Liver cancer (including hepatocellular carcinoma and cholangiocarcinoma) affects over 6,100 people in the UK each year, with incidence rising. The arrival of immunotherapy combinations (atezolizumab + bevacizumab) and targeted therapies for cholangiocarcinoma (FGFR and IDH1 inhibitors) has transformed treatment. UK centres are running trials across all stages and subtypes.
UK liver cancer research is coordinated through the NCRI Hepatobiliary Clinical Studies Group. Major centres include the Royal Marsden, University Hospital Birmingham, and the Freeman Hospital Newcastle. NICE has approved atezolizumab + bevacizumab, durvalumab, and several FGFR inhibitors for liver cancer.
There are currently over 35 actively recruiting liver cancer trials in the UK, covering HCC, cholangiocarcinoma, and rare subtypes.
Types of Liver Cancer Trials
Immunotherapy
Anti-PD-1/PD-L1 combinations for HCC, dual checkpoint blockade, and adjuvant immunotherapy after surgery or ablation.
Targeted Therapy
FGFR inhibitors for cholangiocarcinoma, IDH1 inhibitors, and VEGF-targeted agents for advanced HCC.
Locoregional
TACE, TARE, and ablation techniques combined with systemic therapy for intermediate-stage HCC.
Surgery
Liver transplantation criteria expansion, neoadjuvant therapy before resection, and adjuvant approaches.
Hepatocellular Carcinoma (HCC) Trials
Atezolizumab + bevacizumab — the IMbrave150 regimen is now first-line for advanced HCC. UK trials testing: treatment beyond progression, biomarker-guided therapy, and use in Child-Pugh B patients
Durvalumab + tremelimumab — the STRIDE regimen (anti-PD-L1 + anti-CTLA-4) as an alternative first-line. UK trials comparing to atezo + bev and testing sequencing
Second-line TKIs — regorafenib, cabozantinib, and ramucirumab after first-line immunotherapy. UK trials testing: optimal sequencing, combination with immunotherapy, and earlier use
Adjuvant therapy — immunotherapy after resection or ablation to reduce recurrence, with UK Phase 3 trials actively recruiting
Combination locoregional + systemic — TACE or TARE combined with immunotherapy for intermediate-stage HCC, a major UK research focus
Cholangiocarcinoma (Bile Duct Cancer) Trials
FGFR inhibitors — futibatinib and pemigatinib for FGFR2 fusion-positive cholangiocarcinoma (~10-15% of cases). UK trials testing: earlier use, combination with immunotherapy, and resistance management
IDH1 inhibitors — ivosidenib for IDH1-mutant cholangiocarcinoma (~20% of cases). UK trials exploring combination approaches and use in front-line setting
Immunotherapy — checkpoint inhibitors alone and in combination with chemotherapy for advanced cholangiocarcinoma, regardless of molecular subtype
HER2-targeted therapy — trastuzumab deruxtecan and other HER2-directed agents for HER2-positive cholangiocarcinoma (~10% of cases)
BRAF-directed therapy — dabrafenib + trametinib for BRAF V600E-mutant cholangiocarcinoma, a rare but treatable molecular subset
Who Can Participate?
HCC trials — confirmed hepatocellular carcinoma, Child-Pugh A or B liver function, measurable disease, no prior systemic therapy (for first-line trials) or specific prior treatment (for later-line)
Cholangiocarcinoma trials — histologically confirmed cholangiocarcinoma, FGFR2/IDH1/BRAF/HER2 status known (for targeted therapy trials), measurable disease
Locoregional trials — intermediate-stage HCC suitable for TACE/TARE/ablation, preserved liver function, no extrahepatic spread (for most trials)
Surgical trials — resectable or potentially resectable disease, adequate liver reserve for resection, no significant portal hypertension
General criteria — ECOG 0-1, adequate organ function, no untreated variceal bleeding, controlled viral hepatitis
UK Liver Cancer Trial Locations
London — Royal Marsden Hospital, UCLH, Royal Free Hospital, King's College Hospital
Birmingham — Queen Elizabeth Hospital Birmingham (major liver centre)
Newcastle — Freeman Hospital (transplant centre)
Leeds — St James's University Hospital
Glasgow — Beatson West of Scotland Cancer Centre
Cambridge — Addenbrooke's Hospital
Edinburgh — Royal Infirmary of Edinburgh
🧬 Tip: Get Comprehensive Genomic Profiling
Cholangiocarcinoma treatment is increasingly guided by molecular profiling. Request testing for FGFR2 fusions, IDH1 mutations, BRAF V600E, HER2, and MSI-H/dMMR status. These results determine eligibility for targeted therapy trials. For HCC, ensure your Child-Pugh score and alpha-fetoprotein (AFP) level are documented — these are key eligibility criteria for most trials.
How to Find Your Match
Use our Smart Matcher to find liver cancer trials tailored to your specific situation. Whether you are newly diagnosed, exploring targeted therapy, or seeking advanced treatment options, we can match you to actively recruiting studies.