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A Study of Ramucirumab (LY3009806) in Participants With Advanced Liver Cancer

Primary Purpose

Carcinoma, Hepatocellular

Status
Completed
Phase
Phase 1
Locations
Taiwan
Study Type
Interventional
Intervention
Ramucirumab
FOLFOX4
Sponsored by
Eli Lilly and Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Hepatocellular

Eligibility Criteria

20 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histological or cytological diagnosis of hepatocellular carcinoma (HCC) or imaging findings consistent with HCC in a participant with liver cirrhosis and alpha-fetoprotein > 200 nanogram per milliliter
  • At least 1 measurable or non-measurable lesion
  • Child-Pugh A
  • Barcelona Clinic Liver Cancer (BCLC) stage C or BCLC stage B not amenable to locoregional therapy or refractory to locoregional therapy
  • Eastern Cooperative Oncology Group Performance Status of 0 or 1
  • Have not received previous systemic therapy for advanced HCC
  • Have resolution to Grade ≤1 of all clinically significant toxic effects of prior locoregional therapy
  • Adequate organ function including: Absolute neutrophil coun t≥1.5×109/liter (L), hemoglobin ≥9 gram/deciliter, and platelets ≥90×109/L; Total bilirubin level ≤1.5 the upper limit of the normal range (ULN), aspartate transaminase and alanine transaminase ≤5 ULN, albumin >28 gram/L; Serum creatinine level ≤1.5 ULN; or calculated serum creatinine clearance ≥50 milliliter/minute; International Normalized Ratio≤1.5 and partial thromboplastin time ≤5 seconds above ULN
  • The urinary protein is ≤ 1+. If ≥ 2+ proteinuria, the 24-hour urine protein is <1000 milligram
  • An estimated life expectancy of at least 12 weeks

Exclusion Criteria:

  • Received any investigational therapy or non-approved drug within 28 days prior to enrollment
  • Undergone major surgery within 28 days prior to enrollment, or undergone central venous access device placement within 7 days prior to enrollment
  • Undergone hepatic locoregional therapy within 28 days prior to enrollment
  • Undergone radiation to any nonhepatic site within 14 days prior to enrollment
  • Prior liver transplant
  • Fibrolamellar carcinoma or cholangiocellular carcinoma
  • Received any transfusion, blood component preparation, erythropoietin, albumin preparation, or granulocyte-colony stimulating factors within 14 days prior to enrollment
  • Receiving therapeutic anticoagulation with warfarin, low-molecular weight heparin, or similar agents
  • Receiving ongoing therapy with nonsteroidal anti-inflammatory agents or other antiplatelet agents.
  • Known human immunodeficiency virus infection or acquired immunodeficiency syndrome-related illness
  • Active or uncontrolled clinically serious infection
  • Uncontrolled thrombotic or hemorrhagic disorder
  • Serious or nonhealing wound, ulcer, or bone fracture within 28 days prior to enrollment
  • History of gastrointestinal perforation or obstruction
  • History of or current hepatic encephalopathy or current clinically meaningful ascites
  • Known allergy to monoclonal antibody, fluorouracil, oxaliplatin or their excipients
  • Interstitial pneumonia or interstitial fibrosis of the lung
  • Central nervous system metastases or carcinomatous meningitis
  • Known history of dihydropyrimidine dehydrogenase deficiency
  • Symptomatic congestive heart failure, unstable angina pectoris, or symptomatic or poorly controlled cardiac arrhythmia
  • Experienced any arterial thromboembolic event
  • Uncontrolled arterial hypertension
  • Grade 3-4 venous thromboembolic events occurring within 3 months prior to enrollment
  • Experienced any grade 3-4 gastrointestinal bleeding or any variceal bleeding episode in the 3 months prior to enrollment requiring transfusion, endoscopic or operative intervention
  • Esophageal or gastric varices that require immediate intervention or represent a high bleeding risk
  • Pre-existing grade ≥ 2 motor or sensory neuropathy

Sites / Locations

  • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
  • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
  • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ramucirumab + FOLFOX4

Arm Description

8 milligram/kilogram (mg/kg) ramucirumab given intravenously (IV) on Day 1 followed by FOLFOX4 (folinic acid + fluorouracil + oxaliplatin chemotherapy regimen) given IV on Day 1 of 2 week cycles: FOLFOX4 every 2 weeks: 85 milligram per square meter (mg/m²) oxaliplatin IV on Day 1 200 mg/m² folinic acid(FA) IV on days 1 and 2 400 mg/m² 5-FU bolus on days 1 and 2 600 mg/m2 5-FU 22-h continuous infusion on Days 1 and 2 Participants may continue to receive treatment until discontinuation criteria are met.

