Transarterial Chemoembolization (TACE) and Stereotactic Body Radiation (SBRT) in Patients With Hepatocellular Carcinoma (HCC) Prior to Liver Transplantation
HCC - Hepatocellular Carcinoma
What this study involves
The registry says this study is recruiting. Individual locations may have different availability.
- Study type
- Interventional
- Phase
- Not applicable
- Age range
- 18 years - Not specified
- Sex eligible
- All sexes
- Healthy volunteers
- Not accepted
- Participants
- 44 Estimated
These are starting points, not an eligibility decision. The research team must review the full requirements.
About the research
In this randomised study it should be investigated, whether and to what extent standard TACE treatment combined with additional stereotactic body radiotherapy (SBRT) leads to improved outcomes for patients with HCC when used as a bridging therapy prior to liver transplantation.
Read the full description
Hepatocellular carcinoma (HCC) is one of the most frequent malignancies worldwide and is characterized by a rising incidence. A first line curative treatment option is surgical resection. As most patients with HCC suffer from liver cirrhosis, resection is often constrained due to limited liver function. In patients with tumors within Milan criteria, liver transplantation remains a curative therapeutic option even if liver resection is not feasible. Due to organ shortage, there are long waiting periods and waitlist withdrawal because of tumor progression remains an eminent risk. Hence, bridging therapies are used to halt tumor growth. Transarterial chemoembolization (TACE) is one of the most commonly used bridging therapies. Other possible bridging therapies are local ablation and stereotactic body radiation therapy (SBRT). Importantly, there are several studies showing a potential benefit of the combination of TACE and SBRT in the treatment of HCC. Recently, we were able to show a high rate of complete histopathological response in patients who were treated with a combination of TACE and SBRT as bridging to liver transplant, suggesting a potential benefit of combining both therapies in a pre-transplant setting.
Who may be able to participate?
The list below is the sponsor’s full registry wording. It can include conditions, prior treatment, test results and other requirements. A match in search does not mean you qualify.
Inclusion Criteria:
1. Written informed consent obtained from the subject prior to performing any protocol related procedures, including screening evaluations.
2. Age ≥ 18 years at time of study entry.
3. HCC diagnosed by histopathology and/or according to EASL or AASLD criteria at an early stage (BCLC A or UNOS T2), without any curative treatment option (resection or ablation) other than liver transplantation as determined by tumor board decision of at least one tumor lesion. Guidance: Patients with prior HCC who had surgery or locoregional treatment and had a complete remission for over 2 years and develop denovo HCC at a location different from previously treated HCC lesion(s) are eligible to participate.
4. Patients planned for liver transplantation after discussion within a multidisciplinary board.
5. Patients eligible to receive a matchReMELD-Na (SE-ReMELD-Na) - Score for hepatocellular carcinoma according to German transplant regulations. Guidance: All listing assessments must be completed before first on-study radiologic tumor assessment (first radiologic tumor assessment in treatment follow-up).
6. Treatment of all lesions by SBRT is feasible as determined by the local physician. The central review board recommendation process has been initiated (i.e. image upload by site).
7. At least one measurable site of disease with spiral CT scan or MRI according to mRECIST for HCC.
8. Sufficient liver function (\< Child Pugh B8)
9. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1.
10. Adequate blood count, liver enzymes and renal function:
1. Hemoglobin ≥ 7 g/dL, absolute neutrophil count ≥ 1000 /µL, platelets ≥ 35000/µL
2. Total bilirubin and serum albumin as part of Child Pugh requirement
3. ALAT and ASAT ≤5 x ULN
11. Patients with active HIV Infection must show a CD4 cell count above 200/µL and no detectable HIV RNA for at least three months prior to the study
12. Female patients with reproductive potential must have a negative urine or serum pregnancy test within 14 days prior to start of the study (randomization).
13. Patients of childbearing potential who are sexually active must use an adequate contraceptive method with a failure rate less than 1 % per year. Enrolled patients must agree to use adequate contraception for the duration of study treatment and up to 6 months after the end of the treatment (depending on treatment received), manufactures recommendation (TACE) and local guidelines.
14. Subject is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up.
Exclusion Criteria:
1. Involvement in the planning and/or conduct of the study.
2. Prior local tumor specific treatment of the same tumor nodule within the last 24 months.
3. Histological proven fibrolamellar HCC or mixed HCC/cholangiocarcinoma.
4. Other invasive malignancies within the past 2 years (except for non-melanoma skin cancer or non-invasive bladder cancer).
5. Impaired liver function Child-Pugh Class B \> 7.
6. Ongoing or active systemic infection or psychiatric illness/social situations that would limit compliance with study requirements. Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs, or compromise the ability of the patient to give written informed consent.
7. Dementia or significantly altered mental status that would prohibit the understanding or rendering of information, consent, and compliance with the requirements of the protocol.
8. Pregnancy and breastfeeding. Should a patient become pregnant, the treating physician has to be informed immediately.
9. Any condition, comorbidity or circumstance that, in the opinion of the investigator, would interfere with evaluation of study treatment or affect patient safety or study results.
