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The Dragon PLC Trial (DRAGON-PLC)

Sponsor: Maastricht University

NCT ID: NCT06914648

View on ClinicalTrials.gov ↗

At a glance

What the study gets you
Access to the study treatment being tested
Type of study
Interventional (receives a drug or procedure)
Time in hospital
In-person visits at study sites — visit count not specified by the sponsor
Drug or intervention
Portal Vein Embolization (procedure), Hepatic Vein Embolization (procedure)
How long the study runs
Study runs about 91 months (dates as stated)
About the drug or intervention
Portal Vein Embolization — procedure: Description: Portal Vein embolization with Glue by a transhepatic approach · Hepatic Vein Embolization — procedure: Hepatic Vein Embolization with Vascular plugs via a transjugular or transfemoral approach in the same session as the PVE procedure
Patient visit burden
Not specified by the sponsor

In plain English

This study, run by Maastricht University, is looking at adults with primary liver cancer, including hepatocellular carcinoma (HCC, a cancer that starts in the liver) and cholangiocarcinoma (bile duct cancer). It is for people who need a procedure called portal vein embolisation (PVE, blocking a vein in the liver to help the remaining part grow) before surgery. The full aims and treatments of the trial are Not stated — ask the trial team.

Who can take part

  • Adults aged 18 or over
  • Diagnosed with primary liver cancer, specifically certain types of bile duct cancer (inside or outside the liver) or hepatocellular carcinoma (HCC)
  • Need portal vein embolisation (PVE, blocking a vein so the remaining liver grows) because the future liver remnant (the part left after surgery) is too small — the size needed depends on how well the liver is working
  • Able to understand the trial and agree to take part

Who may not be able to

  • Severe scarring of the liver (cirrhosis) with a Child-Pugh score of B or C
  • High blood pressure in the liver's veins (portal hypertension)
  • An infection of the bile tubes (cholangitis)
  • People who are pregnant
  • Women who have not been through the menopause and cannot or will not use contraception (specifically long-acting or hormonal contraception)
  • People who cannot have surgery because of other health problems, as decided by the local medical team
  • Liver cancers other than the types listed above
  • People for whom the PVE or HVE procedure is not possible due to the liver's anatomy
  • Cancer that has spread outside the liver and cannot be removed or destroyed
  • People unable to understand the study information or give informed consent

What taking part involves

  • • Not stated — ask the trial team

Time commitment: Not stated — ask the trial team

Plain-English summary (AI-generated) from registry data. Not eligibility advice — only the trial team can confirm whether you can take part. Use the eligibility checker to see how your health profile matches this trial.

Type of study
Testing a treatment
Ages
18 Years and over
Who
All
Number of participants
358
Started
2025-04-01
Last checked
2025-02

Plain English Summary

What is this study?

  • • Testing a new treatment for primary liver cancer
  • • NA - 358 participants
  • • The goal of the DRAGON PLC clinical trial is to determine whether portal vein embolization (PVE) combined with hepatic vein embolization (HVE) improves resectability and overall survival in patients with initially unresectable primary liver cancer compared to standard PVE alone

Who can take part?

  • • Ages 18 Years and over
  • • Diagnosed with primary liver cancer

Where?

  • • Belfast - Belfast Health and Social Care Trust
  • • Birmingham - Queen Elizabeth Hospital
  • • Liverpool - Aintree University Hospital
  • • London - Kings college Hospital
  • • +2 more UK sites

This is a simplified summary. Always discuss with your doctor before making any decisions.

About This Trial

The goal of the DRAGON PLC clinical trial is to determine whether portal vein embolization (PVE) combined with hepatic vein embolization (HVE) improves resectability and overall survival in patients with initially unresectable primary liver cancer compared to standard PVE alone. This trial specifically focuses on patients with hepatocellular carcinoma and cholangiocarcinoma. The main questions this trial aims to answer are whether combined PVE and HVE increases the proportion of patients who become resectable within 3 weeks and improves 5-year overall survival compared to PVE alone by enhancing liver hypertrophy. Participants will: * Undergo either standard PVE or combined PVE and HVE. * Have regular imaging to assess liver resectability. * Be monitored for survival outcomes up to 5 years after intervention.

