About this trial
This is a Phase Ib/II, open-label, multicenter, randomized umbrella study in participants with advanced liver cancers. The study is designed with the flexibility to open new treatment arms as new treatments become available, close existing treatment arms that demonstrate minimal clinical activity or unacceptable toxicity, modify the participant population, or introduce additional cohorts of participants with other types of advanced primary liver cancer.
Cohort 1 will enroll participants with locally advanced or metastatic hepatocellular carcinoma (HCC) who have not received prior systemic therapy for their disease. Eligible participants will initially be randomly assigned to one of several treatment arms (Stage 1). Participants who experience loss of clinical benefit or unacceptable toxicity during Stage 1 may be eligible to receive treatment with a different treatment combination (Stage 2). When a Stage 2 treatment combination is available, this will be introduced by amending the protocol.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 within 7 days prior to randomization
Locally advanced or metastatic and/or unresectable hepatocellular carcinoma (HCC) with diagnosis confirmed by histology/cytology or clinically by American Association for the Study of
Liver Diseases criteria in cirrhotic patients
Child-Pugh class A within 7 days prior to randomization
Disqualifiers
Prior treatment with CD137 agonists or immune checkpoint blockade therapies or inhibitors targeting HIF2a
Treatment with investigational therapy within 28 days prior to initiation of study
Treatment with locoregional therapy to liver within 28 days prior to initiation of study, or non-recovery from side effects of any such procedure
Untreated or incompletely treated esophageal and/or gastric varices with bleeding or at high risk for bleeding
Trial design
Parallel
Treatments tested in this trial
Atezolizumab
DrugAtezolizumab will be administered at a dose of 1200 mg by IV on Day 1 of each 21 day cycle.
Bevacizumab 15 mg/kg
DrugBevacizumab will be administered at a dose of 15 mg/kg by IV infusion on Day 1 of each 21 day cycle.
Tiragolumab
DrugTiragolumab will be administered at a dose of 600 mg by IV infusion on Day 1 of each 21 day cycle.
Tocilizumab
DrugTocilizumab will be administered at a dose of 8 mg/kg by IV infusion on Day 1 of each 21 day cycle.
TPST-1120
DrugTPST-1120 will be administered at a dose of 1200 mg by mouth on Days 1-21 of each 21 day cycle.
Tobemstomig 2100 mg
DrugTobemstomig will be administered at a dose of 2100 mg by IV infusion on Days 1 and 15 of each 28 day cycle.
Bevacizumab 10 mg/kg
DrugBevacizumab will be administered at a dose of 10 mg/kg by IV infusion on Days 1 and 15 of each 28 day cycle.
Tobemstomig 600 mg
DrugTobemstomig will be administered at a dose of 600 mg by IV infusion on Day 1 of each 21 day cycle.
Tobemstomig 1200 mg
DrugTobemstomig will be administered at a dose of 1200 mg every 3 weeks.
ADG126
DrugADG126 will be administered at a dose of 6 mg/kg by IV infusion on Day 1 of every other cycle (cycle length = 21 days).
IO-108 1800 mg
DrugIO-108 will be administered at a dose 1800 mg by IV infusion on Day 1 of each 21 day cycle.
NKT2152
DrugNKT2152 will be administered by mouth.
IO-108 1200 mg
DrugIO-108 will be administered at a dose 1200 mg by IV infusion on Day 1 of each 21 day cycle.
Treatment groups
11
Treatment groupsSee each treatment group below.
Trial outcomes
Primary outcomes
Objective Response Rate (ORR)
ORR, defined as the proportion of participants with a complete response or partial response on two consecutive occasions \>=4 weeks apart during Stage 1, as determined by the investigator according to RECIST v1.1.
Secondary outcomes
Progression Free Survival (PFS)
PFS after randomization, defined as the time from randomization to the first occurrence of disease progression or death from any cause (whichever occurs first) in Stage 1, as determined by the investigator according to RECIST v1.1.
Overall Survival (OS)
OS after randomization, defined as the time from randomization to death from any cause.
OS at Specific Timepoints
OS at a specific timepoint, such as Month 6
Duration of Response (DOR)
DOR, defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause (whichever occurs first) in Stage 1, as determined by the investigator according to RECIST v1.1.
Sponsors and contacts
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Hoffmann-La Roche
Lead sponsor
Adagene Inc
Collaborator
Tempest Therapeutics
Collaborator
NiKang Therapeutics, Inc.
Collaborator
Immune-Onc Therapeutics
Collaborator