The Phase II Study of Icaritin in Patients With Advanced Hepatocellular Carcinoma
Primary Purpose
Hepatocellular Carcinoma (HCC)
Status
Completed
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Icaritin
Sponsored by

About this trial
This is an interventional treatment trial for Hepatocellular Carcinoma (HCC)
Eligibility Criteria
Inclusion Criteria:
Patients may be entered in the study only if they meet all of the following criteria:
- The age is between 18 and 75.
- Patients who have HCC which should be histologically or cytologically confirmed. At least one lesion, not previously treated ( can be accurately measured at baseline as ≥ 10 mm in the longest diameter with computed tomography (CT) per RECIST 1.1)
- Patients who cannot accept or is not willing to have surgery or any interventional therapy via hepatic artery, or had surgery and any Interventional therapy via hepatic artery more than 4 weeks with disease progression, and cannot tolerate Sorafenib or Oxaliplatin doublet chemotherapy or cannot use or refused to use them
- Child-Pugh status A or B (≤7) ( Either albumin or haemachrome is >2)
- ECOG PS: 0 or 1.
- Patients who have a life expectancy of at least 12 weeks.
- Patients who have not received chemotherapy and target therapy. If patients received radiation therapy or surgery, the treatment should be at least 4 weeks prior to enrollment and any AE and wounds during the treatment should be recovered. If patient received adjuvant chemotherapy, the treatment should be at least 6 months prior to enrollment.
Meet following laboratory parameters:
Haematology ( no blood transfusion or Blood products or Hematopoietic growth factor within 14 days)
- Hemoglobin ≥ 90 g/dL
- Neutrophil cell count≥1.5 × 10^9/L
- Platelet count ≥ 80 × 10^9/L
Clinical chemistry,
- Albumin ≥ 29 g/dL (no albumin transfusion or blood product within 14 days)
- ALT and AST < 5 × ULN
- Total bilirubin ≤ 1.5 × ULN
- Serum creatinine ≤ 1.5 × ULN
- If HBV-DNA≥10^4, anti-virus therapy should be used until HBV-DNA< 10^4
- Patients is willing to participate in the study with good compliance and must have given written informed consent prior to any study specific screening
- Patients who did not participate in any other study 4 weeks prior to enrollment and all adverse events occurs before should be recovered.
Exclusion Criteria:
Patients who meet with any below criterion should not be included in the study:
- Previously known intrahepatic cholangiocarcinoma, mixed cell carcinoma and fibrolamellar carcinoma; previous or concurrent malignant tumor (healed skin basal cell carcinoma and carcinoma in situ of uterine cervix are not included);
- Women in pregnancy or lactation;
- Patients who have hypertension and blood pressure are not well controlled after treatments with antihypertensive drugs (systolic pressure > 150mmHg, diastolic pressure >100mmHg); patients who have grade II or higher myocardial ischemia or myocardial infarction and poorly controlled arrhythmia (including QTC interval≥ 450ms) and grade III-IV cardiac insufficiency according to NYHA criteria; Ultrasound Cardiogram on heart: LVEF (left ventricular ejection fraction)<50%;
- Patients are incapable of swallow, or have chronic diarrhea or intestinal obstruction, which significantly affects administration and absorption of study drug;
- Patients potentially have gastrointestinal hemorrhage (such as local active ulcer foci, occult blood in stools ++ or even higher), previous medical records of alimentary tract hemorrhage within six months;
- Patients who have central nervous system metastasis;
- Patients who have coagulation disorder (prothrombin time > 16s, activated partial thromboplastin time > 43s, thrombin time >21s, fibrinogen< 2g/L), subjects showing hemorrhagic tendency or accepting thrombolytic or anticoagulant therapy;
- Patients who have psychiatric disorders or previous medical history of psychotropic drug abuse;
- Patients who have seroperitoneum with clinical symptoms, requring remedial abdominal paracentesis or drainage, or Child-Pugh score ≥2.