Outcomes

Primary Outcome Measures

Number of Participants With One or More Serious Adverse Event(s) (SAEs) Considered by the Investigator to be Related to Study Drug Administration
A summary of other non-serious Adverse Events (AEs), and all Serious Adverse Events (SAE's), regardless of causality, is located in the Reported Adverse Events section.

Secondary Outcome Measures

Pharmacokinetics (PK): Maximum Concentration (Cmax) of Ramucirumab
Maximum Concentration (Cmax)
PK:Area Under the Concentration-Time Curve (AUC[0-∞]) of Ramucirumab
Area under the concentration-time curve.
Number of Participants With Anti-Ramucirumab Antibodies
Percentage of Participants With Best Response of Complete Response (CR) or Partial Response (PR) (Overall Response Rate [ORR])
Response was defined using Response Evaluation Criteria In Solid Tumors (RECIST, version[v] 1.1) criteria.CR was defined as the disappearance of all target and non-target lesions and all target and non-target lymph nodes were non-pathological or normal in size [<10 millimeter (mm) short axis]. PR is at least a 30% decrease in the sum of diameter of target lesions, taking as reference the baseline sum diameters. Progressive Disease(PD): At least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (including the baseline sum if that is the smallest).In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. Percentage of participants with CR or PR= (number of participants whose best overall response was CR or PR)/(number of participants treated)*100.

Full Information

First Posted
February 20, 2014
Last Updated
May 3, 2018
Sponsor
Eli Lilly and Company
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1. Study Identification

Unique Protocol Identification Number
NCT02069041
Brief Title
A Study of Ramucirumab (LY3009806) in Participants With Advanced Liver Cancer
Official Title
Phase 1b Study of 5-FU/FA and Oxaliplatin (FOLFOX4) Plus Ramucirumab (LY3009806) in Patients With Advanced Hepatocellular Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
April 2014 (undefined)
Primary Completion Date
September 2016 (Actual)
Study Completion Date
September 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eli Lilly and Company

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The main purpose of this study is to determine if the advised dose of ramucirumab is safe to be taken with chemotherapy treatment in participants with advanced liver tumors.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma, Hepatocellular

