CTC liver cancer study now open to recruitment in the UK
31 August 2022
A study in the treatment of liver cancer run by the CR UK & UCL Cancer Trials Centre opened to recruitment at The Royal Free Hospital this month. 

PRIMER-1 will compare treatments for patients with the most common type of liver cancer, which is known as hepatocellular carcinoma (HCC). The study aims to recruit 60 patients from approximately 10 sites in the UK over the next two years. 

Liver cancer is the fourth most common cause of cancer-related death worldwide, a statistic which is currently increasing in Europe and America.  The only potential options to cure the disease are a liver transplant, surgery, or a method of destroying the tumour known as ablation; however, all methods are associated with high rates of the disease recurring, with 70% of surgery patients in particular relapsing within five years. 

PRIMER-1 will look at how a patient’s liver tumour responds when given two cycles of drug treatment prior to surgery. This treatment will involve one of three options: a targeted cancer drug called lenvatinib; a drug which stimulates the body’s immune system known as pembrolizumab; or the two drugs combined. After this, all patients will then go on to have surgery, followed by a further 17 cycles pembrolizumab treatment. 

PRIMER-1 arrives at a time where currently no additional treatments have been shown to reduce the relapse rate among patients following surgery for hepatocellular carcinoma (HCC). As Professor Tim Meyer, the trial’s chief investigator, explains: ‘The 5-year survival is one of the lowest for any malignancy. Lenvatinib and pembrolizumab are active in advanced HCC, and PRIMER 1 will explore the efficacy of these drugs in the pre-operative setting with the aim of improving outcomes following surgery.

‘A comprehensive program of translational research will provide novel insights into the effect of these agents on the immune microenvironment and mechanisms of resistance’.

Data from the study will be used to inform the design of future liver cancer trials looking to demonstrate the benefit of immunotherapy treatment around the time of surgery. 

PRIMER-1 is phase II randomised open-label study run by the CR UK & UCL Cancer Trials Centre and funded by Merck, Sharp & Dhome (MSD). More information can be found on the trial webpage.

Image: Micrograph of hepatocellular carcinoma, © Michael Bonert

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