Study Investigating the Association of NP137 With Atezolizumab-Bevacizumab Combination in First Line in Unresectable Hepatocellular Carcinoma
The study will assess the safety of the association of NP137 with the standard of care Atezolizumab-Bevacizumab in first line setting in patients with unresectable hepatocellular carcinoma.The study drug which is tested is the NP137 in association with Atezolizumab-Bevacizumab to allow a better tumor response as well as better survival outcomes with an acceptable safety.
• Males or females ≥ 18 years of age
• Histologically confirmed (liver biopsy within 24 previous weeks) and documented unresectable hepatocellular carcinoma
• Patients with a BCLC C or BCLC B status ineligible for or in failure of locoregional treatment, as per the Barcelona Clinic Liver Cancer (BCLC) staging system
• No prior systemic therapy for advanced HCC
• Liver tumor burden \< 50% of the liver (per Investigator judgment)
• Child-Pugh A (≤ 6) without any history of cirrhotic decompensation within the past 6 months
• Antiviral therapy required in hepatitis B virus patients (Hepatitis B antigen positive)
• Willing to have liver biopsy between C4 and C5
• Presence of a measurable tumor per RECIST v1.1 criteria
⁃ Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1
⁃ Life expectancy ≥ 12 weeks
⁃ Absence of previous liver decompensation
⁃ In case of cirrhosis, last esophageal varices detection by esogastroduodenal endoscopy have to be performed within last the 6 months before inclusion
⁃ Adequate hematologic function prior to the first dose of NP137, defined as:
⁃ Absolute neutrophils count ≥ 1500 cells/μL 14.2. Hemoglobin ≥ 9 g/dL with no transfusion within 4 weeks prior to first planned dose of NP137 14.3. Platelet count \> 50,000/μL with no transfusion within 2 weeks prior to first planned dose of NP137
⁃ Adequate renal function prior to first dose, defined as:
‣ 1. Serum creatinine \< 1.5 × Upper limit of normal (ULN ) 15.2. Creatinine clearance ≥ 30 mL/min/m2 (by Cockroft-Gault equation of 24-hour urine) if creatinine ≥ 1.5 × ULN
⁃ Adequate hepatic function prior first dose, defined as AST/ALT ≤ 5 × ULN
⁃ Women patients of childbearing potential must have a negative serum pregnancy test at screening and baseline, and be willing to use a highly effective contraception. The patient should be advised to continue the contraception for at least 6 months following the completion of dosing. Women with cessation for \> 24 months of previously occurring menses, or women of any age who have had a hysterectomy, or have had both ovaries removed will be considered to be of non-childbearing potential.
⁃ Male patients of reproductive potential must be willing to use one acceptable method of contraception, as judged by Investigator and Sponsor and/or to refrain from donating sperm from the time of screening through at least 6 months following the completion of dose administration.
⁃ Amenable to computed tomography (CT) with 3 or 4 phase liver or magnetic resonance imaging (MRI) of abdomen and pelvis, and CT of chest, or MRI of whole body, for initial tumor size measurements and subsequent follow-up.
⁃ Absence of other clinically relevant abnormalities for any screening laboratory test results as judged by the Investigator and Sponsor.
⁃ Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
⁃ Able to understand and provide written informed consent
⁃ Patients covered by Health Insurance System