ClinicalTrials.gg
Not yet recruitingNCT07269158Updated Dec 8, 2025

A Phase IIb Randomized Clinical Trial of Immune Checkpoint Inhibitor-based Maintenance Therapy in Patients With Advanced Biliary Tract Cancer

A Phase 1/2 interventional study of Durvalumab or Pembrolizumab and Durvalumab or Pembrolizumab + Levnatinib in Biliary Tract Neoplasms, Advanced Cancer and Immunotherapy, sponsored by Yonsei University. Not yet recruiting at 1 site in South Korea. Open to participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2025-12-08.

Sponsored by Yonsei University · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
19 Years and older
Sex
All
01

Study summary

"Biliary tract cancer (BTC) is a rare malignancy with a poor prognosis. Most patients present with unresectable disease, and even after curative-intent resection, recurrence is common. Since the ABC-02 trial, gemcitabine plus cisplatin (Gem/Cis) has been established as the standard first-line regimen, but the median overall survival (OS) remains approximately 11.7 months. Recent studies combining immune checkpoint inhibitors (ICIs) such as durvalumab or pembrolizumab with Gem/Cis have improved OS to 12.7-12.9 months, establishing ICI-based combination therapy as the new standard. However, the optimal maintenance therapy following initial chemoimmunotherapy remains undefined.

This phase IIb study enrolls patients with advanced BTC who achieved disease control after at least eight cycles of Gem/Cis plus ICI. The trial compares the efficacy and safety of ICI monotherapy maintenance versus ICI in combination with lenvatinib, venadaparib, or interleukin-2 (IL-2, SLC-3010).

Lenvatinib, through inhibition of FGFR2 and modulation of the tumor immune microenvironment, is expected to enhance ICI efficacy. PARP inhibitors may be beneficial in patients with homologous recombination deficiency (HRD) or platinum-sensitive disease. Additionally, IL-2 can activate tumor-infiltrating lymphocytes and alleviate the immunosuppressive microenvironment, potentially augmenting ICI responsiveness.

This study aims to explore a novel maintenance strategy integrating molecular targeted therapy, DNA damage repair modulation, and cytokine-based immunotherapy to overcome the limitations of current ICI monotherapy in BTC. The combination approach is expected to improve disease control and survival outcomes in patients with advanced BTC.

Read the detailed description

This phase IIb randomized trial assesses the efficacy and safety of immune checkpoint inhibitor (ICI) monotherapy versus ICI-based combination maintenance therapy with lenvatinib, venadaparib, or SLC-3010 in advanced biliary tract cancer. Durvalumab (q4w) or pembrolizumab (q3w) serve as backbone ICIs. For each group, Lenvatinib is given orally once daily, venadaparib orally, or SLC-3010 as a 60-minute IV infusion. Recommended phase II doses will be established via a 3+3 dose-escalation design, with toxicity management per NCI-CTCAE v5.0.

02

Conditions studied

  • Biliary Tract Neoplasms
  • Advanced Cancer
  • Immunotherapy

Keywords

  • Biliary Tract Neoplasms [including Intrahepatic Cholangiocarcinoma, Extrahepatic Cholangiocarcinoma, and Gallbladder Neoplasms]
03

In context

Biliary Tract Neoplasms

519 studies on the registry are indexed under Biliary Tract Neoplasms; 199 are open to participants now.

This study's planned enrollment of 160 is above the median of 58 across 427 interventional studies indexed under Biliary Tract Neoplasms.

Browse Biliary Tract Neoplasms studies →

Lead sponsor

Yonsei University is the lead sponsor of 1,418 studies on the registry; 241 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

-Patients with advanced biliary tract cancer who have completed at least 8 cycles of Durvalumab plus Gemcitabine and Cisplatin treatment without radiologic evidence of disease progression, and are planned to receive Durvalumab maintenance therapy.

(Patients treated with Pembrolizumab plus Gemcitabine/Cisplatin are also eligible if they are to continue Pembrolizumab monotherapy without Gemcitabine as maintenance therapy.)

  • Patients who are 20 years of age or older at the time of signing the form.
  • Patients with confirmed biliary tract cancer, including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, or gallbladder carcinoma.

(Patients with neuroendocrine tumors or sarcomas are excluded.)

