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Not yet recruitingNCT07827807PearlUpdated Sep 18, 2026

PEARL Trial: Partial TACE Enhancing Anti-tumor Response With Lenvatinib in Unresectable HCC

A Phase 2 interventional study of Lenvatinib and Partial transarterial chemoembolization (TACE) in Hepatocellular Carcinoma, sponsored by Chang Gung Memorial Hospital. Not yet recruiting. Open to participants aged 20 Years and older. Per ClinicalTrials.gov, last updated 2026-09-18.

Sponsored by Chang Gung Memorial Hospital · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
20 Years and older
Sex
All
01

Study summary

This is a single-arm, open-label, phase II clinical trial. Patients with unresectable hepatocellular carcinoma (HCC) who are eligible for lenvatinib treatment will receive partial transarterial chemoembolization (TACE) targeting up to two liver segments containing the largest tumor volume or lesions at risk of rupture, in combination with standard lenvatinib therapy. The partial TACE approach is designed as a liver-function-sparing technique that limits ischemic territory while preserving hepatic reserve.

Read the detailed description

Primary objective:

-1-year progression-free survival (PFS) by mRECIST

Secondary objectives:

  • 1-year overall survival (OS)
  • Objective response rate (ORR) and disease control rate (DCR) per RECIST v1.1 and mRECIST
  • Incidence of hepatic decompensation within 30 days after treatment (defined as: bilirubin > 3 mg/dL, new or worsened ascites, or hepatic encephalopathy)
  • Duration of response (DOR)

Exploratory Endpoints:

  • Depth of response (DpR)
  • Immune profile changes from baseline (assessed by multiparametric flow cytometry and single-cell RNA sequencing)
02

Conditions studied

  • Hepatocellular Carcinoma

Keywords

  • HCC
  • Liver tumor
  • TACE
  • lenvatinib
03

Who can participate

Ages eligible
20 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Diagnosis of HCC confirmed by histology/cytology or typical imaging features, unsuitable for surgical resection or liver transplantation

  • Age ≥ 20 years at the time of signing informed consent
  • ECOG performance status 0-1
  • BCLC stage B or C (without main portal vein thrombosis)
  • Child-Pugh score 5-7 (Class A or B7) within 28 days of registration
  • Adequate bone marrow, liver, and renal function
  • Blood pressure adequately controlled
  • Ability to understand and sign written informed consent

Exclusion criteria

Exclusion Criteria:

Prior systemic therapy for HCC

  • Main portal vein thrombosis
  • Prior locoregional therapy within 4 weeks
  • Uncontrolled hypertension
  • Clinically significant cardiovascular disease within 6 months
  • Pregnancy or breastfeeding
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    Partial TACE Enhancing Anti-tumor Response with Lenvatinib in unresectable HCC

    Lenvatinib: Oral administration at 12 mg once daily (body weight ≥ 60 kg) or 8 mg once daily (body weight \< 60 kg). Treatment continues until disease progression, unacceptable toxicity, or patient withdrawal. Partial TACE: Performed within 4 weeks after starting lenvatinib.

    Drug: Lenvatinib · Procedure: Partial transarterial chemoembolization (TACE)

Interventions

  • DrugLenvatinib

    Oral lenvatinib 12 mg once daily for body weight 60 kg or greater, or 8 mg once daily for body weight less than 60 kg. Treatment continues until disease progression, unacceptable toxicity, or patient withdrawal.

  • ProcedurePartial transarterial chemoembolization (TACE)

    Transarterial chemoembolization targeting up to two liver segments containing the largest tumor volume or lesions at risk of rupture, performed within 4 weeks after starting lenvatinib. This liver-function-sparing approach limits the ischemic territory in order to preserve hepatic reserve.

    Also known as: Partial TACE

05

What researchers measure

Primary outcomes

  1. 1-year progression-free survival (PFS) by mRECIST

    Percentage of participants alive and free of disease progression at 1 year. Progression-free survival is measured from the start date of study treatment to the date of first documented disease progression according to modified RECIST (mRECIST) or death from any cause, whichever occurs first.

