ClinicalTrials.gg
Not yet recruitingNCT07786792MUSE2Updated Sep 2, 2026

Biomarker and Mechanism Study of Systemic Therapy in Unresectable HCC

An observational study in Hepatocellular Carcinoma, sponsored by Shanghai Zhongshan Hospital. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-02.

Sponsored by Shanghai Zhongshan Hospital · Observational

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Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
400
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-15

Among 63 studies in Carcinoma, Hepatocellular by Shanghai Zhongshan Hospital — 26 open to participants now, 30 under way, 3 of them phase 3. Carcinoma, Hepatocellular · Shanghai Zhongshan Hospital.

Planned enrollment
7th of 21
400 · median 300
Started
2026
with 8 others
Observational
21 of 63
13 open now
Primary completion
2027-01
later than 18 of 29 live
Registered
62nd of 63
by date

Among the 63 studies in Carcinoma, Hepatocellular by Shanghai Zhongshan Hospital, this one is the 7th largest by planned enrollment of the 21 observational ones that give a count, is one of 9 that started in 2026, is one of 21 observational ones, reaches primary completion later than 18 of the 29 other live ones, and was the 62nd 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

26 of the 63 studies in Carcinoma, Hepatocellular by Shanghai Zhongshan Hospital are open now, in 1 country. Recruiting first, the newest first:

20 more — sign in →

By country, each count listing its studies:

All 26 open studies →

Where they have run

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 →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 63 studies in Carcinoma, Hepatocellular by Shanghai Zhongshan Hospital, or all of them as a file.
02

Study summary

The goal of this observational study is to evaluate the safety and efficacy of systemic therapies and identify predictive molecular biomarkers in patients with intermediate to advanced stage or unresectable hepatocellular carcinoma (HCC).

The main questions it aims to answer are:What is the objective response rate (ORR) of systemic therapy regimens in this patient population? Which 3-4 specific biomarkers (including tumor or peripheral blood-derived genes, proteins, ctDNA, and immune cell subsets) can reliably predict the efficacy of systemic treatment?

03

Conditions studied

  • Hepatocellular Carcinoma

Keywords

  • Hepatocellular Carcinoma
  • Immunotherapy
  • Systemic Therapy
  • Biomarker
  • ctDNA
  • Observational Study
  • Multi-omics
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population consists of patients with intermediate to advanced stage or unresectable hepatocellular carcinoma (HCC) confirmed by histology, cytology, or clinical diagnostic criteria. Eligible patients must have an ECOG performance status of 0 to 2 and well-preserved liver function, defined as Child-Pugh class A or a score of 7. The population includes patients who are scheduled to receive standard systemic therapies, such as targeted therapy combined with immunotherapy or dual immunotherapy, either alone or in combination with local therapies like transcatheter arterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC).

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

  • or cytologically confirmed hepatocellular carcinoma (HCC), or meeting the clinical diagnostic criteria of the "Guidelines for Diagnosis and Treatment of Primary Liver Cancer (2024 Edition)" issued by the National Health Commission of China.
  • Assessed by the investigator as unsuitable for surgical resection, or having intermediate to advanced stage HCC. Intermediate to advanced HCC is defined as Barcelona Clinic Liver Cancer (BCLC) stage B/C or China Liver Cancer (CNLC) stage IIa/IIb/IIIa/IIIb.
  • liver function class A or a score of 7. (ECOG) performance status score of 0 to 2.
  • Willing to receive targeted therapy combined with immunotherapy or dual immunotherapy, and signed the form (applicable to the prospective cohort).
  • Adequate bone marrow and organ function, meeting the following laboratory indicators: (ANC) >= 1.0x10\^9/L without the use of granulocyte colony-stimulating factor within the past 14 days; >= 50x10\^9/L without blood transfusion within the past 14 days; >= 90g/L without blood transfusion or erythropoietin use within the past 14 days; Total \<= 3 x (ULN); Albumin >= 28g/L without human serum albumin or plasma infusion within the past 14 days; (AST) and alanine aminotransferase (ALT) \<= 5 x ULN; Serum creatinine \<= 1.5 x ULN; Good coagulation function, defined as an (INR) of prothrombin time \<= 1.5 x ULN.
  • Subjects at risk of pregnancy (male or female) must use a method with an annual failure rate of less than 1% during the entire treatment period and until 120 days after the last dose of the study drug (or 180 days after the last dose of chemotherapy drugs).