  • Patients who are willing and able to provide written informed consent for participation in the study.
  • Patients with according to version 1.1.
  • performance status of 0 or 1.
  • Estimated ≥ 3 months.
  • Patients with adequate organ and bone marrow function, without transfusion or administration of hematopoietic growth factors (e.g., G-CSF) within 2 weeks prior to treatment initiation, defined as follows:
  • ≥ 9.0 g/dL
  • (ANC) ≥ 1.5 × 10⁹/L
  • count ≥ 75 × 10⁹/L
  • Serum creatinine ≤ 1.5 × (ULN), or estimated ≥ 45 mL/min (calculated using the Cockcroft-Gault formula; see Appendix 7)
  • and ALT ≤ 3.0 × ULN (≤ 5.0 × ULN if liver are present)
  • Total ≤ 2.0 × ULN (≤ 3.0 × ULN for patients with Gilbert's syndrome)
  • (INR) ≤ 1.5 or prothrombin time ≤ 1.5 × ULN
  • Activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN
  • Women of must agree to use highly effective during the entire study period and for at least 6 months after the last dose of product, and must have a negative serum pregnancy test within 14 days prior to first dose.
  • Male patients who have not undergone sterilization must agree to use highly effective contraception during the entire study period and for at least 120 days after the last dose of investigational product.
  • Patients who are willing to provide tumor tissue samples obtained by endoscopic or excisional biopsy.
  • Patients who are able to understand and comply with the study procedures and are considered likely to complete the study by the investigator.

Exclusion criteria

Exclusion Criteria:

  1. Patients who have received more than 10 cycles of (ICI) plus Gemcitabine and Cisplatin combination therapy for advanced biliary tract cancer.
  2. Patients who have been treated for, or have evidence of recurrence or progression of, any other than biliary tract cancer within the past 3 years.

    Exceptions: Patients who have been disease-free for ≥3 years after curative treatment, or patients with the following malignancies are not excluded: basal cell carcinoma of the skin, Stage I squamous cell carcinoma of the skin, carcinoma in situ, intramucosal carcinoma, or superficial bladder carcinoma.

  3. Patients with residual adverse events from prior therapy or surgery that may interfere with the safety evaluation of the product.
  4. Patients with a history of to any component of monoclonal antibody products.
  5. Patients with a history or evidence of active, non-infectious interstitial lung disease (pneumonitis).
  6. Patients with symptomatic or clinically active brain or requiring treatment.

    (Patients with asymptomatic, stable, and untreated may be enrolled.)

  7. Patients who are immunodeficient or are receiving systemic or other therapy within 7 days prior to the first dose of the investigational product.

    (Physiologic doses of corticosteroids, such as for acute asthma exacerbation, may be allowed after consultation with the principal investigator.)

  8. Patients with uncontrolled or significant cardiovascular disease, defined as any of the following:

    • Myocardial infarction within 180 days prior to randomization
    • Uncontrolled angina within 180 days prior to randomization
    • Congestive heart failure classified as (NYHA) Class III or IV
    • Uncontrolled hypertension despite appropriate therapy (systolic ≥150 mmHg or diastolic ≥90 mmHg for >24 hours)
    • arrhythmia requiring treatment
  9. Patients with severe chronic infections or active infections, including active or previously known tuberculosis.
  10. Patients with active disease that has required systemic treatment (e.g., disease-modifying agents, corticosteroids, or immunosuppressants) within the past 2 years.

    (Replacement therapy, such as thyroxine, insulin, or physiologic corticosteroid replacement for adrenal or pituitary insufficiency, is not considered systemic treatment.)

  11. Patients who have received any anticancer therapy other than immune checkpoint inhibitor + Gemcitabine + Cisplatin combination therapy for biliary tract cancer.

    ( chemotherapy completed ≥6 months before study drug initiation is permitted.)

  12. Patients who have undergone major surgery under general anesthesia within 28 days or minor/local surgery within 14 days before the start of study treatment.

    (Diagnostic procedures such as laparoscopic may be allowed upon investigator's discretion.)

  13. Patients who, in the opinion of the investigator, have any condition, treatment, active or ongoing symptomatic infection, or abnormal laboratory finding that could confound study results, interfere with study participation, or pose undue risk to the patient.
  14. Patients with a known history of psychiatric disorders or substance abuse that may interfere with compliance to study requirements.
  15. Patients with a known history of (HIV-1/2) infection.
  16. Patients with active (HBsAg-positive and HBV DNA detected) or active (anti-HCV positive with detectable HCV RNA).

    Exception: Patients with inactive or asymptomatic HBV carriers, chronic HBV infection, or non-active HCV infection are eligible if HBV DNA \< 500 IU/mL (or \< 2500 copies/mL) at screening.

  17. Pregnant or breastfeeding women.
  18. Patients who have received any unapproved or investigational drug, combination product, or formulation within 28 days prior to the start of study treatment.
  19. Any other condition that, in the opinion of the investigator, makes the patient unsuitable for participation in this clinical study.
Terms in these criteria, in plain language(33)

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.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

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.