Sites / Locations
- Cancer institute & hospital, chinese academy of medical sciences
- Beijing Shenogen Biomedical Co., Ltd
- NanJing PLA 81 Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Icaritin
Arm Description
Icaritin 600 mg orally, twice daily for a total daily dose of 1200 mg
Outcomes
Primary Outcome Measures
time to progress(TTP)
The study will be an open-label, single-armed study to evaluate the clinical benefit of Icaritin 600 mg twice daily with oral administration for total of 1200 mg daily added to Best Supportive Care in patients with advanced HCC.
Secondary Outcome Measures
Progression-free survival (PFS)
PFS is defined as the time from the date of the first dose of study drug to first documentation of objective disease progression or to death on study due to any cause, whichever occurs first. It will be analyzed in the same way as TTP.
Overall survival (OS)
OS: This is defined as the time from the date of first study dose to the date of death, regardless of the cause of death. Patients who were alive at the time of the analysis will be censored at the date of the last follow up assessment. Patients without follow up assessment will be censored at the day of last dose and patients with no post baseline information will be censored at the time of first study dose. Overall survival is defined as the length of time from first dose of treatment until death. It will be analyzed in the same way as TTP.
Overall response rate (ORR) (proportion of patients with confirmed partial and complete responses)
ORR: it is defined as the percentage of the patients achieving remission (including PR and CR) of tumors during treatment or within 30 days after the initiative treatment as confirmed by the RECIST1.1.
Overall disease control rate (DCR)
DCR: during first-line therapy is defined as SD for 8 weeks or longer, CR plus PR as determined by the RESIST 1.1 criteria for patients with measurable disease.
Objective response rate and disease control rate will be determined along with 95% confidence intervals.
Assessment on Quality of life
The descriptive analysis will be used for the data from quality of life questionnaire (EORTC QLQ-C30 V3.0 and HCC-18).
Type, incidence, severity, seriousness and relationship to study drug of adverse events (AEs) and serious adverse events (SAEs);
To assess the safety and tolerability of Icaritin in patients with advanced hepatocellular carcinoma
Laboratory abnormal findings
To assess the safety and tolerability of Icaritin in patients with advanced hepatocellular carcinoma
Full Information
NCT ID
NCT01972672
First Posted
October 14, 2013
Last Updated
January 25, 2021
Sponsor
Beijing Shenogen Biomedical Co., Ltd
Collaborators
Chinese Academy of Medical Sciences, NanJing PLA 81 Hospital, 307 Hospital of PLA, Qingdao University
1. Study Identification
Unique Protocol Identification Number
NCT01972672
Brief Title
The Phase II Study of Icaritin in Patients With Advanced Hepatocellular Carcinoma
Official Title
An Open-label,Single-arm Phase II Study of Icaritin in Patients With Advanced Hepatocellular Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
January 2021
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
August 2015 (Actual)
Study Completion Date
March 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Beijing Shenogen Biomedical Co., Ltd
Collaborators
Chinese Academy of Medical Sciences, NanJing PLA 81 Hospital, 307 Hospital of PLA, Qingdao University
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The primary objective of the study is to assess the time to progression (TTP) in patients with advanced HCC treated with Icaritin .
Detailed Description
Icaritin is a newly discovered small molecular compound which is high selective ERa36 modulators ,the preclinical PK&PD and toxicity studies showed it can inhibit the growth of HCC cancer cells both in vitro and in vivo, combining clinical data perhaps it will be a very promising new drug to treat hepatocellular carcinoma (HCC) by targeting this nongenomic pathway. Shenogen decided to further investigate the efficacy and safety of Icaritin and to explore potential gene targets for treating HCC.
The results of phase I study showed Icaritin has good safety and tolerance. The biological availability of Icaritin after meal is high and the half-life is relatively short.
