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Nolatrexed Dihydrochloride Compared With Doxorubicin in Treating Patients With Recurrent or Unresectable Liver Cancer

Primary Purpose

Liver Cancer

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
doxorubicin hydrochloride
nolatrexed dihydrochloride
Sponsored by
Eximias Pharmaceutical
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Liver Cancer focused on measuring localized unresectable adult primary liver cancer, advanced adult primary liver cancer, recurrent adult primary liver cancer, adult primary hepatocellular carcinoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically or cytologically proven or presumptive diagnosis of hepatocellular carcinoma Presumptive diagnosis based on rising alpha-fetoprotein (AFP) levels over 2 assessments, CT scan or MRI of liver, spiral CT scan of portal/splenic vein, and biopsy evidence of cirrhosis Unresectable or recurrent disease after prior surgical resection or embolization therapy Fibrolamellar histology allowed if considered surgically unresectable based on tumor size, extrahepatic involvement, or multiple lobe involvement CLIP (Cancer of the Liver Italian Program) score less than 4 Concurrent assignment to a transplantation list allowed PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 60-100% Life expectancy: Not specified Hematopoietic: Absolute neutrophil count at least 1,200/mm^3 Platelet count at least 80,000/mm^3 Hepatic: Bilirubin no greater than 3.0 mg/dL (except for known Gilbert's Syndrome) AST no greater than 5 times upper limit of normal (ULN) PT no greater than 1.5 times ULN Renal: Creatinine no greater than 2.0 mg/dL Cardiovascular: No uncontrolled hypertension within the past 3 months No unstable angina, symptomatic congestive heart failure, or myocardial infarction within the past 3 months No uncontrolled cardiac arrhythmia Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No active bacterial infections HIV negative No AIDS No other primary malignancy except carcinoma in situ of the cervix or urinary bladder or non-melanoma skin cancer No mental incapacitation or psychiatric illness that would preclude study participation No other severe disease that would preclude study participation Candidate for placement of a central venous access device PRIOR CONCURRENT THERAPY: Biologic therapy: Prior biologic therapy allowed No concurrent biologic therapy Chemotherapy: No prior IV doxorubicin except intraarterial administration in locoregional therapy Endocrine therapy: Prior endocrine therapy allowed No concurrent endocrine therapy Radiotherapy: Prior radiotherapy allowed No concurrent radiotherapy Surgery: See Disease Characteristics Surgery allowed if previously unresectable lesions become resectable Recovered from any prior surgery No concurrent liver transplantation Other: No other concurrent investigational or marketed anticancer drugs No other concurrent therapy for hepatocellular carcinoma No concurrent terfenadine, astemizole, or cisapride that may not be interrupted during nolatrexed dihydrochloride administration

Sites / Locations

  • Arizona Clinical Research Center, Incorporated
  • Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
  • Tower Cancer Research Foundation
  • Scripps Cancer Center at Scripps Clinic
  • David and Donna Long Center for Cancer Treatment at Sharp Grossmont Hospital
  • Veterans Affairs Medical Center - Long Beach
  • California Pacific Medical Center - Pacific Campus
  • Olive View - UCLA Medical Center Foundation
  • California Hematology/Oncology Medical Group
  • Helen F. Graham Cancer Center
  • Lombardi Cancer Center at Georgetown University Medical Center
  • Florida Cancer Institute - Bayonet Point
  • University of Miami Sylvester Comprehensive Cancer Center
  • Oncology-Hematology Group of South Florida, P.A.
  • Ocala Research Institute, Incorporated
  • Cancer Research Center of Hawaii
  • Robert H. Lurie Comprehensive Cancer Center at Northwestern University
  • University of Illinois at Chicago Cancer Center
  • Holden Comprehensive Cancer Center at University of Iowa
  • Louisiana Oncology Associates - Lafayette
  • Stanley S. Scott Cancer Center at Louisiana State University Medical Center - New Orleans
  • Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
  • University of Minnesota Cancer Center
  • Saint Louis University Cancer Center
  • Siteman Cancer Center at Barnes-Jewish Hospital
  • UNMC Eppley Cancer Center at the University of Nebraska Medical Center
  • Hackensack University Medical Center
  • Veterans Affairs Medical Center - Albuquerque
  • Albert Einstein Cancer Center at Albert Einstein College of Medicine
  • New York Weill Cornell Cancer Center at Cornell University
  • Herbert Irving Comprehensive Cancer Center at Columbia University
  • SUNY Upstate Medical University Hospital
  • New York Medical College
  • Cleveland Clinic Taussig Cancer Center
  • Albert Einstein Cancer Center
  • Cancer Centers of the Carolinas - Eastside
  • Medical City Dallas Hospital
  • Joe Arrington Cancer Research and Treatment Center
  • St. Boniface General Hospital
  • Ottawa Hospital Regional Cancer Centre - General Campus
  • Princess Margaret Hospital
  • Fundacion de Investagacion De Diego

