Transarterial Chemoembolization (TACE) Versus TACE Plus Stereotactic Body Radiation Therapy (SBRT) in Liver Carcinoma

What this study is about

Trans-arterial chemoembolization (TACE) is a standard treatment for patients with hepatocellular carcinoma (also called liver cancer). This is where chemotherapy is injected into the arteries of the liver and liver cancer. Unfortunately, the tumour grows after TACE in many patients. A new treatment using a specialized radiation procedure called Stereotactic ablative body radiotherapy (SBRT) may increase the chance to control liver cancer. SBRT allows radiation treatments to be focused more precisely, and be delivered more accurately than with older treatments. The purpose of this study is to find out if TACE alone versus TACE plus SBRT is better for you and your liver cancer.

Who can join (things the study team will check)

✅ You may be able to join if…

• Primary hepatobiliary cancer confirmed pathologically
• Non - lymphoma liver metastases confirmed pathologically
• Radiographic liver lesions most consistent with metastases, in a patient with known pathologically proven non - lymphoma cancer and a previously negative CT or MRI of the liver
• Hepatocellular carcinoma diagnosed with vascular enhancement of the lesion consistent with hepatocellular carcinoma, and with an elevated AFP, in the setting of cirrhosis or chronic hepatitis.
• ≤ 5 liver lesions measurable on a contrast - enhanced liver CT or MRI performed within 90 days prior to study entry.
• Primary liver lesion or liver metastases measuring ≤ 25 cm.
• Extrahepatic cancer is permitted if liver involvement is judged to be life - limiting.
• All intrahepatic disease must be encompassed within the radiation fields according to protocol criteria.
• Patient must be judged medically or surgically unresectable
• Zubrod Performance Scale = 0 - 3
• Age > 18
• All intrahepatic disease must be amenable to TACE
• Previous liver resection or ablative therapy is permitted.
• Chemotherapy must be completed at least 2 weeks prior to radiation therapy or TACE, and not planned to be administered for at least 1 week (for anthracyclines at least 4 weeks) after completion of treatment.
• Life expectancy > 6 months.
• Women of childbearing potential and male participants must practice adequate contraception.
• Patient must sign study specific informed consent prior to study entry. Pretreatment Evaluations Required for Eligibility:
• A complete history and general physical examination.
• CBC, INR, Total bilirubin, albumin, alkaline phosphatase, ALT, AST within 4 weeks prior to study entry. Appropriate levels are as follows:
• Absolute neutrophil count (ANC) ≥ 1,500 cells / mm3

+ 6 more criteria — see the full checklist in the app.

🚫 You may not be able to join if…

• Severe cirrhosis or liver failure defined as Child Pugh > B7
• Primary liver tumor or liver metastasis > 25 cm in maximal dimension.
• Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
• Severe, active co-morbidity, defined as limiting the patients life to less than 6 months
• Active hepatitis or clinically significant liver failure.
• Pregnancy, nursing women, or women of childbearing potential, and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be teratogenic.

Where this trial is running

• London Health Sciences Centre, London Regional Cancer Program, London, Ontario, Canada

Who to contact

Michael Lock, M.D. · 519-685-8650 · michael.lock@lhsc.on.ca

It's completely normal to call and ask questions before deciding anything. Mention the study ID: NCT03895359.