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Liver cancer is a rare disease with two types: hepatocellular carcinoma and cholangiocarcinoma (cancer of the bile duct). Together, there are about 41,260 new cases in the US each year. However, a few of these cases will include features of both cancer types—even rarer. When this occurs, the cancer is called combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CC). Unfortunately, patients with this type of liver cancer have poor results—in part because it so aggressive. In many cases, it has spread (advanced) beyond the liver by the time it is found and cannot be removed by surgery.
Doctors commonly use chemotherapy to treat patients with this form of liver cancer. Researchers at the ECOG-ACRIN Cancer Research Group are studying if they can improve results for patients by giving chemotherapy along with drugs that help the body’s immune system fight cancer. Their goal is to determine if giving two immunotherapy drugs, bevacizumab and atezolizumab, with chemotherapy may kill more tumor cells than chemotherapy alone, allowing patients to live longer. Early studies suggest this may be the case, but clinical trial EA2205 aims to confirm it.
This trial is for people with cHCC-CC that cannot be removed by surgery or has spread to another part of the body (advanced, metastatic). Patients must not have had any prior treatments that may affect the entire body (systemic). Patients may be eligible if they have had therapy only to the liver area.
Participants in EA2205 will be assigned randomly by a computer to one of two groups. Group 1 will receive the usual chemotherapy drugs to treat cHCC-CC, gemcitabine and cisplatin. These drugs are given through a vein in the arm (intravenously) on days 1 and 8 of each treatment cycle. Group 2 will also receive gemcitabine and cisplatin on days 1 and 8 of each treatment cycle, but they will have additional intravenous treatment on day 1 with the study drugs, bevacizumab and atezolizumab. Treatment cycles last for 21 days. Patients in both groups may continue treatment until it stops working or causes unacceptable side effects.
This study is led by David Hsieh, MD of UT Southwestern/Harold C. Simmons Comprehensive Cancer Center.
Learn more about EA2205 at ecog-acrin.org.