A Phase I Study Evaluating Safety and Efficacy of Hepatic Intra-Arterial Administration of Ipilimumab in Combination With Intra-venous Nivolumab for Advanced Hepatocellular Carcinoma
To determine the Maximum Tolerated Dose (MTD), and the recommended Phase 2 dose of HIA Ipilimumab in combination with IV Nivolumab by monitoring the Dose Limiting Toxicity (DLT) within 1 month after IA Ipilimumab administration in dose-escalation phase.
• Adult Men and women ≥ 18 years old
• Patient should understand, sign, and date the written informed consent form prior to any protocol-specific procedures performed.
• Patient should be able to comply with treatment, PK, and pharmacodynamic sample collection and willing to comply with study visits and procedures as per protocol.
• Patients must have pathological confirmation of HCC.
• Patient should be considered as non resectable by Multidisciplinary Team and liver surgeon, and non-eligible for liver transplantation (advanced HCC, BCLC C).
• Patient who progresses on, or is intolerant to, or has refused standard first line therapy and eligible for receiving IV infusion of Nivolumab and HIA administration of Ipilimumab
• Patient with active intrahepatic HCC. Part of the disease should not have undergone local treatments (including chemoembolization, or percutaneous targeted therapies).
• Patients with or without active viral infection (i.e., HCV, HBV) are eligible. Patients with active HBV/HCV are eligible provided they are adequately treated to control the disease.
• Patients should have measurable disease as defined by mRECIST criteria for response assessment.
⁃ ECOG status of 0 or 1 (Appendix 2).
⁃ Life expectancy of ≥ 12 weeks at the time of informed consent per Investigator assessment.
⁃ Adequate organ function as defined by the following:
∙ White blood cells (WBCs) ≥ 2000/mL
‣ Neutrophils ≥ 1000/mL
‣ Platelets ≥ 75 × 103/mL
‣ Hemoglobin ≥ 8.0 g/dL
‣ Creatinine \< 1.5 × ULN or creatinine clearance ≥ 40mL/min (Cockcroft-Gault formula)
‣ ALT and AST ≤ 3 × ULN or \< 5 x ULN in case of liver metastasis
‣ Lipase and amylase ≤ 1.5 × ULN
‣ Total bilirubin ≤ 1.5 × ULN
‣ Normal thyroid function, or stable on hormone supplementation per investigator assessment
⁃ Child-Pugh A, Without history of encephalopathy or clinically significant ascites
⁃ Women of childbearing potential (WOCBP) must have a negative urine or serum β-HCG pregnancy test within 14 days prior inclusion. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. Sexually active female patients must agree to use two methods of effective contraception, one of them being a barrier method, or to abstain from sexual activity during the study and for at least 5 months after last study drug administration or must refrain from heterosexual activity during this same period.
⁃ Sexually active males patients must agree to use condom during the study and for at least 7 months after the last study treatment administration. Also, it is recommended their women of childbearing potential partner use a highly effective method of contraception for the same duration.
⁃ Patients shall be eligible to undergo pre-treatment and on-treatment tumor biopsies. Patients who either do not consent to a pre-treatment tumor biopsy or do not have accessible lesions will not be eligible.
⁃ Resolved acute effects of any prior therapy to baseline severity or NCI CTCAE v5 Grade ≤1 except for AEs not constituting a safety risk by investigator judgment.
⁃ Patients must be affiliated to a social security system or beneficiary of the same