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XIAP Antisense AEG35156 in Combination With Sorafenib in Patients With Advanced Hepatocellular Carcinoma (HCC)

Primary Purpose

Advanced Hepatocellular Carcinoma

Status
Completed
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
AEG35156 antisense IV infusion
Sorafenib
Sponsored by
Aegera Therapeutics
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Hepatocellular Carcinoma focused on measuring Advanced Hepatocellular carcinoma, liver, cancer, antisense, sorafenib

Eligibility Criteria

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

Inclusion Criteria:

  • HCC diagnosed by:

    • Histology, or
    • AASLD Criteria in which the diagnosis is made clinically in a patient with a known hepatitis B or cirrhosis of other etiology has a liver mass of > 2cm with typical features of HCC (i.e., hypervascular with washout in the portal/venous phase) on a dynamic imaging study (contrast CT / USG / MRI) or alternatively if the AFP is >200 ng/ml.
  • The tumor is not suitable for curative treatment (resection / transplant / local ablative therapies) or the patient is medically inoperable or refuses such treatment.
  • At least one measurable lesion according to RECIST criteria.
  • Age > 18 years.
  • Life expectancy of greater than 12 weeks.
  • ECOG performance status ≤ 2 (please refer to Appendix 1).
  • Child-Pugh score A or B (please refer to Appendix 2).
  • Adequate organ functions defined as:

    • ANC ≥ 1.5 x 109/L
    • Platelet count ≥ 75 x 109/L
    • Creatinine ≤ 1.5 x ULN
    • ALT or AST < 2.5 x ULN
    • Total bilirubin < 50 μmol/L
    • INR <1.7
    • No encephalopathy clinically
    • Normal ECG
  • For women of child-producing potential, the use of effective contraceptive methods during the study.
  • Prior local therapy to tumor (e.g. surgery, RFA, PEI, chemo-embolization, radiotherapy) is allowed provided that there is a target lesion not subjected to local therapy and/or disease progression has been documented in the target lesion subjected to local therapy. The treatment must be completed at least 4 weeks and patient has recovered from all the acute toxicities of that treatment.
  • For patients with hepatitis B, the patient must receive antiviral therapy prior to or with registration.

Exclusion Criteria:

  • Child-Pugh score C.
  • Patients who have had prior systemic chemotherapy.
  • Patients who have had any other cancer related therapy including radiotherapy within 4 weeks prior to entering the study.
  • Patients receiving any other investigational agents concurrently.
  • Patients with known brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.
  • Patients who have peripheral neuropathy.
  • Uncontrolled intercurrent disease such as, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements.
  • Known bleeding diathesis.
  • Pregnant or nursing women. NOTE: Women of child-bearing potential must agree to use adequate contraception (sterile or surgically sterile; hormonal or barrier method of birth control; or abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
  • Men who are unwilling to use acceptable forms of birth control when engaging in sexual contact with women of child bearing potential.
  • Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy.
  • Serious nonmalignant disease that could compromise protocol objectives in the opinion of the investigator and/or the sponsor.
  • Patients who are currently receiving any other investigational agent. Subjects who have used a previous antisense oligonucleotide in the last 90 days will be excluded.
  • Unwillingness or inability to comply with procedures required in this protocol.

Sites / Locations

  • Tuen Mun Hospital
  • Queen Elizabeth Hospital
  • Queen Mary Hospital

Outcomes

Primary Outcome Measures

To determine the recommended dose of AEG35156 in combination with sorafenib patients with advanced HCC
13 patients were enrolled into the phase 1 dose escalation part of the study. The recommended dose was determined to be 300 mg.
To evaluate the efficacy of AEG35156 in combination with sorafenib based on PFS(PII) using sorafenib alone for comparison

Secondary Outcome Measures

To determine the safety profile of AEG35156 in combination with sorafenib in advanced HCC
To determine the response rate of AEG35156 in combination with sorafenib in advanced HCC

Full Information

First Posted
April 16, 2009
Last Updated
July 12, 2011
Sponsor
Aegera Therapeutics
Collaborators
Chinese University of Hong Kong
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1. Study Identification

Unique Protocol Identification Number
NCT00882869
Brief Title
XIAP Antisense AEG35156 in Combination With Sorafenib in Patients With Advanced Hepatocellular Carcinoma (HCC)
Official Title
A Phase 1-2, Open-Label Study of The X-Linked Inhibitor of Apoptosis (XIAP) Antisense AEG35156 in Combination With Sorafenib in Patients With Advanced Hepatocellular Carcinoma (HCC)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2011
Overall Recruitment Status
Completed
Study Start Date
March 2009 (undefined)
Primary Completion Date
March 2011 (Actual)
Study Completion Date
May 2011 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Aegera Therapeutics
Collaborators
Chinese University of Hong Kong

