OHSU Knight Cancer Institute
This phase II trial tests how well giving Y-90 radioembolization, durvalumab, tremelimumab and zanzalintinib works for the treatment of hepatocellular carcinoma that cannot be removed by surgery (unresectable) and that has spread to nearby tissue or lymph nodes (locally advanced). Y-90 radioembolization is a therapy that injects radioactive particles directly into an artery that feeds liver tumors to cut off their blood supply. Immunotherapy with monoclonal antibodies, such as durvalumab and tremelimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Zanzalintinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving Y-90 radioembolization, durvalumab, tremelimumab and zanzalintinib may be effective for treating unresectable and locally-advanced hepatocellular carcinoma.
PRIMARY OBJECTIVE: I. To assess proportion of participants that are progression-free at 6 months. SECONDARY OBJECTIVES: I. To assess safety of study intervention. II. To estimate objective response rate (ORR) for study intervention. III. To estimate disease control rate (DCR) for study intervention. IV. To estimate time to disease progression (TTP) for study intervention. V. To estimate progression-free survival. VI. To estimate overall survival (OS) for study intervention. EXPLORATORY OBJECTIVE: I. To evaluate therapy induced changes in the tumor and tumor immune microenvironments. OUTL…
Inclusion Criteria: * Participant must provide written informed consent before any study-specific procedures or interventions are performed * Participants aged ≥ 18 years * Body weight \> 30 kg * Patients must have radiologically, or histologically or cytologically confirmed hepatocellular cancer that is not amenable to transplant or resection: * Barcelona Clinic Liver Cancer Stage B or C * Cirrhosis grade of Child-Pugh (CP) A or CP-B7 (excluding albumin-bilirubin \[ALBI\] grade 3) * Fibrolamellar and mixed hepatocellular/cholangiocarcinoma subtypes are not eligible * Disease must not…
Undergo angiogram
Undergo tumor biopsy
Undergo blood and urine sample collection
Undergo CT scan
Given IV
Undergo MRI
Undergo SPECT
Given IV
Given via transartieral radioembolization procedure
Given PO