7-day is permitted for palliative radiation to bone lesions

  6. Active or history of disease or immune deficiency, including, but not limited to, myasthenia gravis, myositis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, antiphospholipid antibody syndrome, Wegener granulomatosis, or multiple sclerosis with following exceptions:

    1. Patients with hypothyroidism stable on hormone replacement
    2. Controlled type 1 diabetes mellitus and on an insulin regimen
    3. Any chronic skin condition that does not require systemic therapy
  7. Prior allogeneic stem cell or solid organ transplantation
  8. Any condition requiring systemic treatment with either (> 10 mg daily prednisone equivalent) or other medications within 14 days prior to initiation of study treatment
  9. History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins
  10. Having active or
  11. Moderate to severe or intractable ascites
  12. Presence of hepatic encephalopathy
  13. History of other than HCC within 2 years prior to screening, with the exception of malignancies with a negligible risk of or death (e.g., 5-year OS rate >90%)
  14. Uncontrolled severe medical comorbidities, including significant cardiovascular disease (such as Class II or greater cardiac disease, myocardial infarction, or cerebrovascular accident) within 3 months prior to the initiation of study treatment, unstable arrhythmia, or unstable angina or any significant medical illness or abnormal laboratory findings that, in the investigator's judgement, would increase the risk to the participant associated with study participation
  15. Female participants who are pregnant or breastfeeding or male or female participants of who are not willing to employ effective from screening to 6 months after the last study drug administration
  16. Judgment by the investigator that the participant should not participate in the study if the participant is unlikely to comply with study procedures, restrictions, and requirements
Terms in these criteria, in plain language(29)

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.

Metastases

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

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

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.

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

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.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

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.

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.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Factorial assignment
Masking
None (open label)
Enrollment
128 participants (estimated)

Study arms

  • Experimental
    Arm A

    concurrent therapy of Immunotherapy based combination therapy and Proton beam radiation therapy

    Radiation: Particle beam radiation therapy

  • No intervention
    Arm B

    concurrent therapy of Immunotherapy based combination therapy

Interventions

  • RadiationParticle beam radiation therapy

    The prescribed dose and fractionation for proton therapy to the PTV will be determined by the physician, taking into account the dose-volume constraints of normal tissues such as the liver and bowel.

06

What researchers measure

Primary outcomes

  1. PFS (Progression-free survival)

    PFS is defined as the time from the date of treatment initiation to the date of the first observation of progressive disease (PD) by the investigator according to RECIST v1.1 criteria or death from any cause.

    Time frame: up to approximately 3 years

Secondary outcomes

  1. OS(overall survival)

    OS is defined as the time from the date of treatment initiation to the date of death from any cause.

    Time frame: up to approximately 3 years

  2. TTP(Time to progression)

    TTP is defined as the time from the date of treatment initiation to the date of the first observation of PD by the investigator according to RECIST v1.1 criteria.

    Time frame: up to approximately 3 years

  3. ORR(Objective response rate)

    ORR is defined as the proportion of participants whose best overall response is CR or PR as determined by the investigator according to RECIST v1.1 criteria.

    Time frame: up to approximately 3 years

  4. DCR(Disease control rate)

    DCR is defined as the proportion of participants whose best overall response is a CR, PR, or SD as determined by the investigator according to RECIST v1.1 criteria.

    Time frame: up to approximately 3 years

  5. DoR(Duration of response)

    DoR is defined as the time interval from the date of the first occurrence of a documented objective response (CR or PR, whichever occurs first) until the first date that disease progression or death is documented, whichever occurs first.

    Time frame: up to approximately 3 years

  6. TTR(Time to response)

    TTR is defined as the time from the date of treatment initiation to the date of the first observation of a documented objective response (CR or PR, whichever occurs first).

    Time frame: up to approximately 3 years

07

Study locations

2 of 2 sites recruiting
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 26, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06828380
Responsible party
Bo Hyun Kim (Principal Investigator, National Cancer Center, Korea) — Principal investigator
First posted
Feb 14, 2025
Start date
Apr 15, 2025
Primary completion
Aug 6, 2028 (estimated)
Completion
Aug 6, 2028 (estimated)
Last update
Dec 26, 2025

Study contacts

Yumi Yang
Contact
75427@ncc.re.kr
+82-10-3134-9044

Oversight

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

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