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NCT Number: NCT07378709

Exploratory Blood-Based Biomarkers in TACE-Treated Hepatocellular Carcinoma

The goal of this observational study is to evaluate changes in selected biomarkers and their potential connection with early radiological outcomes in adult patients with hepatocellular carcinoma (HCC) who are candidates for Transarterial Chemoembolization (TACE) treatment. The main questions it aims to answer are whether specific biomarkers change in response to TACE treatment and if there is a correlation between these changes and early radiological treatment response as measured by Modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Participants will undergo standard-of-care TACE as decided by a multidisciplinary team and will provide blood samples at predefined, clinically relevant time points, specifically before the first TACE procedure and during subsequent follow-up cycles on the day of either a new TACE or a control Computed Tomography (CT) scan. Additionally, participants will undergo routine clinical and radiological assessments, including multiphase CT or Magnetic Resonance Imaging (MRI) scans four to eight weeks after the procedure to monitor treatment success, with all data being collected from medical records and standard diagnostic procedures.

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Key information

Conditions

Hepatocellular Carcinoma (HCC) Adenocarcinoma Carcinoma Carcinoma, Hepatocellular Digestive System Diseases Digestive System Neoplasms Liver Diseases Liver Neoplasms Neoplasms Neoplasms by Histologic Type Neoplasms by Site Neoplasms, Glandular and Epithelial

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

KBC Bežanijska kosa

Belgrade, Serbia

Location status: Recruiting

Location contact

Jovana Popović, Medical Doctor

CONTACT

[email protected]

0038162214194

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age ≥ 18 years.
  • Diagnosis of hepatocellular carcinoma (HCC) based on LI-RADS CT/MRI v2018 criteria or histopathological verification
  • Candidate for TACE as part of standard treatment (BCLC criteria)
  • Child-Pugh score ≤ 7 at the time of TACE indication
  • ECOG performance status 0 at the time of TACE indication
  • Availability of at least one follow-up multiphase CT or MRI scan 4-8 weeks after TACE

Exclusion criteria

  • Child-Pugh score ≥8 at the time of TACE indication
  • Eastern Cooperative Oncology Group (ECOG) performance status > 0 at the time of TACE indication.
  • Presence of extrahepatic dissemination and/or macrovascular invasion
  • Technically unfeasible TACE (e.g., inability to identify feeder artery)
  • Severe uncorrectable coagulopathy or cytopenia
  • Severe allergy or contraindication to iodine contrast agent or drugs used during TACE
  • Pregnancy or breastfeeding
  • Inability to provide signed informed consent

Treatment and study plan

Primary outcomes

  1. Correlation between blood-based biomarkers and early radiological response

    Time frame: From baseline (before first TACE) up to the follow-up assessment 4-8 weeks after the procedure.

    Evaluation of changes in selected biomarkers (including AFP and PIVKA-II) and their potential association with early radiological outcomes following TACE, assessed using mRECIST criteria (Complete Response, Partial Response, Stable Disease, or Progressive Disease).

Secondary outcomes

  1. Radiological Response Assessment via mRECIST.

    Time frame: 4-8 weeks after each TACE procedure.

    Tumor response will be evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST), a categorical scale used to assess viable tumor based on arterial enhancement on CT or MRI scans.

    Scale Information:

    Scale Type: Categorical

    Minimum Value: Complete Response (CR) - best outcome

    Maximum Value: Progressive Disease (PD) - worst outcome

    Directionality: Higher category represents a worse outcome

    Categories:

    Complete Response (CR)

    Partial Response (PR)

    Stable Disease (SD)

    Progressive Disease (PD)

    Outcome Reporting:

    The percentage of patients achieving each response category (CR, PR, SD, PD) will be reported.

  2. Changes in Tumor Marker Levels (AFP and PIVKA-II).

    Time frame: Baseline (Day 0, before first TACE) and at each follow-up cycle (4-8 weeks after procedure).

    Measurement of the change in serum levels of Alpha-fetoprotein (AFP) and Protein Induced by Vitamin K Absence (PIVKA-II from baseline to follow-up points.

  3. Assessment of Liver Function Post-TACE.

    Time frame: From baseline up to 8 weeks after the final TACE procedure.

    Liver function will be monitored using the Child-Pugh Liver Function Score, which evaluates hepatic reserve based on five clinical and laboratory parameters (bilirubin, albumin, INR/prothrombin time, ascites, and hepatic encephalopathy).

    The score is calculated at baseline and during follow-up assessments to evaluate potential liver function deterioration after TACE.

    Scale Information:

    Full Scale Name: Child-Pugh Liver Function Score

    Scale Type: Ordinal numeric scale with clinical class categories

    Minimum Value: 5 points - best liver function (Child-Pugh Class A)

    Maximum Value: 15 points - worst liver function (Child-Pugh Class C)

    Directionality: Higher scores represent a worse clinical outcome

    Score Ranges / Classes:

    5-6 points: Child-Pugh A (well-compensated liver disease)

    7-9 points: Child-Pugh B (significant functional impairment)

    10-15 points: Child-Pugh C (severe hepatic dysfunction)

  4. Exploratory Serum Biomarker Profiling (Proteomics, miRNA, and Oxidative Stress).

    Time frame: From baseline (Day 0, before first TACE) up to the first follow-up assessment (4-8 weeks post-procedure).

    An exploratory evaluation of serum samples to identify changes in protein profiles (proteomics), circulating microRNA (miRNA) signatures, and markers of oxidative stress (e.g., Malondialdehyde, Superoxide Dismutase) as potential predictors or indicators of radiological response to Drug-eluting Bead Trans arterial Chemoembolization (DEB-TACE).

Study contacts

Contact information is provided by the study sponsor or research team.

Marko Stojanović, Medical Doctor

CONTACT

[email protected]

00381601435353

Sponsors and collaborators

Lead sponsor

University of Belgrade

Other

Registry information

Official study title

Blood-Based Biomarkers for Prediction and Monitoring of Response to TACE in Hepatocellular Carcinoma: A Pilot Study

Acronym: BLOOD-TACE-P

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
Jan 30, 2026
Registry last updated
Feb 5, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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