A multi-national, investigator-initiated and industry-backed clinical trial has been launched to test the efficacy of a novel radiotherapy and immunotherapy combination that aims to improve health outcomes for patients with the primary liver cancer, hepatocellular carcinoma (HCC).

Led by the National Cancer Centre Singapore (NCCS), the AHCC09 (STRATUM) study has received SGD19.2 million in funding from industry partners Roche and Sirtex and will be conducted across 13 sites in the Asia Pacific (APAC) region.

Liver cancer is the sixth most common cancer in the world and fourth most common cause of cancer deaths globally. In Singapore, it is the third most common cause of cancer deaths in males and fifth most common cause in females. Up to a third of patients in the APAC region present with intermediate stage HCC at diagnosis, making it the biggest sub-group of HCC patients. 

Current standard-of-care for intermediate stage HCC is local delivery of chemotherapy to the tumour using a procedure called embolisation (TACE), or radiation delivery via blood vessels directly to the tumour, in a procedure called Yttrium-90 radioembolisation (Y90-RE). In recent years, immunotherapy has been used to treat HCC with promising results. However, only a subset of HCC patients, around 30%, respond to immunotherapy.

Research previously conducted by a NCCS team showed that Y90-RE boosted immune cells with anti-tumour activity and potentially enhance the efficacy of immunotherapy for HCC patients. Building on those findings, the same team has launched AHCC09 (STRATUM) to compare the safety and efficacy of Y90-RE followed by the immunotherapy atezolizumab and bevacizumab. This will be compared against a control group with Y90-RE followed by a placebo. Atezolizumab and bevacizumab are immunotherapies that are currently approved to treat HCC along with a number of other cancers.