About this trial
This project targets patients with a form of primary liver cancer, specifically "hepatocellular carcinoma". This disease often develops in the context of a chronically diseased liver, caused by viral infections, excessive alcohol consumption, or fatty liver. Primarily due to the rise of the latter risk factor, liver cancer is one of the few cancer types whose incidence continues to increase globally, year after year. As a result, liver cancer has become the third most common cause of cancer-related deaths worldwide. There exists a significant challenge in reducing the disease on all fronts: prevention, diagnosis, and treatment.
This research aims to personalize the treatment of liver cancer patients, tailoring it to the individual. More specifically, this research seeks to identify patients with immunotherapy-sensitive liver cancer by biomarkers before treatment begins. Determining whether a tumor is immunotherapy-sensitive is internationally recognized as one of the most important challenges within this condition. Based on a combination of existing laboratory techniques on tumor tissue and/or blood, the investigators seek to predict the likelihood of this treatment's success before initiating it. With this knowledge, the investigators could recommend alternative treatments to patients with tumors that are unresponsive. This way, they would also avoid exposure to the side effects of an ineffective therapy.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
General
Male or female, age > 18 years
Diagnosis or suspected diagnosis of hepatocellular carcinoma based on imaging
Pathologically confirmed HCC
Disqualifiers
Poor liver function and/or performance status which prohibits active treatment
Pathologically proven other malignancies of the liver, including primary cholangiocarcinoma or liver metastases
Treatment plan other than systemic treatment or local treatment (resection or ablation), such as TACE, TARE, liver transplantation
Trial design
Parallel
Treatments tested in this trial
Blood and tissue sample
Other interventionProspective collection of additional blood and tissue samples for study-specific analyses at specific timepoints, at the same time as routine procedures.
Treatment groups
Trial outcomes
Primary outcomes
Spatial orientation
Spatial orientation of cell types of interest in the tumour microenvironment (TME) of HCC using a variety of techniques: multiplex IHC, spatial proteomics and spatial transcriptomics. Samples from early (cohort 3) and advanced HCC (cohort 2) will be used.
TCR sharing
Identification of shared TCR sequences between PBMCs and tumor tissue using RNA and TCR sequencing. Exploration of the degree of TCR sharing in early and advanced HCC.
Antigen identification
The investigators will use tumor tissue and PBMC to construct an antigenic landscape of advanced HCC. To achieve this goal the investigators will use a unique technique called Transcriptome-Wide Screening for T cell Antigen Research (TWISTAR).
Biomarker validation
This study will be used to validate two candidate predictive biomarkers (CD45RA effector-memory CD8 T-cells/PDL1-expressing CXCL10+ macrophages) AND TCR sharing between tumor and blood in relation to response to immunotherapy in HCC. The investigators will compare the biomarker positive and biomarker negative groups in terms of progression-free survival and overall survival (Kaplan-Meier time-to-event) in the context of known prognostic clinical variables (multivariable cox proportional hazards model).
Sponsors and contacts
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Universitaire Ziekenhuizen KU Leuven
Lead sponsor
Flemish institute of biotechnology (VIB)
Collaborator