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.

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.

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.

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.

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.

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.

Metastases

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

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.

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.

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.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

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.

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.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

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.

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.

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.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

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.

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.

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.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
160 participants (estimated)

Study arms

  • Experimental
    Immunotherapy Maintenance

    Durvalumab or Pembrolizumab

    Drug: Durvalumab or Pembrolizumab

  • Active comparator
    Immunotherapy Maintenance + Lenvatinib

    Durvalumab or Pembrolizumab + Levnatinib

    Drug: Durvalumab or Pembrolizumab + Levnatinib

  • Active comparator
    Immunotherapy Maintenance + Venadaparib

    Durvalumab or Pembrolizumab + Venadaparib

    Drug: Durvalumab or Pembrolizumab + Venadaparib

  • Active comparator
    Immunotherapy Maintenance + SCL-3010

    Durvalumab or Pembrolizumab + SCL-3010

    Drug: Durvalumab or Pembrolizumab + SCL-3010

Interventions

  • DrugDurvalumab or Pembrolizumab

    Phase 2 Durvalumab 1500mg IV D1, q 4weeks or Pembrolizumab 200mg IV D1, q 3weeks

  • DrugDurvalumab or Pembrolizumab + Levnatinib

    Durvalumab 1500mg IV D1, q 4weeks or Pembrolizumab 200mg IV D1, q 3weeks Lenvatinib 12mg (≥60 kg) PO q 1cycle or 8mg (\<60 kg) PO q 1cycle

  • DrugDurvalumab or Pembrolizumab + Venadaparib

    Durvalumab or Pembrolizumab + Venadaparib

  • DrugDurvalumab or Pembrolizumab + SCL-3010

    Durvalumab or Pembrolizumab + SCL-3010

This study also gives Pembrolizumab, Lenvatinib, Durvalumab. No intervention listed here names it: that was found by reading the record.

06

What researchers measure

Primary outcomes

  1. Phase Ib: Recommended Phase II Dose

    Recommended Phase II Dose decided during DLT periods

    Time frame: Up to 4 years

  2. Phase II: Progression Free Survival(PFS)

    Progression-free survival (PFS) is the length of time from the start of treatment until the disease progresses or the patient dies from any cause, whichever occurs first.

    Time frame: Up to 4 years

Secondary outcomes

  1. Objective response rate, ORR

    Objective response rate (ORR) is the proportion of patients achieving complete response (CR) or partial response (PR) per RECIST 1.1.

    Time frame: Up to 4 years

  2. Overall Survival, OS

    Overall survival (OS) is defined as the time interval from cycle 1 day 1 to death from any cause or last follow-up.

    Time frame: Up to 4 years

  3. Disease Control Rate, DCR

    Disease control rate (DCR) is the proportion of patients with CR, PR, or stable disease (SD) per RECIST 1.1.

    Time frame: Up to 4 years

  4. Duration of Response, DOR

    Duration of response (DOR) is defined as the time interval from the first documented response (CR or PR) per RECIST 1.1 to tumor progression, death, or last follow-up.

    Time frame: Up to 4 years

  5. Number of participants with treatment-related adverse events as assessed by CTCAE v5.0

    Safety per NCI CTCAE v5.0 (Number of participants with treatment-related adverse events as assessed by CTCAE v5.0)

    Time frame: Up to 4 years

  6. Quality of life (QoL) determined by EORTC QLQ-C30

    QoL determined by EORTC QLQ-C30

    Time frame: Up to 4 years

  7. Quality of life (QoL)

    QoL determined by EORTC QLQ-BIL21.

    Time frame: Up to 4 years

07

Study locations

1 site
08

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

Start is estimated for Dec 2025; primary completion for Sep 2029, 45 months later.

Of 48 phase 1/2 interventional studies under Biliary Tract Neoplasms, half reached primary completion within 60 months of starting (the median), counting those still running; a quarter within 33 and three quarters within 68. This study's planned 45 months is below that.

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

Registered
Nov 14, 2025
First posted
Dec 8, 2025
StartEst.
Dec 2025
Primary completionEst.
Sep 2029
CompletionEst.
Sep 2029
Last update
Dec 8, 2025
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 Dec 8, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07269158
Lead sponsor
Yonsei University
Responsible party
Sponsor
First posted
Dec 8, 2025
Start date
Dec 2025 (estimated)
Primary completion
Sep 2029 (estimated)
Completion
Sep 2029 (estimated)
Last update
Dec 8, 2025

Oversight

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

Not currently enrolling

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drugs tested here: Pembrolizumab · Lenvatinib

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