Outcomes

Primary Outcome Measures

Overall survival

Secondary Outcome Measures

Time to progression
Time to treatment failure
Response rate (complete response, partial response, stable disease)
Survival probabilities at 3, 6, 9, and 12 months
Safety
Response to treatment in patients with and without prior therapy

Full Information

First Posted
March 3, 2001
Last Updated
June 25, 2013
Sponsor
Eximias Pharmaceutical
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1. Study Identification

Unique Protocol Identification Number
NCT00012324
Brief Title
Nolatrexed Dihydrochloride Compared With Doxorubicin in Treating Patients With Recurrent or Unresectable Liver Cancer
Official Title
A Phase III Randomized Controlled Study Comparing the Survival of Patients With Unresectable Hepatocellular Carcinoma (HCC) Treated With THYMITAQ to Patients Treated With Doxorubicin
Study Type
Interventional

2. Study Status

Record Verification Date
October 2005
Overall Recruitment Status
Completed
Study Start Date
September 2000 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
November 2005 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Eximias Pharmaceutical

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known which chemotherapy regimen is more effective for liver cancer. PURPOSE: Randomized phase III trial to compare the effectiveness of two different chemotherapy regimens in treating patients who have recurrent or unresectable liver cancer.
Detailed Description
OBJECTIVES: Compare the overall survival in patients with unresectable or recurrent hepatocellular carcinoma treated with nolatrexed dihydrochloride vs doxorubicin. Compare time to progression, time to treatment failure, and response rates in patients treated with these regimens. Compare the probability of survival at 3, 6, 9, and 12 months in patients treated with these regimens. Compare the safety and clinical benefit of these regimens in these patients. Compare the response rates and survival of patients who have received prior therapy or no prior therapy after treatment with these two regimens. Compare the rates of conversion from unresectable to resectable lesions in patients treated with these regimens. OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to CLIP score (0-1 vs 2-3) and Karnofsky performance status (60-70% vs 80-100%). Patients are randomized to one of two treatment arms. Arm I: Patients receive nolatrexed dihydrochloride IV continuously on days 1-5. Arm II: Patients receive doxorubicin IV on day 1. Treatment continues in both arms every 3 weeks in the absence of unacceptable toxicity or disease progression. Patients are followed every 2 months for survival. PROJECTED ACCRUAL: Approximately 446 patients (223 per treatment arm) will be accrued for this study within 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Liver Cancer
Keywords
localized unresectable adult primary liver cancer, advanced adult primary liver cancer, recurrent adult primary liver cancer, adult primary hepatocellular carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Masking
None (Open Label)
Allocation
Randomized

