Study on Regorafenib and Yttrium-90 Radioembolization for Liver Cancer That Cannot Be Removed by Surgery

Inclusion Criteria

• Adults aged 18 and older.
• Have liver cancer that cannot be surgically removed.
• Have a liver function score of Child-Pugh A-B7.
• Have specific blood test results showing:
  • Bilirubin levels less than 1.5 times the normal limit.
  • Liver enzymes (AST and ALT) less than 5 times the normal limit.
  • Creatinine levels less than or equal to 1.5 times the normal limit.
  • Blood clotting times (INR/PTT) less than or equal to 1.5 times the normal limit. Patients on blood thinners like warfarin or heparin can participate if they have no clotting issues.
  • Platelet count over 100,000/mm3, hemoglobin at least 9 g/dL, and neutrophil count at least 1,500/mm3.
• A test shows that radioembolization can be safely performed.
• No previous systemic treatment for liver cancer.
• Agree to follow contraception guidelines during the study.

Exclusion Criteria

• A test shows blood vessel issues that prevent radioembolization.
• Have had radioembolization before.
• Have major disease outside the liver.
• Have cancer that has spread to the brain.
• Have not recovered from major surgery or plan to have major surgery within 30 days of joining the study.
• Have a non-healing wound, ulcer, or bone fracture.
• Have HIV or active hepatitis B or C needing antiviral treatment.
• Have an ongoing severe infection.
• Have uncontrolled high blood pressure despite treatment.
• Have significant heart disease, including:
  • Severe heart failure.
  • Active heart disease.
  • Heart rhythm issues needing treatment other than beta blockers or digoxin.
  • Unstable chest pain or recent heart attack.
• Have a history of bleeding disorders.
• Have had a severe bleeding event recently.
• Have had recent blood clots or strokes.
• Have another untreated or active cancer, except for certain non-threatening types.
• Have impaired decision-making ability.