    Time frame: 1 year after start of study treatment

Secondary outcomes

  1. 1-year overall survival (OS)

    Percentage of participants alive at 1 year. Overall survival is measured from the start date of study treatment to the date of death from any cause.

    Time frame: 1 year after start of study treatment

  2. Objective response rate (ORR) by mRECIST

    Percentage of participants with a best overall response of confirmed complete response or partial response, as assessed by modified RECIST (mRECIST). Tumor response is assessed by CT or MRI every 12 weeks from the start of study treatment; a first objective response is confirmed by a second imaging assessment 4 weeks later.

    Time frame: Up to 12 months after start of study treatment

  3. Objective response rate (ORR) by RECIST v1.1

    Percentage of participants with a best overall response of confirmed complete response or partial response, as assessed by RECIST version 1.1. Tumor response is assessed by CT or MRI every 12 weeks from the start of study treatment; a first objective response is confirmed by a second imaging assessment 4 weeks later.

    Time frame: Up to 12 months after start of study treatment

  4. Disease control rate (DCR) by mRECIST

    Percentage of participants with a best overall response of confirmed complete response, partial response, or stable disease, as assessed by modified RECIST (mRECIST). Tumor response is assessed by CT or MRI every 12 weeks from the start of study treatment.

    Time frame: Up to 12 months after start of study treatment

  5. Disease control rate (DCR) by RECIST v1.1

    Percentage of participants with a best overall response of confirmed complete response, partial response, or stable disease, as assessed by RECIST version 1.1. Tumor response is assessed by CT or MRI every 12 weeks from the start of study treatment.

    Time frame: Up to 12 months after start of study treatment

  6. Duration of response (DOR) by mRECIST

    Time from the date of first documented objective response (complete or partial response) to the date of first documented disease progression, as assessed by modified RECIST (mRECIST). Reported in months.

    Time frame: Up to 12 months after start of study treatment

  7. Incidence of hepatic decompensation

    Percentage of participants with hepatic decompensation within 30 days after treatment. Hepatic decompensation is defined as any of the following: total bilirubin greater than 3 mg/dL, new or worsened ascites, or hepatic encephalopathy.

    Time frame: Within 30 days after treatment

  8. Incidence of treatment-emergent adverse events

    Number of participants with treatment-emergent adverse events and serious adverse events, graded according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

    Time frame: From first dose of study treatment up to 30 days after the last dose

Other outcomes

  1. Depth of response (maximum percentage reduction from baseline in the sum of viable target lesion diameters)

    Maximum percentage reduction from baseline in the sum of viable target lesion diameters, as assessed by modified RECIST (mRECIST). Reported as percentage change from baseline.

    Time frame: Up to 12 months after start of study treatment

  2. Change from baseline in immune cell subset frequencies assessed by multiparametric flow cytometry

    Change from baseline in the frequencies of peripheral blood immune cell subsets measured by multiparametric flow cytometry, including CD4+ and CD8+ T cells, regulatory T cells, natural killer cells, mucosal-associated invariant T cells, and myeloid populations, together with the activation and exhaustion markers PD-1, TIM-3, HLA-DR, and CD38. Reported as percentage of live cells.

    Time frame: Baseline, within 24 hours before TACE, within 48 hours after TACE, Week 12, and Week 24

  3. Change from baseline in immune cell composition assessed by single-cell RNA sequencing

    Change from baseline in immune cell composition measured by single-cell RNA sequencing of peripheral blood mononuclear cells and tissue samples, reported as percentage of sequenced cells assigned to each annotated immune cell cluster.

    Time frame: Baseline, within 24 hours before TACE, within 48 hours after TACE, Week 12, and Week 24

06

Study locations

No study locations are listed for this record.

07

Registry details

Key details

Study ID
NCT07827807
Lead sponsor
Chang Gung Memorial Hospital
Responsible party
Sponsor
First posted
Sep 18, 2026
Start date
Sep 30, 2026 (estimated)
Primary completion
May 31, 2029 (estimated)
Completion
May 31, 2029 (estimated)
Last update
Sep 18, 2026

Study contacts

PO-Ting-Lin
Contact
linpoting0101@gmail.com
886975362702

Oversight

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

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