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
doxorubicin hydrochloride
Intervention Type
Drug
Intervention Name(s)
nolatrexed dihydrochloride
Primary Outcome Measure Information:
Title
Overall survival
Secondary Outcome Measure Information:
Title
Time to progression
Title
Time to treatment failure
Title
Response rate (complete response, partial response, stable disease)
Title
Survival probabilities at 3, 6, 9, and 12 months
Title
Safety
Title
Response to treatment in patients with and without prior therapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically proven or presumptive diagnosis of hepatocellular carcinoma Presumptive diagnosis based on rising alpha-fetoprotein (AFP) levels over 2 assessments, CT scan or MRI of liver, spiral CT scan of portal/splenic vein, and biopsy evidence of cirrhosis Unresectable or recurrent disease after prior surgical resection or embolization therapy Fibrolamellar histology allowed if considered surgically unresectable based on tumor size, extrahepatic involvement, or multiple lobe involvement CLIP (Cancer of the Liver Italian Program) score less than 4 Concurrent assignment to a transplantation list allowed PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 60-100% Life expectancy: Not specified Hematopoietic: Absolute neutrophil count at least 1,200/mm^3 Platelet count at least 80,000/mm^3 Hepatic: Bilirubin no greater than 3.0 mg/dL (except for known Gilbert's Syndrome) AST no greater than 5 times upper limit of normal (ULN) PT no greater than 1.5 times ULN Renal: Creatinine no greater than 2.0 mg/dL Cardiovascular: No uncontrolled hypertension within the past 3 months No unstable angina, symptomatic congestive heart failure, or myocardial infarction within the past 3 months No uncontrolled cardiac arrhythmia Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No active bacterial infections HIV negative No AIDS No other primary malignancy except carcinoma in situ of the cervix or urinary bladder or non-melanoma skin cancer No mental incapacitation or psychiatric illness that would preclude study participation No other severe disease that would preclude study participation Candidate for placement of a central venous access device PRIOR CONCURRENT THERAPY: Biologic therapy: Prior biologic therapy allowed No concurrent biologic therapy Chemotherapy: No prior IV doxorubicin except intraarterial administration in locoregional therapy Endocrine therapy: Prior endocrine therapy allowed No concurrent endocrine therapy Radiotherapy: Prior radiotherapy allowed No concurrent radiotherapy Surgery: See Disease Characteristics Surgery allowed if previously unresectable lesions become resectable Recovered from any prior surgery No concurrent liver transplantation Other: No other concurrent investigational or marketed anticancer drugs No other concurrent therapy for hepatocellular carcinoma No concurrent terfenadine, astemizole, or cisapride that may not be interrupted during nolatrexed dihydrochloride administration
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregory R. Suplick
Organizational Affiliation
Eximias Pharmaceutical
Official's Role
Study Chair
Facility Information:
Facility Name
Arizona Clinical Research Center, Incorporated
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85715
Country
United States
Facility Name
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Facility Name
Tower Cancer Research Foundation
City
Beverly Hills
State/Province
California
ZIP/Postal Code
90211
Country
United States
Facility Name
Scripps Cancer Center at Scripps Clinic
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
David and Donna Long Center for Cancer Treatment at Sharp Grossmont Hospital
City
La Mesa
State/Province
California
ZIP/Postal Code
91942
Country
United States
Facility Name
Veterans Affairs Medical Center - Long Beach
City
Long Beach
State/Province
California
ZIP/Postal Code
90822
Country
United States
Facility Name
California Pacific Medical Center - Pacific Campus
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
Olive View - UCLA Medical Center Foundation
City
Sylmar
State/Province
California
ZIP/Postal Code
91342
Country
United States
Facility Name
California Hematology/Oncology Medical Group
City
Torrance
State/Province
California
ZIP/Postal Code
90505
Country
United States
Facility Name
Helen F. Graham Cancer Center
City
Newark
State/Province
Delaware
ZIP/Postal Code
19713
Country
United States
Facility Name
Lombardi Cancer Center at Georgetown University Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Florida Cancer Institute - Bayonet Point
City
Hudson
State/Province
Florida
ZIP/Postal Code
34667
Country
United States
Facility Name
University of Miami Sylvester Comprehensive Cancer Center
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Oncology-Hematology Group of South Florida, P.A.
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
Ocala Research Institute, Incorporated
City
Ocala
State/Province
Florida
ZIP/Postal Code
34480
Country
United States
Facility Name
Cancer Research Center of Hawaii
City
Honolulu
State/Province
Hawaii
ZIP/Postal Code
96813
Country
United States
Facility Name
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Illinois at Chicago Cancer Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Holden Comprehensive Cancer Center at University of Iowa
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242-1009
Country
United States
Facility Name
Louisiana Oncology Associates - Lafayette
City
Lafayette
State/Province
Louisiana
ZIP/Postal Code
70506
Country
United States
Facility Name
Stanley S. Scott Cancer Center at Louisiana State University Medical Center - New Orleans
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
Facility Name
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21215
Country
United States
Facility Name
University of Minnesota Cancer Center
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Saint Louis University Cancer Center
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Siteman Cancer Center at Barnes-Jewish Hospital
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
UNMC Eppley Cancer Center at the University of Nebraska Medical Center
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68198-7680
Country
United States
Facility Name
Hackensack University Medical Center
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
Veterans Affairs Medical Center - Albuquerque
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87108
Country
United States
Facility Name
Albert Einstein Cancer Center at Albert Einstein College of Medicine
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
New York Weill Cornell Cancer Center at Cornell University
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Herbert Irving Comprehensive Cancer Center at Columbia University
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
SUNY Upstate Medical University Hospital
City
Syracuse
State/Province
New York
ZIP/Postal Code
13210
Country
United States
Facility Name
New York Medical College
City
Valhalla
State/Province
New York
ZIP/Postal Code
10595
Country
United States
Facility Name
Cleveland Clinic Taussig Cancer Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44111
Country
United States
Facility Name
Albert Einstein Cancer Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19141
Country
United States
Facility Name
Cancer Centers of the Carolinas - Eastside
City
Greenville
State/Province
South Carolina
ZIP/Postal Code
29615
Country
United States
Facility Name
Medical City Dallas Hospital
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
Joe Arrington Cancer Research and Treatment Center
City
Lubbock
State/Province
Texas
ZIP/Postal Code
79410-1894
Country
United States
Facility Name
St. Boniface General Hospital
City
Winnipeg
State/Province
Manitoba
ZIP/Postal Code
R2H 2A6
Country
Canada
Facility Name
Ottawa Hospital Regional Cancer Centre - General Campus
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
Facility Name
Princess Margaret Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Facility Name
Fundacion de Investagacion De Diego
City
Santurce
ZIP/Postal Code
00909
Country
Puerto Rico

12. IPD Sharing Statement

Citations:
PubMed Identifier
17634485
Citation
Gish RG, Porta C, Lazar L, Ruff P, Feld R, Croitoru A, Feun L, Jeziorski K, Leighton J, Gallo J, Kennealey GT. Phase III randomized controlled trial comparing the survival of patients with unresectable hepatocellular carcinoma treated with nolatrexed or doxorubicin. J Clin Oncol. 2007 Jul 20;25(21):3069-75. doi: 10.1200/JCO.2006.08.4046.
Results Reference
result

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Nolatrexed Dihydrochloride Compared With Doxorubicin in Treating Patients With Recurrent or Unresectable Liver Cancer

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