ClinicalTrials.gg
Not yet recruitingNCT07829926LENTIG-HCCUpdated Sep 21, 2026

Lenvatinib Plus Tislelizumab With or Without Gefitinib for Advanced Liver Cancer

A Phase 2 interventional study of Lenvatinib and Tislelizumab in Hepatocellular Carcinoma (HCC), sponsored by First Affiliated Hospital of Wenzhou Medical University. Not yet recruiting. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-21.

Sponsored by First Affiliated Hospital of Wenzhou Medical University · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
120
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

This study is for people with unresectable or advanced hepatocellular carcinoma who have not received previous systemic treatment for liver cancer.

The study will compare lenvatinib plus tislelizumab with or without gefitinib. Participants will be randomly assigned to receive either lenvatinib, tislelizumab, and gefitinib, or lenvatinib and tislelizumab. The study is open-label, so participants and study doctors will know the treatment group.

The main outcomes are progression-free survival and the number of participants with adverse events of special interest. Progression-free survival is the time from randomization until the cancer gets worse or the participant dies. Adverse events of special interest are predefined side effects that require close monitoring.

The study will also evaluate tumor response, overall survival, other side effects, and exploratory biomarkers.

Read the detailed description

This is a prospective, randomized, open-label, phase II clinical trial evaluating lenvatinib plus tislelizumab with or without gefitinib as first-line treatment for unresectable or advanced hepatocellular carcinoma.

Eligible participants will be adults with unresectable or advanced hepatocellular carcinoma who have not received prior systemic anticancer therapy for hepatocellular carcinoma. Participants will be randomly assigned in a 1:1 ratio to receive either lenvatinib plus tislelizumab and gefitinib, or lenvatinib plus tislelizumab. Randomization will be performed centrally. Because gefitinib is administered only in the experimental arm and treatment management differs between groups, the study will be open-label. To reduce assessment bias, radiographic tumor assessments will be evaluated by a blinded independent imaging review committee.

The primary outcome measures are progression-free survival and the number of participants with adverse events of special interest. Progression-free survival will be assessed according to RECIST version 1.1. Adverse events of special interest include protocol-defined events requiring close monitoring, such as selected immune-related, hepatic, gastrointestinal, pulmonary, bleeding, thrombotic, dermatologic, renal, endocrine, and infusion-related events.

Secondary outcomes include overall survival, objective response rate, disease control rate, duration of response, treatment-emergent adverse events, serious adverse events, alpha-fetoprotein response, and conversion to curative-intent local therapy when applicable.

Study treatment will continue until radiographic disease progression, unacceptable toxicity, withdrawal of consent, initiation of new anticancer therapy, death, or other protocol-defined discontinuation criteria. Tumor assessments will be performed at protocol-defined intervals using CT or MRI. Safety will be monitored through adverse event reporting and protocol-defined clinical and laboratory assessments.

Exploratory analyses may include evaluation of epidermal growth factor receptor-related biomarkers, tumor immune microenvironment, circulating tumor DNA, tumor mutation profiles, alpha-fetoprotein dynamics, and other candidate biomarkers to explore potential associations with treatment response, disease progression, resistance, and safety.

02

Conditions studied

  • 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 120 is above the median of 54 across 2,618 interventional studies indexed under Carcinoma, Hepatocellular.

Browse Carcinoma, Hepatocellular studies →

Lead sponsor

First Affiliated Hospital of Wenzhou Medical University is the lead sponsor of 83 studies on the registry; 57 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 75 Years
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

  • Age 18 to 75 years, male or female.
  • Histologically or clinically/radiologically confirmed hepatocellular carcinoma.
  • Unresectable or advanced hepatocellular carcinoma requiring systemic therapy.
  • No prior systemic anticancer therapy for hepatocellular carcinoma.
  • At least one according to version 1.1.
  • performance status of 0 to 1.
  • class A liver function.
  • of at least 12 weeks.
  • Adequate hematologic, hepatic, renal, and coagulation function as defined in the protocol.
  • For participants with virus infection, antiviral therapy must be given according to local practice, and hepatitis B virus DNA must meet protocol-defined requirements.
  • Participants of must agree to use effective during the study and for the protocol-defined period after the last dose of study treatment.
  • Ability to understand and willingness to sign written .

Exclusion criteria

Exclusion Criteria:

  • Prior systemic anticancer therapy for hepatocellular carcinoma.
  • Known fibrolamellar hepatocellular carcinoma, sarcomatoid hepatocellular carcinoma, mixed hepatocellular-cholangiocarcinoma, or other non-hepatocellular carcinoma histology.
  • Prior treatment with an epidermal growth factor receptor inhibitor.
  • Uncontrolled hypertension, cardiovascular disease, or serious bleeding or thrombotic events within the protocol-defined period.
  • Active or high-risk gastrointestinal bleeding, untreated or inadequately treated esophageal or gastric varices, or clinically significant coagulation disorder.
  • History of interstitial lung disease, drug-induced pneumonitis, radiation pneumonitis requiring treatment, or active pneumonitis.
  • Active disease or history of autoimmune disease requiring systemic treatment, except as allowed by the protocol.
  • Active uncontrolled infection, including uncontrolled virus infection or virus infection requiring treatment but not adequately controlled.
  • Known infection with uncontrolled disease, if applicable according to local regulations.
  • Clinically significant ascites, hepatic encephalopathy, or other evidence of hepatic decompensation.
  • Untreated or symptomatic central nervous system .
  • Major surgery, locoregional therapy, radiotherapy, or other anticancer therapy within the protocol-defined before randomization.
  • Inability to swallow oral medication or any condition that may significantly affect absorption of oral study drugs.
  • Known allergy or to lenvatinib, tislelizumab, gefitinib, or any of their .
  • Pregnancy or breastfeeding.
  • Any other condition that, in the investigator's judgment, would make the participant unsuitable for the study or interfere with study treatment, safety evaluation, or protocol compliance.
Terms in these criteria, in plain language(18)