More detail

Primary liver cancer (PLC) is the third most common cause of cancer death worldwide. Surgical resection is the mainstay for a curative approach as contemporary chemotherapy and immune-based therapies only lead to a median survival of 10-14 months. A complete surgical resection increases the median survival to 42 months (range 32-52 months). However, PLC is mainly diagnosed at an advanced stage and \>70% of PLC patients are ineligible for an immediate surgical approach. There are different reasons that make a patient ineligible for surgery, one important reason is the risk of liver failure after the surgery due to a small remnant liver. This study aims to improve the oncological, radiological and surgical strategy to allow more patients to undergo liver resection safely, to improve quality of life and to extend overall survival at acceptable costs. Adequate function of the future liver remnant (FLR) is a prerequisite for surgical resectability. This is necessary in order to avoid liver failure after surgery, a major cause of morbidity (38%) and mortality (27%). To mitigate this risk, regenerative strategies based on preoperative calculation of the FLR volume and function are essential. Patients with technically resectable disease but predicted insufficient FLR volume or function are referred to as primarily unresectable or potentially resectable (PU/PR). These patients can undergo strategies that capitalize on the regenerative capacity of the liver which aim to preoperatively increase the FLR volume and function in order to allow surgery. Many of the patients that are primarily unresectable due to an insufficient FLR can become ultimately and safely resectable after the induction of adequate FLR-hypertrophy by the current standard, portal vein embolisation (PVE). However, 25% of patients do not show sufficient FLR growth after PVE and are unable to safely undergo resection. A new approach has been developed to improve this. Combined portal and hepatic vein embolisation (PVE/HVE) has great promise in terms of increasing FLR growth, resection rate (RR), safety and potentially, overall survival. Establishing PVE/HVE as the new standard could result in increased survival and a better quality of life (QoL) for patients.

Primary Liver CancerHepatocellular Carcinoma (HCC)Cholangiocarcinoma

How this trial compares with your answers

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What we know so far

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Preliminary match based on your answers. Full eligibility requires on-site assessment including medical history, physical exam, and lab tests. This does not guarantee enrolment.

Eligibility at a Glance

Key info

  • Age: 18 Years and over
  • Who can join: All genders

What the study is looking for

  • ✓PLC diagnosis, specifically iCCC, pCCC, and HCC;
  • ✓Age ≥ 18 years;
  • ✓Able to understand the trial and provide agreement to take part.

Who cannot take part

  • ✗Liver cirrhosis with a Child-Pugh score of B or C;
  • ✗Presence of portal hypertension;
  • ✗Presence of cholangitis;
  • ✗Pregnant women;
  • ✗Premenopausal females not able/willing to commit to contraception (specifically long-acting reversible contraception...
See the full criteria
Inclusion Criteria: * PLC diagnosis, specifically iCCC, pCCC, and HCC; * Requiring PVE due to an FLR volume is \<30% in normally functioning livers, \<40% in livers with potentially impaired function e.g. resulting from prior systemic therapy induction or bile duct colonization / transpapillary biliary drainage, or \<50% in livers with severely impaired function resulting from liver cirrhosis (max. Child Pugh A5) OR function on hepatobiliary scintigraphy (HEBIS) is \< 2.7 %/min/m2; * Age ≥ 18 years; * Able to understand the trial and provide informed consent. Exclusion Criteria: * Liver cirrhosis with a Child-Pugh score of B or C; * Presence of portal hypertension; * Presence of cholangitis; * Pregnant women; * Premenopausal females not able/willing to commit to contraception (specifically long-acting reversible contraception or hormonal contraception); * Patients unresectable due to prohibitive comorbidities (decision made by local multidisciplinary team); * Patients with hepatic malignancies other than iCCC, pCCC or HCC; * PVE/HVE anatomically not feasible; * Any patient with non-resectable or non-ablatable extrahepatic metastatic disease. * Unable to understand the study information, study instructions and give informed consent

Where Is This Study? (6 UK sites)

Belfast Health and Social Care Trust

Belfast, United Kingdom

NOT_YET_RECRUITING
Site contact (verified)
D.G. Vass, Dr.Principal Investigator

Queen Elizabeth Hospital

Birmingham, United Kingdom

NOT_YET_RECRUITING
Site contact (verified)
R. Sutcliffe, Dr.Principal Investigator

Aintree University Hospital

Liverpool, United Kingdom

NOT_YET_RECRUITING
Site contact (verified)
R. Díaz-Nieto, Dr.Principal Investigator

Kings college Hospital

London, United Kingdom

NOT_YET_RECRUITING
Site contact (verified)
K. Menon, Dr.Principal Investigator

Oxford University Hospitals NHS Foundation Trust

Oxford, United Kingdom

NOT_YET_RECRUITING
Site contact (verified)
K.V. UdupaPrincipal Investigator

University Hospital Southampton

Southampton, United Kingdom

NOT_YET_RECRUITING
Site contact (verified)
J.N. Primrose, Prof.Principal Investigator

How to Get in Touch

Fenna A van der Zijden, MSc Technical Medicine

Sponsor contact

CONTACT

+31640911632 fenna.van.der.zijden@mumc.nl

Sinead James, MD

Sponsor contact

CONTACT

+31 638463945 sinead.james@mumc.nl
Data sourced from ClinicalTrials.gov · Last verified: 2025-02