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ramucirumab + FOLFOX4
Arm Type
Experimental
Arm Description
8 milligram/kilogram (mg/kg) ramucirumab given intravenously (IV) on Day 1 followed by FOLFOX4 (folinic acid + fluorouracil + oxaliplatin chemotherapy regimen) given IV on Day 1 of 2 week cycles: FOLFOX4 every 2 weeks: 85 milligram per square meter (mg/m²) oxaliplatin IV on Day 1 200 mg/m² folinic acid(FA) IV on days 1 and 2 400 mg/m² 5-FU bolus on days 1 and 2 600 mg/m2 5-FU 22-h continuous infusion on Days 1 and 2 Participants may continue to receive treatment until discontinuation criteria are met.
Intervention Type
Biological
Intervention Name(s)
Ramucirumab
Other Intervention Name(s)
IMC-1121B, LY3009806
Intervention Description
Administered IV.
Intervention Type
Drug
Intervention Name(s)
FOLFOX4
Other Intervention Name(s)
FOLFOX4 (leucovorin + fluorouracil + oxaliplatin)
Intervention Description
Administered IV.
Primary Outcome Measure Information:
Title
Number of Participants With One or More Serious Adverse Event(s) (SAEs) Considered by the Investigator to be Related to Study Drug Administration
Description
A summary of other non-serious Adverse Events (AEs), and all Serious Adverse Events (SAE's), regardless of causality, is located in the Reported Adverse Events section.
Time Frame
Baseline through study completion (Up To 8 Months)
Secondary Outcome Measure Information:
Title
Pharmacokinetics (PK): Maximum Concentration (Cmax) of Ramucirumab
Description
Maximum Concentration (Cmax)
Time Frame
Cycle 1 and Cycle 3: 0,1.0,1.5,2.0,3.0,5.0,24.0,48.0,168.0,336.0 hours
Title
PK:Area Under the Concentration-Time Curve (AUC[0-∞]) of Ramucirumab
Description
Area under the concentration-time curve.
Time Frame
Cycle 1 and Cycle 3: 0,1.0,1.5,2.0,3.0,5.0,24.0,48.0,168.0,336.0 hours
Title
Number of Participants With Anti-Ramucirumab Antibodies
Time Frame
Baseline through 6.1 Months
Title
Percentage of Participants With Best Response of Complete Response (CR) or Partial Response (PR) (Overall Response Rate [ORR])
Description
Response was defined using Response Evaluation Criteria In Solid Tumors (RECIST, version[v] 1.1) criteria.CR was defined as the disappearance of all target and non-target lesions and all target and non-target lymph nodes were non-pathological or normal in size [<10 millimeter (mm) short axis]. PR is at least a 30% decrease in the sum of diameter of target lesions, taking as reference the baseline sum diameters. Progressive Disease(PD): At least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (including the baseline sum if that is the smallest).In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. Percentage of participants with CR or PR= (number of participants whose best overall response was CR or PR)/(number of participants treated)*100.
Time Frame
Response to Disease Progression or Death (Up To 7 Months)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histological or cytological diagnosis of hepatocellular carcinoma (HCC) or imaging findings consistent with HCC in a participant with liver cirrhosis and alpha-fetoprotein > 200 nanogram per milliliter At least 1 measurable or non-measurable lesion Child-Pugh A Barcelona Clinic Liver Cancer (BCLC) stage C or BCLC stage B not amenable to locoregional therapy or refractory to locoregional therapy Eastern Cooperative Oncology Group Performance Status of 0 or 1 Have not received previous systemic therapy for advanced HCC Have resolution to Grade ≤1 of all clinically significant toxic effects of prior locoregional therapy Adequate organ function including: Absolute neutrophil coun t≥1.5×109/liter (L), hemoglobin ≥9 gram/deciliter, and platelets ≥90×109/L; Total bilirubin level ≤1.5 the upper limit of the normal range (ULN), aspartate transaminase and alanine transaminase ≤5 ULN, albumin >28 gram/L; Serum creatinine level ≤1.5 ULN; or calculated serum creatinine clearance ≥50 milliliter/minute; International Normalized Ratio≤1.5 and partial thromboplastin time ≤5 seconds above ULN The urinary protein is ≤ 1+. If ≥ 2+ proteinuria, the 24-hour urine protein is <1000 milligram An estimated life expectancy of at least 12 weeks Exclusion Criteria: Received any investigational therapy or non-approved drug within 28 days prior to enrollment Undergone major surgery within 28 days prior to enrollment, or undergone central venous access device placement within 7 days prior to enrollment Undergone hepatic locoregional therapy within 28 days prior to enrollment Undergone radiation to any nonhepatic site within 14 days prior to enrollment Prior liver transplant Fibrolamellar carcinoma or cholangiocellular carcinoma Received any transfusion, blood component preparation, erythropoietin, albumin preparation, or granulocyte-colony stimulating factors within 14 days prior to enrollment Receiving therapeutic anticoagulation with warfarin, low-molecular weight heparin, or similar agents Receiving ongoing therapy with nonsteroidal anti-inflammatory agents or other antiplatelet agents. Known human immunodeficiency virus infection or acquired immunodeficiency syndrome-related illness Active or uncontrolled clinically serious infection Uncontrolled thrombotic or hemorrhagic disorder Serious or nonhealing wound, ulcer, or bone fracture within 28 days prior to enrollment History of gastrointestinal perforation or obstruction History of or current hepatic encephalopathy or current clinically meaningful ascites Known allergy to monoclonal antibody, fluorouracil, oxaliplatin or their excipients Interstitial pneumonia or interstitial fibrosis of the lung Central nervous system metastases or carcinomatous meningitis Known history of dihydropyrimidine dehydrogenase deficiency Symptomatic congestive heart failure, unstable angina pectoris, or symptomatic or poorly controlled cardiac arrhythmia Experienced any arterial thromboembolic event Uncontrolled arterial hypertension Grade 3-4 venous thromboembolic events occurring within 3 months prior to enrollment Experienced any grade 3-4 gastrointestinal bleeding or any variceal bleeding episode in the 3 months prior to enrollment requiring transfusion, endoscopic or operative intervention Esophageal or gastric varices that require immediate intervention or represent a high bleeding risk Pre-existing grade ≥ 2 motor or sensory neuropathy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST)
Organizational Affiliation
Eli Lilly and Company
Official's Role
Study Director
Facility Information:
Facility Name
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
City
Tainan
ZIP/Postal Code
70403
Country
Taiwan
Facility Name
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
City
Taipei
ZIP/Postal Code
10048
Country
Taiwan
Facility Name
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
City
Taoyuan City
ZIP/Postal Code
33305
Country
Taiwan

12. IPD Sharing Statement

Citations:
PubMed Identifier
33017497
Citation
Lin CC, Yang TS, Yen CJ, Cheng R, Liu J, Hsu C. Safety and Preliminary Efficacy of Ramucirumab in Combination with FOLFOX4 in Patients with Advanced Hepatocellular Carcinoma: A Nonrandomized, Open-Label, Phase Ib Study. Oncologist. 2020 Dec;25(12):e1921-e1929. doi: 10.1002/onco.13550. Epub 2020 Oct 31.
Results Reference
derived

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A Study of Ramucirumab (LY3009806) in Participants With Advanced Liver Cancer

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