This study involves people with hepatocellular carcinoma, which is a type of liver cancer that cannot be removed by surgery or has spread to other parts of the body. The study is for people whose cancer has gotten worse after trying a first treatment that included a specific type of medicine called an anti-PD-(L)1 compound. The study will test several medicines: visugromab (also known as CTL-002), nivolumab, and lenvatinib. Some people in the study will receive visugromab combined with nivolumab and lenvatinib, while others will receive placebo along with lenvatinib. Sodium chloride solution will be used to prepare the medicines for infusion into the vein. The purpose of the study is to see how well visugromab works when combined with nivolumab and lenvatinib compared to placebo and lenvatinib in controlling the cancer.
During the study, participants will receive their assigned treatment for up to 36 months. Visugromab and nivolumab will be given through a vein, while lenvatinib will be taken by mouth as capsules. The study will check how the cancer responds to treatment by looking at scans and other tests. Doctors will measure how long it takes before the cancer gets worse and how long people live. They will also check for any side effects from the medicines and ask participants questions about how they are feeling and their quality of life.
Before joining the study, participants must have cancer that can be measured on scans and must have tried one previous treatment that included an anti-PD-(L)1 medicine for at least 12 weeks. Their liver function must be in good condition, and they must have adequate blood counts, kidney function, and other organ functions. The study will monitor participants throughout treatment to track both how well the treatment works and any side effects that may occur.



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