Y-90 with Durvalumab, Gemcitabine, and Cisplatin for Bile Duct Cancer

This study is testing a combination of treatments for bile duct cancer (intrahepatic cholangiocarcinoma) that cannot be removed by surgery. The treatments include Yttrium-90 (Y-90), a type of radiation, along with two chemotherapy drugs, gemcitabine and cisplatin, and an immunotherapy drug called durvalumab. Researchers want to see how safe and effective this combination is. You might be able to join if you are at least 18 years old and have this type of bile duct cancer. The study will measure how long people live without their cancer growing (progression-free survival) and look at any serious side effects. The current status of this study is unclear, and it plans to enroll about 30 people.

Study design
This is a Phase II study that will give the same treatment to all participants (single-arm) and everyone will know what treatments they are receiving (open-label). About 30 people are expected to participate.
What's involved
You will undergo screening to see if you qualify, receive study treatments, and have evaluations and follow-up visits. You will be followed for up to 52 weeks after stopping the study treatment.
Compensation
Not stated in the trial record.
Follow-up
Participants will be followed for up to 52 weeks after stopping treatment to monitor progression-free survival and side effects.

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NCT05655949

Y-90 With Durvalumab/Gem/Cis in Intrahepatic Cholangio

Recruiting
PHASE2Ages 18+InterventionalTreatment
Beth Israel Deaconess Medical Center
~30 participants
Updated 2026-04-22 on ClinicalTrials.gov
What's tested:GemcitabineCisplatinDurvalumabYttrium-90

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Median Progression Free Survival (PFS)
Measured over Enrollment to end of treatment and up to 52 weeks thereafter
+1 more outcome measured
Bile Duct Cancer
Cholangiocarcinoma
Cholangiocarcinoma Non-resectable
Cholangiocarcinoma Metastatic
Metastatic Intrahepatic Cholangiocarcinoma
1 sites across 1 states
Massachusetts1
  • Andrea Bullock, MD, MPH · PRINCIPAL_INVESTIGATOR · Beth Israel Deaconess Medical Center

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Eligibility criteria

Inclusion

Ability to comprehend and willingness to sign a written ICF for the study
Male and female participants at least 18 years of age at the time of signing the ICF
Histologically or cytologically confirmed locally advanced unresectable or metastatic intrahepatic cholangiocarcinoma; at least one intrahepatic lesion must be present
Radiographically measurable or evaluable disease by CT or MRI per RECIST v1.1 criteria
ECOG performance status ≤1
Body weight \>30 kg
Must have a life expectancy of at least 12 weeks
Participants must have adequate marrow function as defined below:
Hemoglobin ≥9.0 g/dL
Absolute neutrophil count (ANC) ≥1.0 × 109 /L
Platelet count ≥75 × 109/L
Participants must have adequate renal function as defined below:
Serum creatinine ≤ 1.5 mg/dL OR
Measured creatinine clearance (CL) \>40 mL/min or Calculated creatinine CL\>40 mL/min by the Cockcroft-Gault formula (Cockcroft and Gault 1976) or by 24-hour urine collection for determination of creatinine clearance
Participants must have adequate hepatic function as defined below:
Bilirubin ≤1.5 x ULN
ALT ≤ 2.5 x ULN unless liver metastases are present, in which case it must be ≤5x ULN
AST ≤ 2.5 x ULN unless liver metastases are present, in which case it must be ≤5x ULN
This will not apply to patients with confirmed Gilbert's syndrome (persistent or recurrent hyperbilirubinemia that is predominantly unconjugated in the absence of hemolysis or hepatic pathology), who will be allowed only in consultation with their physician
No known history of active HBV or HCV infection.
Note: Participants with Hepatitis C who have been clinically cured, defined as persistent absence of Hepatitis C RNA detected by polymerase chain reaction (PCR) test in serum 12 weeks after completing antiviral treatment, are eligible for this study
Note: Participants with a history of Hepatitis B infection that are currently on viral suppressive therapy are eligible for enrollment
Adequate coagulation studies as demonstrated by prothrombin (PT) and partial thromboplastin (PTT) time within normal limits (\</= 1.5 x ULN) in the absence of anticoagulation medication. Participants receiving anticoagulation may be approved by sponsor
Participants with known human immunodeficiency virus (HIV) on effective highly-active antiretroviral therapy (HAART) with undetectable viral load within 6 months are eligible for this trial, so long as the following criteria are met:
HAART does not interact with or have overlapping toxicities with study medication, per discretion of the treating provider
CD4 count is ≥350 cells/uL, viral load is undetectable, and not taking prohibited cytochrome (CYP)-interacting medications
Probable long-term survival with HIV if cancer were not present
Stable on a HAART regimen for ≥4 weeks and willing to adhere to their HAART regimen with minimal overlapping toxicity and drug-drug interactions with the experimental agents in this study
HIV is not multi-drug resistant
Taking medication and/or receiving antiretroviral therapy that does not interact or have overlapping toxicities with the study medication