The phase Ib study enrolled 28 subjects. Among the 18 HCC subjects, 12 subjects received treatment in the oral administration group with 600 mg once, twice per day, after meal 30 minutes, 6 subjects received treatment in the oral administration group with 800 mg once, twice per day, after meal 30 minutes. The results showed that in the 600mg group there are 12 HCC patients whose therapeutic efficacy is evaluable now, one case of PR (10%), 5 cases of SD (50%) and 4 cases of PD (40%) were observed.Safety data showed that totally 24 AEs are probably related to investigational drug. Among them, 19 AEs are grade I, 5 AEs are grade II, no grade III or above AE.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma (HCC)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
70 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Icaritin
Arm Type
Experimental
Arm Description
Icaritin 600 mg orally, twice daily for a total daily dose of 1200 mg
Intervention Type
Drug
Intervention Name(s)
Icaritin
Other Intervention Name(s)
SNG-162
Intervention Description
Icaritin 600 mg orally, twice daily for a total daily dose of 1200 mg
Primary Outcome Measure Information:
Title
time to progress(TTP)
Description
The study will be an open-label, single-armed study to evaluate the clinical benefit of Icaritin 600 mg twice daily with oral administration for total of 1200 mg daily added to Best Supportive Care in patients with advanced HCC.
Time Frame
1-2 years
Secondary Outcome Measure Information:
Title
Progression-free survival (PFS)
Description
PFS is defined as the time from the date of the first dose of study drug to first documentation of objective disease progression or to death on study due to any cause, whichever occurs first. It will be analyzed in the same way as TTP.
Time Frame
1-2 years
Title
Overall survival (OS)
Description
OS: This is defined as the time from the date of first study dose to the date of death, regardless of the cause of death. Patients who were alive at the time of the analysis will be censored at the date of the last follow up assessment. Patients without follow up assessment will be censored at the day of last dose and patients with no post baseline information will be censored at the time of first study dose. Overall survival is defined as the length of time from first dose of treatment until death. It will be analyzed in the same way as TTP.
Time Frame
1-2 years
Title
Overall response rate (ORR) (proportion of patients with confirmed partial and complete responses)
Description
ORR: it is defined as the percentage of the patients achieving remission (including PR and CR) of tumors during treatment or within 30 days after the initiative treatment as confirmed by the RECIST1.1.
Time Frame
1-2 years
Title
Overall disease control rate (DCR)
Description
DCR: during first-line therapy is defined as SD for 8 weeks or longer, CR plus PR as determined by the RESIST 1.1 criteria for patients with measurable disease.
Objective response rate and disease control rate will be determined along with 95% confidence intervals.
Time Frame
1-2 years
Title
Assessment on Quality of life
Description
The descriptive analysis will be used for the data from quality of life questionnaire (EORTC QLQ-C30 V3.0 and HCC-18).
Time Frame
1-2 years
Title
Type, incidence, severity, seriousness and relationship to study drug of adverse events (AEs) and serious adverse events (SAEs);
Description
To assess the safety and tolerability of Icaritin in patients with advanced hepatocellular carcinoma
Time Frame
1-2 years
Title
Laboratory abnormal findings
Description
To assess the safety and tolerability of Icaritin in patients with advanced hepatocellular carcinoma
Time Frame
1-2 years
Other Pre-specified Outcome Measures:
Title
p-STAT3 and ER-α36 expression
Description
Explore endpoints
Time Frame
1-2 years
Title
Blood biomarkers of estradiol (E2), hepatocyte growth factor (HGF), interleukin-6 (IL-6), transforming growth factor β (TGF-β), and alpha-fetoprotein (AFP);
Description
Explore endpoints
Time Frame
1-2 years
Title
Gene expression profiling of blood cells and tumor biopsies
Description
Explore endpoints
Time Frame
1-2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients may be entered in the study only if they meet all of the following criteria:
The age is between 18 and 75.
