Status:

NOT_YET_RECRUITING

Adjuvant Everolimus in High-Risk Hepatocellular Carcinoma After Curative Resection (SEVERANCE Trial)

Lead Sponsor:

Yonsei University

Conditions:

Carcinom

Hepatocellular

Eligibility:

All Genders

20-75 years

Phase:

PHASE2

Brief Summary

"Hepatic resection is the primary curative treatment for patients with a single, liver-confined hepatocellular carcinoma (HCC) without cirrhosis and is also considered in patients with cirrhosis if re...

Eligibility Criteria

Inclusion

  • Alkaline phosphatase level \> 2.5 times the ULN
  • Proteinuria defined as a urine protein-to-creatinine ratio \> 1.0 g/gCr or ≥ 2+ on urine dipstick
  • Patients who received systemic therapy prior to hepatic resection
  • Prior treatment with anti-CTLA-4, anti-PD-1, or anti-PD-L1 therapies
  • Renal impairment with estimated glomerular filtration rate (eGFR) \< 30 mL/min/1.73m² (based on MDRD formula)
  • Total cholesterol \> 350 mg/dL or triglycerides \> 500 mg/dL
  • History of severe acute (within the past 4 weeks) or chronic hypersensitivity reactions requiring treatment to everolimus or drugs with a similar chemical structure
  • Pregnant or breastfeeding women, women who are possibly pregnant, or women of childbearing potential who are unable to use highly effective contraception† during the study period and for 8 weeks after the last dose
  • Any condition deemed by the investigator to render the patient unsuitable for participation in the clinical trial
  • Highly effective contraception is defined as methods with a failure rate of less than 1% per year, including bilateral tubal occlusion, male sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices (IUDs), and copper IUDs. Methods such as calendar-based methods, ovulation prediction, symptothermal methods, and post-ovulation methods are not considered adequate contraception.

Exclusion

  • Patients diagnosed with combined hepatocellular-cholangiocarcinoma (HCC-CCC)
  • Presence of clinically significant ascites
  • History of hepatic encephalopathy
  • History of variceal bleeding within 6 months prior to hepatic resection
  • Autoimmune diseases or immunodeficiency disorders
  • Serious cardiovascular diseases, including acute myocardial infarction, acute coronary syndrome, stroke, or heart failure of New York Heart Association (NYHA) Class II or higher
  • History of malignancies other than HCC within the past 5 years
  • Patients with hereditary metabolic disorders such as galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption
  • Patients currently taking medication for psychiatric disorders
  • Absolute neutrophil count (ANC) \< 1500/μL or platelet count \< 75,000/μL
  • AST, ALT, or total bilirubin levels \> 3 times the upper limit of normal (ULN)
  • Alkaline phosphatase level \> 2.5 times the ULN
  • Proteinuria defined as a urine protein-to-creatinine ratio \> 1.0 g/gCr or ≥ 2+ on urine dipstick
  • Patients who received systemic therapy prior to hepatic resection
  • Prior treatment with anti-CTLA-4, anti-PD-1, or anti-PD-L1 therapies
  • Renal impairment with estimated glomerular filtration rate (eGFR) \< 30 mL/min/1.73m² (based on MDRD formula)
  • Total cholesterol \> 350 mg/dL or triglycerides \> 500 mg/dL
  • History of severe acute (within the past 4 weeks) or chronic hypersensitivity reactions requiring treatment to everolimus or drugs with a similar chemical structure
  • Pregnant or breastfeeding women, women who are possibly pregnant, or women of childbearing potential who are unable to use highly effective contraception† during the study period and for 8 weeks after the last dose
  • Any condition deemed by the investigator to render the patient unsuitable for participation in the clinical trial
  • Highly effective contraception is defined as methods with a failure rate of less than 1% per year, including bilateral tubal occlusion, male sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices (IUDs), and copper IUDs. Methods such as calendar-based methods, ovulation prediction, symptothermal methods, and post-ovulation methods are not considered adequate contraception.

Key Trial Info

Start Date :

July 1 2025

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

July 30 2030

Estimated Enrollment :

60 Patients enrolled

Trial Details

Trial ID

NCT06972758

Start Date

July 1 2025

End Date

July 30 2030

Last Update

May 15 2025

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