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RecruitingNCT07417397Updated Feb 18, 2026

Adjuvant TACE in HCC With High-risk Recurrence Factors

A Phase 3 interventional study of Adjuvant transarterial chemoembolization and Intensive follow-up in Hepatocellular Carcinoma, Adjuvant and Transarterial Chemoembolization, sponsored by Guangxi Medical University. Recruiting at 1 site in China. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-02-18.

Sponsored by Guangxi Medical University · Phase 3, Interventional, and Prevention

Phase
Phase 3
Study type
Interventional
Enrollment
442
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

The 5-year recurrence rate after curative hepatectomy of hepatocellular carcinoma (HCC) remains as high as 70%. According to the Chinese Liver Cancer Staging (CNLC), transarterial chemoembolization (TACE) is strongly recommended as an adjuvant therapy after curative hepatectomy, aiming to reduce postoperative recurrence and ultimately improve overall survival. However, the effectiveness of such adjuvant postoperative therapy remains controversial. In contrast, guidelines from other countries or regions do not recommend adjuvant TACE after curative hepatectomy. This discrepancy may stem from the fact that adjuvant TACE primarily serves to detect intrahepatic residual lesions via digital subtraction angiography, rather than exerting preventive or therapeutic effects through the embolic agents or chemotherapeutic drugs themselves. This study will evaluate the impact of adjuvant TACE on recurrence-free survival in HCC patients with high-risk recurrence factors who have undergone curative hepatectomy. This study is a Phase III randomized controlled trial in which a total of 442 eligible participants will be randomized in a 1:1 ratio to either the adjuvant TACE group or the intensive follow-up group. The two groups will be compared with respect to recurrence-free survival, overall survival, incidence of treatment-related adverse events and serious adverse events, incidence of treatment discontinuation due to treatment-related adverse events or serious adverse events, median recurrence-free survival, and time to recurrence.

02

Conditions studied

  • Hepatocellular Carcinoma
  • Adjuvant
  • Transarterial Chemoembolization

Keywords

  • transarterial chemoembolization
  • hepatocellular carcinoma
  • adjuvant
03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1 at enrollment;
  • Child-Pugh class A or B7 (score 5-7);
  • having undergone radical hepatic resection at one of the study centers;
  • histopathologically confirmed HCC;
  • undergo hepatic angiography 4-8 weeks after surgery, with confirmation of no intrahepatic tumor staining;
  • have no prior systemic anti-tumor therapy for HCC;
  • have adequate organ and bone marrow function;
  • estimated life expectancy >6 months;
  • present with at least one high-risk factor for recurrence (such as tumor rupture; maximum tumor diameter >5 cm; multifocal tumors; microvascular invasion on postoperative pathology; Vp1/Vp2 portal vein invasion; lymph node metastasis confirmed by postoperative pathology; positive or narrow surgical margin; and Edmondson grade Ⅲ-Ⅳ differentiation).

Exclusion criteria

Exclusion Criteria:

  • absence of pathological confirmation of HCC;
  • diagnosis of other malignancies within the 5 years prior to enrollment;
  • a history of hepatic encephalopathy, liver transplantation, pleural effusion, ascites, or pericardial effusion with clinical symptoms after curative hepatectomy, as well as a history of drug allergy, active pulmonary tuberculosis, active syphilis infection, autoimmune disease, or long-term glucocorticoid use;
  • participants who have experienced severe infections within 4 weeks before the first dose, or who have previously received systemic anti-tumor therapy;
  • pregnant or lactating women are ineligible for participation;
  • participants who are unable to comply with the treatment regimen or complete the follow-up requirements.
04

Study design

Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
442 participants (estimated)

Study arms

  • Experimental
    Adjuvant transarterial chemoembolization

    For patients in the adjuvant TACE group, after superselective catheterization near the hepatic resection margin, embolization will be performed using an emulsion of 50 mg lobaplatin and 3-5 mL ethiodized poppyseed oil. This chemotherapeutic regimen is adopted from previous RCTs that showed adjuvant TACE significantly reduces postoperative HCC recurrence. The use of polyvinyl alcohol embolic microspheres is not part of the standard adjuvant TACE protocol. In the intensive follow-up group, hepatic arteriography will be performed without subsequent administration of embolic agents or chemotherapeutic drugs. Post-procedure, the catheter and arterial sheath will be removed, with compression applied to the puncture site for hemostasis. The intervention group will receive adjuvant TACE only once.

    Drug: Adjuvant transarterial chemoembolization

  • Active comparator
    Intensive follow-up

    The patients will receive intensive follow-up.

    Other: Intensive follow-up

Interventions

  • DrugAdjuvant transarterial chemoembolization

    For patients in the adjuvant TACE group, after superselective catheterization near the hepatic resection margin, embolization will be performed using an emulsion of 50 mg lobaplatin and 3-5 mL ethiodized poppyseed oil. This chemotherapeutic regimen is adopted from previous RCTs that showed adjuvant TACE significantly reduces postoperative HCC recurrence. The use of polyvinyl alcohol embolic microspheres is not part of the standard adjuvant TACE protocol. In the intensive follow-up group, hepatic arteriography will be performed without subsequent administration of embolic agents or chemotherapeutic drugs. Post-procedure, the catheter and arterial sheath will be removed, with compression applied to the puncture site for hemostasis. The intervention group will receive adjuvant TACE only once.

  • OtherIntensive follow-up

    The patients will receive intensive follow-up.

05

What researchers measure

Primary outcomes

  1. Recurrence-free survival

    The primary outcome is RFS, defined as the time from the date of randomization to the first occurrence of HCC recurrence, as identified by imaging.

    Time frame: two years

06

Study locations

1 of 1 sites recruiting
  • Guangxi Medical University Cancer Hospital
    Nanning, 530021, China
    • Jian-Hong Zhong, PhD · Contact · zhongjianhong66@163.com · 07715301253
    • Jian-Hong Zhong, PhD · Principal investigator
    Recruiting
07

References and documents

Publications

  • Su JY, Huang DJ, Liu SP, Xu XL, Chen SC, Ou JJ, Li JR, Yang TX, Li WY, Fan Y, Wen ZC, Chen L, Qin Z, Long BB, Li DZ, Huang JH, Lu YJ, Zhong JC, Zhu HQ, Ma L, Liang XM, Zhong JH. Adjuvant Transarterial Chemoembolization After Truly Curative Resection Does Not Improve Survival of Patients With Hepatocellular Carcinoma at High Risk of Recurrence: A Target Trial Emulation Study. Hepatol Res. 2025 Sep;55(9):1263-1273. doi: 10.1111/hepr.14219. Epub 2025 Jun 16. PubMed 40522319 ↗

Individual participant data

Plan to share: Yes — Outcome data.

Supporting information: Study protocol, Sap, Csr

08

Registry details

Key details

Study ID
NCT07417397
Lead sponsor
Guangxi Medical University
Responsible party
Jian-Hong Zhong (Professor, Cancer Hospital of Guangxi Medical University) — Principal investigator
First posted
Feb 18, 2026
Start date
Feb 1, 2026
Primary completion
Dec 31, 2029 (estimated)
Completion
Dec 31, 2029 (estimated)
Last update
Feb 18, 2026

Study contacts

Jian-Hong Zhong, PhD
Contact
zhongjianhong66@163.com
07715301253
Jian-Hong Zhong
principal investigator · Guangxi Medical University Cancer Hospital

Oversight

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

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