10. Weight less than or equal to 30 kg.
11. Prior radiotherapy to the upper abdomen
Treatment, groups and participation
The registry may describe treatments and study duration without a complete visit calendar. Ask the study team for the exact schedule, procedures, risks, costs and alternatives. Keep your usual care plan unless your treating clinician tells you otherwise.
- Assignment
- Random assignment
- Masking
- No masking
The patients will receive two procedures of TACE prior to liver transplantation
Standard arm: The patients will receive two procedures of TACE prior to liver transplantation
Procedure: The patients will receive two procedures of TACE prior to liver transplantation
The patients will receive two procedures of TACE followed by SBRT prior to liver transplantation
Experimental arm: The patients will receive two procedures of TACE followed by SBRT prior to liver transplantation
Procedure: Stereotactic body radiation therapy (SBRT) in addition to TACE prior to liver transplantation
Stereotactic body radiation therapy (SBRT) in addition to TACE prior to liver transplantation PROCEDURE
The patients will receive a stereotactic body radiation therapy (SBRT) in addition to two procedures of TACE prior to liver transplantation
The patients will receive two procedures of TACE prior to liver transplantation PROCEDURE
The patients will receive two procedures of TACE prior to liver transplantation as bridging therapy (standard of care)
What researchers are measuring
Outcome measures describe what is being studied. They are not proof that a treatment works.
Primary measures
Primary Endpoint: histopathological response (presence of vital tumor tissue) in explant histopathology after liver transplantation.
Time frame: After liver transplantation (at least 24 months after randomization)
The percentage of vital tumor tissue is defined as the maximum percentage of vital tumor tissue per surface area per patient.
Secondary measures
Overall survival (OS)
Time frame: 24 months after randomization
Overall survival (OS) is defined as time from randomization to death from any cause. Overall survival-rate at 24 months is defined as the (estimated) proportion of patients who are still alive 24 months after randomization.
Objective response rate (ORR)
Time frame: up to 24 months after randomization
The objective response rate (ORR) is defined as the proportion of all randomized patients in whom a CR or PR was observed
Complete response rate (CRR)
Time frame: up to 24 months after randomization
The complete response rate (CRR) is defined as the proportion of all randomized patients in whom a CR was observed
Progression-free survival (PFS)
Time frame: up to 24 months after randomization
Progression-free survival (PFS) is defined as time from randomization to objective tumor progression or death from any cause
Recurrence Rate
Time frame: up to 24 months after transplantation
Recurrence Rate is defined as the percentage of patients in whom cancer recurs after transplantation within 24 months. The recurrence is determined by regular standard of care follow-up examinations, which include imaging procedures (CT, MRI, ultrasound) and blood tests (e.g. alpha-fetoprotein). A division is made between local recurrence in the transplanted liver and distant metastases.
Recurrence free survival (RFS)
Time frame: up to 24 months after transplantation
Recurrence free survival (RFS) is defined as time from transplantation to tumor recurrence or death from HCC. Death from any other cause will be used as a censoring event.
Quality of Life Assessments
Time frame: up to 24 months after randomization
Quality of Life evaluated with EQ-5D-5L
Safety reporting - treatment-emergent adverse events
Time frame: Up to 24 months after informed consent
Type, incidence, causal relationship, and severity of treatment-emergent adverse events
Safety reporting - albumin-bilirubin score (ALBI Score)
Time frame: Up to 24 months after informed consent
Analysis of the effect on albumin-bilirubin score (ALBI Score)
Safety reporting - Child Pugh Score
Time frame: Up to 24 months after informed consent
Analysis of the effect on Child Pugh Score
Review the complete result tables and limitations in the official record.
Open official results ↗Research locations (1)
The overall study status and a local site’s status can differ. Confirm that location’s availability before traveling.
1 locations
Klinik und Poliklinik für Innere Medizin II, TUM Klinikum, Rechts der IsarMünchen, GermanyRecruiting
Study team and timeline
- Lead sponsor
- AIO-Studien-gGmbH
- Study start
- Jul 28, 2026 Actual
- Primary completion
- 2031-01 Estimated
- Study completion
- 2031-03 Estimated
- First posted
- Nov 9, 2026 Actual
- Last updated
- Nov 9, 2026 Actual
Official study contacts
Official study title
Transarterial Chemoembolization (TACE) and Stereotactic Body Radiation (SBRT) in Patients With Hepatocellular Carcinoma (HCC) Prior to Liver Transplantation A Randomized, 2-arm Phase II Study Comparing the Combination of Transarterial Chemoembolization (TACE) and Stereotactic Body Radiation (SBRT) Versus TACE Alone in Patients With Hepatocellular Carcinoma as Bridging to Liver Transplantation With Regard to Explant Histopathology
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Source: ClinicalTrials.gov API v2. Information is submitted by sponsors and investigators. NLM does not approve the safety or science of all listed studies. Registry disclaimer.
Retrieved: Nov 12, 2026 · Last registry update: Nov 9, 2026