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Excipients

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

05

Study design

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

Study arms

  • Active comparator
    Control group:Lenvatinib + Tislelizumab

    Lenvatinib + Tislelizumab:Participants in this arm will receive lenvatinib plus tislelizumab as first-line treatment for unresectable or advanced hepatocellular carcinoma. Lenvatinib will be given orally once daily according to body weight. Tislelizumab will be given by intravenous infusion every 3 weeks. Treatment will continue until disease progression, unacceptable toxicity, withdrawal of consent, start of new anticancer therapy, death, or other protocol-defined discontinuation criteria.

    Drug: Lenvatinib · Drug: Tislelizumab

  • Experimental
    Experimental group:Lenvatinib+Tislelizumab+Gefitinib

    Lenvatinib+Tislelizumab+Gefitinib: Participants in this arm will receive lenvatinib plus tislelizumab and gefitinib as first-line treatment for unresectable or advanced hepatocellular carcinoma. Lenvatinib will be given orally once daily according to body weight. Tislelizumab will be given by intravenous infusion every 3 weeks. Gefitinib will be given orally at 250 mg once daily. Treatment will continue until disease progression, unacceptable toxicity, withdrawal of consent, start of new anticancer therapy, death, or other protocol-defined discontinuation criteria.

    Drug: Lenvatinib · Drug: Tislelizumab · Drug: Gefitinib

Interventions

  • Lenvatinib will be administered orally once daily. The dose will be based on baseline body weight: 8 mg once daily for participants weighing less than 60 kg and 12 mg once daily for participants weighing 60 kg or more. Treatment will continue until disease progression, unacceptable toxicity, withdrawal of consent, start of new anticancer therapy, death, or other protocol-defined discontinuation criteria.

    Also known as: LEN

  • Tislelizumab will be administered by intravenous infusion at a dose of 200 mg on Day 1 of each 21-day cycle. Treatment will continue until disease progression, unacceptable toxicity, withdrawal of consent, start of new anticancer therapy, death, or other protocol-defined discontinuation criteria.

    Also known as: TIS

  • Gefitinib will be administered orally at a dose of 250 mg once daily in the experimental arm. Treatment will continue until disease progression, unacceptable toxicity, withdrawal of consent, start of new anticancer therapy, death, or other protocol-defined discontinuation criteria.

    Also known as: GEF

06

What researchers measure

Primary outcomes

  1. Number of Participants With Treatment-Emergent Adverse Events

    Treatment-emergent adverse events are defined as adverse events that occur or worsen after the start of study treatment. Adverse events will be coded and graded according to NCI CTCAE version 5.0. This outcome measure will report the number of participants who experience at least one treatment-emergent adverse event during the study.

    Time frame: From the first dose of study treatment through 90 days after the last dose of study treatment

  2. Progression-Free Survival

    Progression-free survival is defined as the time from randomization to the first documented radiographic disease progression or death from any cause, whichever occurs first. Disease progression will be assessed by a blinded independent imaging review committee according to RECIST version 1.1.

    Time frame: From randomization until disease progression or death from any cause, assessed up to 36 months

Secondary outcomes

  1. Overall Survival

    Overall survival is defined as the time from randomization to death from any cause.

    Time frame: From randomization until death from any cause, assessed up to 36 months

  2. Objective Response Rate

    Objective response rate is defined as the proportion of participants with a best overall response of complete response or partial response, as assessed according to RECIST version 1.1.

    Time frame: From randomization until disease progression, start of new anticancer therapy, or study completion, assessed up to 24 months

  3. Disease Control Rate

    Disease control rate is defined as the proportion of participants with a best overall response of complete response, partial response, or stable disease, as assessed according to RECIST version 1.1.

    Time frame: From randomization until disease progression, start of new anticancer therapy, or study completion, assessed up to 24 months

  4. Duration of Response

    Duration of response is defined for participants who achieve complete response or partial response as the time from the first documented objective response to the first documented disease progression or death from any cause, whichever occurs first.

    Time frame: From first documented objective response until disease progression or death from any cause, assessed up to 24 months

07

Study locations

No study locations are listed for this record.

08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 21, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07829926
Lead sponsor
First Affiliated Hospital of Wenzhou Medical University
Responsible party
Sponsor
First posted
Sep 21, 2026
Start date
Nov 2026 (estimated)
Primary completion
Nov 2026 (estimated)
Completion
Nov 2028 (estimated)
Last update
Sep 21, 2026

Oversight

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

Not currently enrolling

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

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Studies of the drug tested here: Gefitinib

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