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
AEG35156 is a second generation antisense which targets XIAP mRNA to lower XIAP levels and the apoptotic threshold of cancer cells, enhancing their sensitivity to intrinsic death and chemotherapy. Advanced HCC is an attractive target for AEG35156 since XIAP is highly expressed in HCC and may prevent cancer cells from undergoing apoptosis. Second generation antisense molecules are known to accumulate in liver where AEG35156 may down regulate XIAP protein expression in HCC cells thus promoting their apoptotic death.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Hepatocellular Carcinoma
Keywords
Advanced Hepatocellular carcinoma, liver, cancer, antisense, sorafenib

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
75 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
AEG35156 antisense IV infusion
Intervention Description
Dose escalation (100, 200 and 300 mg/day) over 2 hr infusion, once weekly over 21 days (Day 1, 8, 15)
Intervention Type
Drug
Intervention Name(s)
Sorafenib
Other Intervention Name(s)
nexavar
Intervention Description
Sorafenib will be administered at 400 mg BID every day
Primary Outcome Measure Information:
Title
To determine the recommended dose of AEG35156 in combination with sorafenib patients with advanced HCC
Description
13 patients were enrolled into the phase 1 dose escalation part of the study. The recommended dose was determined to be 300 mg.
Time Frame
12 months
Title
To evaluate the efficacy of AEG35156 in combination with sorafenib based on PFS(PII) using sorafenib alone for comparison
Time Frame
12 months
Secondary Outcome Measure Information:
Title
To determine the safety profile of AEG35156 in combination with sorafenib in advanced HCC
Time Frame
12 months
Title
To determine the response rate of AEG35156 in combination with sorafenib in advanced HCC
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: HCC diagnosed by: Histology, or AASLD Criteria in which the diagnosis is made clinically in a patient with a known hepatitis B or cirrhosis of other etiology has a liver mass of > 2cm with typical features of HCC (i.e., hypervascular with washout in the portal/venous phase) on a dynamic imaging study (contrast CT / USG / MRI) or alternatively if the AFP is >200 ng/ml. The tumor is not suitable for curative treatment (resection / transplant / local ablative therapies) or the patient is medically inoperable or refuses such treatment. At least one measurable lesion according to RECIST criteria. Age > 18 years. Life expectancy of greater than 12 weeks. ECOG performance status ≤ 2 (please refer to Appendix 1). Child-Pugh score A or B (please refer to Appendix 2). Adequate organ functions defined as: ANC ≥ 1.5 x 109/L Platelet count ≥ 75 x 109/L Creatinine ≤ 1.5 x ULN ALT or AST < 2.5 x ULN Total bilirubin < 50 μmol/L INR <1.7 No encephalopathy clinically Normal ECG For women of child-producing potential, the use of effective contraceptive methods during the study. Prior local therapy to tumor (e.g. surgery, RFA, PEI, chemo-embolization, radiotherapy) is allowed provided that there is a target lesion not subjected to local therapy and/or disease progression has been documented in the target lesion subjected to local therapy. The treatment must be completed at least 4 weeks and patient has recovered from all the acute toxicities of that treatment. For patients with hepatitis B, the patient must receive antiviral therapy prior to or with registration. Exclusion Criteria: Child-Pugh score C. Patients who have had prior systemic chemotherapy. Patients who have had any other cancer related therapy including radiotherapy within 4 weeks prior to entering the study. Patients receiving any other investigational agents concurrently. Patients with known brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events. Patients who have peripheral neuropathy. Uncontrolled intercurrent disease such as, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements. Known bleeding diathesis. Pregnant or nursing women. NOTE: Women of child-bearing potential must agree to use adequate contraception (sterile or surgically sterile; hormonal or barrier method of birth control; or abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Men who are unwilling to use acceptable forms of birth control when engaging in sexual contact with women of child bearing potential. Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy. Serious nonmalignant disease that could compromise protocol objectives in the opinion of the investigator and/or the sponsor. Patients who are currently receiving any other investigational agent. Subjects who have used a previous antisense oligonucleotide in the last 90 days will be excluded. Unwillingness or inability to comply with procedures required in this protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ann Shing Lee, MBChB(CUHK), FHKAM(Rad)
Organizational Affiliation
Tuen Mun Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tuen Mun Hospital
City
Tuen Mun
State/Province
New Territories, Hong Kong
Country
China
Facility Name
Queen Elizabeth Hospital
City
Hong Kong
Country
China
Facility Name
Queen Mary Hospital
City
Hong Kong
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
24977690
Citation
Lee FA, Zee BC, Cheung FY, Kwong P, Chiang CL, Leung KC, Siu SW, Lee C, Lai M, Kwok C, Chong M, Jolivet J, Tung S. Randomized Phase II Study of the X-linked Inhibitor of Apoptosis (XIAP) Antisense AEG35156 in Combination With Sorafenib in Patients With Advanced Hepatocellular Carcinoma (HCC). Am J Clin Oncol. 2016 Dec;39(6):609-613. doi: 10.1097/COC.0000000000000099.
Results Reference
derived

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XIAP Antisense AEG35156 in Combination With Sorafenib in Patients With Advanced Hepatocellular Carcinoma (HCC)

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