Patients who have HCC which should be histologically or cytologically confirmed. At least one lesion, not previously treated ( can be accurately measured at baseline as ≥ 10 mm in the longest diameter with computed tomography (CT) per RECIST 1.1)
Patients who cannot accept or is not willing to have surgery or any interventional therapy via hepatic artery, or had surgery and any Interventional therapy via hepatic artery more than 4 weeks with disease progression, and cannot tolerate Sorafenib or Oxaliplatin doublet chemotherapy or cannot use or refused to use them
Child-Pugh status A or B (≤7) ( Either albumin or haemachrome is >2)
ECOG PS: 0 or 1.
Patients who have a life expectancy of at least 12 weeks.
Patients who have not received chemotherapy and target therapy. If patients received radiation therapy or surgery, the treatment should be at least 4 weeks prior to enrollment and any AE and wounds during the treatment should be recovered. If patient received adjuvant chemotherapy, the treatment should be at least 6 months prior to enrollment.
Meet following laboratory parameters:
Haematology ( no blood transfusion or Blood products or Hematopoietic growth factor within 14 days)
Hemoglobin ≥ 90 g/dL
Neutrophil cell count≥1.5 × 10^9/L
Platelet count ≥ 80 × 10^9/L
Clinical chemistry,
Albumin ≥ 29 g/dL (no albumin transfusion or blood product within 14 days)
ALT and AST < 5 × ULN
Total bilirubin ≤ 1.5 × ULN
Serum creatinine ≤ 1.5 × ULN
If HBV-DNA≥10^4, anti-virus therapy should be used until HBV-DNA< 10^4
Patients is willing to participate in the study with good compliance and must have given written informed consent prior to any study specific screening
Patients who did not participate in any other study 4 weeks prior to enrollment and all adverse events occurs before should be recovered.
Exclusion Criteria:
Patients who meet with any below criterion should not be included in the study:
Previously known intrahepatic cholangiocarcinoma, mixed cell carcinoma and fibrolamellar carcinoma; previous or concurrent malignant tumor (healed skin basal cell carcinoma and carcinoma in situ of uterine cervix are not included);
Women in pregnancy or lactation;
Patients who have hypertension and blood pressure are not well controlled after treatments with antihypertensive drugs (systolic pressure > 150mmHg, diastolic pressure >100mmHg); patients who have grade II or higher myocardial ischemia or myocardial infarction and poorly controlled arrhythmia (including QTC interval≥ 450ms) and grade III-IV cardiac insufficiency according to NYHA criteria; Ultrasound Cardiogram on heart: LVEF (left ventricular ejection fraction)<50%;
Patients are incapable of swallow, or have chronic diarrhea or intestinal obstruction, which significantly affects administration and absorption of study drug;
Patients potentially have gastrointestinal hemorrhage (such as local active ulcer foci, occult blood in stools ++ or even higher), previous medical records of alimentary tract hemorrhage within six months;
Patients who have central nervous system metastasis;
Patients who have coagulation disorder (prothrombin time > 16s, activated partial thromboplastin time > 43s, thrombin time >21s, fibrinogen< 2g/L), subjects showing hemorrhagic tendency or accepting thrombolytic or anticoagulant therapy;
Patients who have psychiatric disorders or previous medical history of psychotropic drug abuse;
Patients who have seroperitoneum with clinical symptoms, requring remedial abdominal paracentesis or drainage, or Child-Pugh score ≥2.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yan Sun, MD
Organizational Affiliation
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
ShuKui Qin, MD
Organizational Affiliation
NanJing PLA 81 Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cancer institute & hospital, chinese academy of medical sciences
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100021
Country
China
Facility Name
Beijing Shenogen Biomedical Co., Ltd
City
Beijing
State/Province
Beijing
ZIP/Postal Code
102206
Country
China
Facility Name
NanJing PLA 81 Hospital
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210002
Country
China
12. IPD Sharing Statement
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The Phase II Study of Icaritin in Patients With Advanced Hepatocellular Carcinoma
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