Exclusion criteria

Exclusion Criteria:

  • Pathological diagnosis of mixed liver cancer, fibrolamellar hepatocellular carcinoma, or other non-hepatocellular malignant tumor components.
  • Previous or concurrent other malignant tumors, except for adequately treated non-melanoma skin cancer, carcinoma in situ of the cervix, and papillary thyroid carcinoma.
  • History of organ transplantation or hepatic encephalopathy. Known allergy to the selected targeted therapy drugs or immunotherapy drugs or drug , or previous severe allergic reactions to other monoclonal antibodies.
  • History of gastrointestinal perforation and/or fistula within the past 6 months, history of intestinal obstruction (including incomplete intestinal obstruction requiring parenteral nutrition), extensive intestinal resection (partial colon resection or extensive small bowel resection complicated by chronic diarrhea), Crohn's disease, ulcerative colitis, or long-term chronic diarrhea.
  • Active disease requiring systemic treatment (e.g., disease-modifying drugs, , or ) within 2 years prior to the first dose (replacement therapies like thyroxine, insulin, or physiologic corticosteroids for adrenal/pituitary insufficiency are allowed).
  • Known history of primary immunodeficiency disease. Uncontrolled hypertension (systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg after optimal medical treatment), history of hypertensive crisis, or hypertensive encephalopathy.
  • History of esophageal or gastric variceal bleeding events caused by portal hypertension within the past 6 months.
  • Diagnosed with severe (G3) varices by digestive endoscopy within 3 months prior to the first dose, or assessed by the investigator as having a high risk of bleeding. Subjects requiring withdrawal of .
  • Other conditions considered unsuitable by the investigator for participation in this clinical trial.
Terms in these criteria, in plain language(16)

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.

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.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

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.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
400 participants (estimated)
Patient registry
No

Groups and cohorts

  • Systemic Therapy Cohort

    Patients with intermediate to advanced stage or unresectable hepatocellular carcinoma (HCC) receiving systemic therapy alone.

    Drug: Systemic therapy

  • TACE/HAIC + Systemic Therapy Cohort

    Patients with intermediate to advanced stage or unresectable hepatocellular carcinoma (HCC) receiving transcatheter arterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) combined with systemic therapy.

    Drug: Systemic therapy · Procedure: Local therapy

Interventions

  • DrugSystemic therapy

    Including regimens such as Atezolizumab + Bevacizumab, Nivolumab + Ipilimumab.

  • ProcedureLocal therapy

    Including therapy such as TACE, HAIC

This study also gives Nivolumab, Ipilimumab, Atezolizumab. No intervention listed here names it: that was found by reading the record.

06

What researchers measure

Primary outcomes

  1. Objective Response Rate (ORR) Assessed by RECIST v1.1 and HCC mRECIST Criteria

    The ORR will be evaluated according to RECIST v1.1 and HCC mRECIST criteria, defined as the sum of complete response (CR) and partial response (PR) in patients with at least one measurable lesion.defined as the sum of complete response (CR) and partial response (PR) in patients with at least one measurable lesion.

    Time frame: Up to 2 years (assessed every 8 ± 2 weeks)

  2. Levels of Predictive Biomarkers Assessed by Multi-Omics Sequencing and Single Cell RNA Sequencing

    Identify 3-4 predictive biomarkers for the efficacy of HCC systemic therapy, including genes, proteins, ctDNA, and immune cell subsets based on tumor tissue or peripheral blood.

    Time frame: Up to 2 years

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: Undecided

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

Start is estimated for Sep 2026; primary completion for Jan 2027, 4 months later.

Of 303 non-industry observational studies under Carcinoma, Hepatocellular, half reached primary completion within 54 months of starting (the median), counting those still running; a quarter within 35 and three quarters within 114. This study's planned 4 months is below that.

Counting every sponsor, half of 352 studies reached it within 51 months; a quarter within 32 and three quarters within 108.

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

Registered
Aug 23, 2026
First posted
Aug 26, 2026
StartEst.
Sep 1, 2026
Primary completionEst.
Jan 1, 2027
CompletionEst.
Jan 1, 2027
Last update
Sep 2, 2026
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 Sep 2, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07786792
Responsible party
Hui-Chuan Sun (Professor, Shanghai Zhongshan Hospital) — Principal investigator
First posted
Aug 26, 2026
Start date
Sep 1, 2026 (estimated)
Primary completion
Jan 1, 2027 (estimated)
Completion
Jan 1, 2027 (estimated)
Last update
Sep 2, 2026

Study contacts

Hui Li, MD
Contact
li.hui1@zs-hospital.sh.cn
+86 64041990
Chengjie ZZ Zhong
Contact
cjzhong24@m.fudan.edu.cn
18223590185
Huichuan Sun, MD
principal investigator · Fudan University

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 not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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