Oxaliplatin, Capecitabine, and Cetuximab in Treating Patients With Advanced Liver Cancer (NRR)

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

DISEASE CHARACTERISTICS:

• Meets 1 of the following criteria:

  • Histologically confirmed hepatocellular carcinoma
  • Alpha-fetoprotein (AFP) > 400 ng/mL with compatible mass by CT scan or MRI
• Metastatic disease OR not a candidate for surgical resection or immediate liver transplantation
• At least 1 site of measurable disease OR evaluable disease (AFP 2 times upper limit of normal (ULN))
• No evidence of central nervous system (CNS) metastases (unless CNS metastases stable for > 3 months)

PATIENT CHARACTERISTICS:

• Eastern Cooperative Oncology Group (ECOG) performance status 0-2
• Absolute neutrophil count (ANC) ≥ 1,500/mm³
• Hemoglobin ≥ 9 g/dL
• Platelet count ≥ 100,000/mm³
• Bilirubin ≤ 3 times ULN
• International normalized ratio (INR) ≤ 1.5
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 5 times ULN
• Creatinine clearance > 50 mL/min
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No known hypersensitivity to capecitabine, cetuximab, or oxaliplatin or to other murine products
• No comorbid condition which is deemed by the investigator to have a life expectancy of < 6 months
• No New York Heart Association class III-IV coronary artery disease and/or heart failure
• No variceal bleeding within the past 60 days
• No other cancer within the past 5 years except cervical intraepithelial neoplasia, nonmelanoma skin cancer, ductal carcinoma in situ, chronic lymphocytic leukemia, or treated localized prostate cancer with a normal prostate specific antigen level
• No active drug or alcohol abuse
• No prior allergic reaction to a therapeutic antibody
• No serious, uncontrolled infection
• No history of uncontrolled seizures, CNS disorders, or psychiatric disability that, in the opinion of the investigator, would preclude study participation or compliance
• No other serious uncontrolled medical condition that, in the opinion of the investigator, would preclude study participation
• No lack of physical integrity of the upper gastrointestinal tract
• No malabsorption syndrome
• No known existing uncontrolled coagulopathy

PRIOR CONCURRENT THERAPY:

• At least 4 weeks since prior participation in an investigational drug trial
• At least 4 weeks since prior major surgery and recovered
• At least 4 weeks since prior embolization, resection, or ablation
• No prior epidermal growth factor receptor (EGFR)-targeting therapy
• No prior systemic chemotherapy or hepatic artery infusion of chemotherapy
• No concurrent phenytoin

• No concurrent therapeutic warfarin

  • Low-dose non-therapeutic warfarin to maintain patency of venous access devices allowed