Trial seeks to improve outcomes after surgery for liver cancer
19 April 2023
A Royal Free Hospital (RFH) patient has become the first person in the UK to join a study looking at whether two drugs could help patients with liver cancer.
The trial will test whether pembrolizumab and lenvatinib, given prior to surgery, will improve outcomes for patients.
The study is open to people with a type of liver cancer called hepatocellular carcinoma, the most common type of primary liver cancer.
Pembrolizumab is an immunotherapy which works by stimulating the immune system to find the cancer cells and attack them. Doctors already use pembrolizumab to treat other types of cancer.
Lenvatinib prevents the growth of tumours using two methods. First it blocks signals that cancer cells need to grow and divide - without these signals, the cells die. Secondly, it prevents the cells from growing new blood vessels. This leaves the cells with insufficient oxygen and nutrients, which means the tumour shrinks or stops growing. Doctors currently use lenvatinib for some cancers, including liver cancer that has spread to another part of the body.
Chief Investigator Professor Tim Meyer (pictured), consultant in medical oncology and director of the National Institute of Health Research Royal Free Clinical Research Facility, said: “Unfortunately patients who have liver resection for liver cancer have a high chance of relapse and there is currently no approved or proven therapy to reduce that risk.’’
The trial will open in other specialist liver cancer centers in the UK and a total of 60 people will take part. It is a randomized trial and people will be split randomly into three groups. One group will receive pembrolizumab before surgery, another group will receive lenvatinib before surgery and a third group will receive both pembrolizumab and lenvatinib before surgery. In all cases, pre-surgery treatment will last for 6 weeks. After surgery all participants will receive pembrolizumab for one year.
The aim of the trial is to find out how well the treatments work, whether the treatments reduce the chances of liver cancer returning after surgery, what the side effects are and whether there is an impact on the surgical schedule.
Professor Meyer added: “We know all these treatments are effective for advanced stage liver cancer, but we want to discover if we can use them at an earlier stage to reduce the risk of recurrence post-surgery. As part of the trial, we are collaborating with University College London scientists in the Pears Building and internationally to learn more about how these drugs work in liver cancer and what further improvements can be made.’’
Farhan Naim, director of research and development at the Royal Free London, said: “This is a powerful illustration of how collaboration between the Royal Free London, The University College London Institute of Immunity and Transplantation, based at the Pears Building, industry and Cancer Research UK, has the potential to produce high quality research for patient benefit.”