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Efficacy and Safety of ALSS Treatment for ICIs-LF in Patients With HCC

Efficacy and Safety of Artificial Liver Support System Treatment for Immune Checkpoint Inhibitors Related Liver Failure in Patients With Hepatocellular Carcinoma

NCT05484908•Third Affiliated Hospital, Sun Yat-Sen University

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Summary

This study aims to investigate the efficacy and safety of artificial liver support system treatment for immune checkpoint inhibitors related liver failure in patients with hepatocellular carcinoma.

Detailed Description

Immune checkpoint inhibitors (ICIs) are commonly used for advanced stage of hepatocellular carcinoma (HCC) in recent years. The incident rate of Grade 4 immune checkpoint inhibitors-induced immune mediated hepatitis reaches 14.5%. Since these patients usually develop into liver failure, it is urgent to find out a more suitable therapy. Artificial liver support system (ALSS) treatment has been proved to effectively control both immune mediated hepatitis and liver failure, it may be a new therapy for immune checkpoint inhibitors-induced liver failure (ICIs-LF) in patients with HCC. Therefore, this study aims to investigate the efficacy and safety of ALSS treatment, including the classic mode of plasma exchange (PE) and new combination mode of double plasma molecular adsorption system (DPMAS) with sequential low-dose plasma exchange (LPE), for ICIs-LF in patients with HCC. Sixty patients with HCC and ICIs-LF will be enrolled in this study. The participants are randomly divided into trial group (DPMAS+LPE, and comprehensive internal medical treatment) and control group (PE and comprehensive internal medical treatment). Symptoms, signs, laboratory tests results, adverse events, mortality rates are recorded from treatment baseline to 12 weeks.

Eligibility

Age

18 - 65 years

Sex

ALL

Healthy Volunteers

Inclusion Criteria

•1. Age from 18 to 65 years old;
•2. Clinical diagnosis of chronic hepatitis b virus infection (positive hepatitis b surface antigen or positive hepatitis b virus DNA \> 0.5 year);
•3. Clinical diagnosis of hepatocellular carcinoma and receive immune checkpoint inhibitors treatment. The last treatment of immune checkpoint inhibitors is less than three months from inclusion;
•4. The level of hepatitis b virus DNA \< 2000 IU/mL；
•5. Serum aspartate aminotransferase/alanine aminotransferase \> 20 times upper limit of normal；serum total bilirubin\>10 times upper limit of normal；
•6. Prothrombin time international ratio \> 1.5;
•7. Platelets \> 50\*10 E9/L;
•8. Without intrahepatic bile duct dilation due to tumor progression.

Exclusion Criteria

•1. Other active liver diseases;
•2. Other malignancy;
•3. Pregnancy or lactation;
•4. Human immunodeficiency virus infection or congenital immune deficiency diseases;
•5. Severe diabetes, autoimmune diseases; unstable infarction due to cardio-cerebrovascular events; other important organ dysfunctions or transplantation;
•6. Active bleeding, disseminated intravascular coagulation, thrombosis, or thrombotic disease;
•7. Patients received artificial liver support system treatment in one week before inclusion;
•8. Patients can not follow-up;
•9. Investigator considering inappropriate

Locations (1)

Third Affiliated Hospital of Sun Yat-sen University

Guangzhou, Guangdong, China

Key Dates

Start Date

August 12, 2022

Primary Completion Date

December 31, 2024

Completion Date

December 31, 2024

Last Updated

November 29, 2024

Enrollment

ESTIMATED participants

Conditions

Immune-Mediated HepatitisLiver FailureHepatocellular Carcinoma

Interventions

DPMAS+LPE

OTHER

Comprehensive internal medical treatment

OTHER

Contacts

Wenxiong Xu, Doctor

CONTACT

+8613760783281 xuwenx@mail.sysu.edu.cn

Liang Peng, Doctor

CONTACT

+8613533978874 pliang@mail.sysu.edu.cn

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Data Source & Attribution

This clinical trial information is sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

ClinicalTrials.gov last update: November 29, 2024Data synced to Clareo: March 29, 2026

Modifications: This data has been reformatted for display purposes. Eligibility criteria have been parsed into inclusion/exclusion sections. Location data has been geocoded to enable distance-based search. For the authoritative and most current information, please visit ClinicalTrials.gov.

Neither the United States Government nor Clareo Health make any warranties regarding the data. Check ClinicalTrials.gov frequently for updates.

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Efficacy and Safety of ALSS Treatment for ICIs-LF in Patients With HCC

Inclusion Criteria

Exclusion Criteria

Early Detection of Liver Cancer by QUS

Association Between Galectin-3 Levels and Outcomes in Patients With Renal Cell Carcinoma, Transitional Cell Carcinoma , Non Small Cell Lung Cancer, and Hepatocellular Carcinoma, Treated With PD-1/PDL-1 Inhibitors

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