Exclusion

Surgically resectable disease at enrollment
Histologically or cytologically confirmed diagnosis of primary hepatocellular carcinoma or mixed adenocarcinoma/hepatocellular carcinoma
Received prior systemic chemotherapy and/or radiotherapy for intrahepatic cholangiocarcinoma. Prior surgical resection and adjuvant chemotherapy or chemoradiotherapy is allowed if more than 6 months have elapsed since last dose of treatment, and if the tumor is amenable to Y-90 SIRT
Prior treatment with anti-PD-1, anti-PD-L, including durvalumab antibody, or any other drug treatment specifically targeting T-cell co-stimulation or checkpoint pathways
Any of the following within 6 months of screening:
New York Heart Association (NYHA) Class III or IV heart failure
Myocardial infarction, unstable angina pectoris, or symptomatic coronary artery disease
Unstable arrhythmia
Stroke to transient ischemic attack
Previous malignancies, except for adequately treated non-melanoma skin cancer, in-situ cancer, or any other cancer from which the subject has been disease-free for at least 3 years
Severe chronic obstructive or other pulmonary disease with chronic baseline hypoxemia due to potential for gemcitabine-induced bronchospasm and/or durvalumab-induced pneumonitis
Major surgery (other than diagnostic) within 4 weeks of study treatment day 1
Active, uncontrolled or untreated bacterial, viral, or fungal infection that requires systemic therapy
Active, untreated HIV, HBV, or HCV
Subjects who have participated in another investigational drug or device study within 4 weeks prior to study registration.
Female patients of child-bearing potential Female patients of childbearing potential who are not abstinent and intend to be sexually active with a non sterilized male partner must use at least 1 highly effective method of contraception (Table 2) from the time of screening throughout the total duration of the drug treatment and the drug washout period (90 days after the last dose of durvalumab monotherapy). Non-sterilised male partners of a female patient of childbearing potential must use male condom plus spermicide throughout this period. Cessation of birth control after this point should be discussed with a responsible physician. Periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of birth control. Female patients should also refrain from breastfeeding throughout this period.
Male patients with a female partner of childbearing potential Non-sterilized male patients who are not abstinent and intend to be sexually active with a female partner of childbearing potential must use a male condom plus spermicide from the time of screening throughout the total duration of the drug treatment and the drug washout period (90 days after the last dose of durvalumab monotherapy). However, periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of contraception. Male patients should refrain from sperm donation throughout this period.
Women \<50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and if they have luteinizing hormone and follicle-stimulating hormone levels in the post-menopausal range for the institution.
Women ≥50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments, had radiation-induced menopause with last menses \>1 year ago, had chemotherapy-induced menopause with last menses \>1 year ago.
Copper T intrauterine device
Levonorgestrel-releasing intrauterine system (e.g., Mirena®)a
Implants: Etonogestrel-releasing implants: e.g. Implanon® or Norplant®
Intravaginal: Ethinylestradiol/etonogestrel-releasing intravaginal devices: e.g. NuvaRing®
Injection: Medroxyprogesterone injection: e.g. Depo-Provera®
Combined Pill: Normal and low dose combined oral contraceptive pill
Patch: Norelgestromin/ethinylestradiol-releasing transdermal system: e.g. Ortho Evra® Minipillc: Progesterone based oral contraceptive pill using desogestrel: Cerazette® is currently the only highly effective progesterone-based
Any concomitant disease or condition that could interfere with the conduct of the study, or that would in the option of the investigator pose an unacceptable risk to the subject in the study
Contraindications to Y-90 SIRT per assessment by treating Interventional Radiologist (eg significant vascular drainage of the tumor to the lung that increases the potential for pulmonary toxicity)
Unwillingness or inability to comply with the study protocol
History of allogenic organ transplantation.
Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease \[e.g., colitis or Crohn's disease\], diverticulitis \[with the exception of diverticulosis\], systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome \[granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc\]). The following are exceptions to this criterion:
Patients with vitiligo or alopecia
Patients with hypothyroidism (e.g., following Hashimoto syndrome) stable on hormone replacement
Any chronic skin condition that does not require systemic therapy
Patients without active disease in the last 5 years may be included but only after consultation with the study physician
Patients with celiac disease controlled by diet alone
Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent
History of active primary immunodeficiency
Active infection including tuberculosis (clinical evaluation that includes clinical history, physical examination and radiographic findings, and TB testing in line with local practice
Current or prior use of immunosuppressive medication within 14 days before the first dose of durvalumab. The following are exceptions to this criterion:
Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra articular injection)
Systemic corticosteroids at physiologic doses not to exceed \<\<10 mg/day\>\> of prednisone or its equivalent
Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication)
Receipt of live attenuated vaccine within 30 days prior to the first dose of IP. Note: Patients, if enrolled, should not receive live vaccine whilst receiving IP and up to 30 days after the last dose of IP.
Female patients who are pregnant or breastfeeding or male or female patients of reproductive potential who are not willing to employ effective birth control from screening to 90 days after the last dose of durvalumab monotherapy.
Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.
  • Median Progression Free Survival (PFS)Enrollment to end of treatment and up to 52 weeks thereafter

    PFS is defined as the time from date of entry into the study until the date of disease progression (according to RECIST v1.1 and assessed by an independent central reviewer) or death, whichever occurs first.

  • Incidence of Grade 3 or Higher Treatment-Related ToxicityEnrollment to end of treatment and up to 52 weeks thereafter

    All grade 3 or higher adverse events (AE) with treatment attribution of possibly, probably or definite based on CTCAEv5 as reported on case report forms. Incidence is the number of patients experiencing at least one treatment-related grade 3 or higher AE of any type during the time of observation.