Hepatic Arterial Infusion Chemotherapy(HAIC) for Hepatoma After Resection (HAICAT)
Primary Purpose
Hepatocellular Carcinoma
Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Oxaliplatin(OXA), 5-fluorouracil (5-FU)
Hepatic arterial catheter implantation
Sponsored by
About this trial
This is an interventional prevention trial for Hepatocellular Carcinoma focused on measuring Hepatocellular Carcinoma, Hepatic arterial infusion chemotherapy
Eligibility Criteria
Inclusion Criteria:
- 18 years and older
- Informed consent Confirmation of diagnosis of HCC: For subjects undergoing surgical resection histological confirmation is mandatory (a post surgery pathology report is required for both histological confirmation and risk stratification).
- After qualifying at the time of scanning, by independent radiology review diagnosed CR (no residual tumor deposit radical therapy Assess their level of risk of disease recurrence by tumor characteristics as moderate or high risk
- Subjects who have undergone surgical resection for treatment of HCC with curative intent within 4 months from staging to potentially curative treatment.
- At least 3 weeks (21 days) but not more than 7 weeks (49 days), from resection course, to CT/MRI scan date. A timeframe of 4 weeks after surgical resection is recommended.
- Male or female subjects ≥ 18 years of age Confirmation of complete response(CR)- (absence of residual tumor after curative treatment), on the eligibility scan by independent radiological review.
- For subjects undergoing surgical resection pathology proven complete removal of tumor. Intermediate or High Risk of recurrence as assessed by tumor characteristics.
- Child-Pugh score 5 -7 points. A Child-Pugh score of 7 points is allowed only in the absence of ascites.
- Eastern Cooperative Oncology Group (ECOG) Performance Status of 0.
- Adequate bone marrow, liver and renal function as assessed by central lab by means of the following laboratory requirements from samples within 14 days prior to randomization: Alpha fetoprotein ≤ 400 ng/mL
- Women of childbearing potential must have a negative serum pregnancy test performed within 14 days prior to the start of treatment (assessed centrally).
Exclusion Criteria:
- Recurrent HCC Child-Pugh score 7 points with presence of ascites.
- The following tumor characteristics: Low risk of recurrence after curative treatment defined as any of the following: for local ablation patients: single lesions ≤ 2 cm for surgical resection patients: single lesions ≤ 2 cm without microscopic vascular invasion, without tumor satellites and histologically well differentiated. ≥ 3 lesions or 2-3 lesions of which any are ≥ 3 cm in size (largest diameter, unidimensional measurement) prior curative treatment (surgical resection or local ablation) single lesion ≥ 5 cm (largest diameter, unidimensional measurement) in size prior local ablation.
- Macrovascular invasion Extrahepatic spread (including regional lymph nodes and invasion into adjacent structures)
- History of cardiovascular disease:
- History of HIV infection Active clinically serious infections (≥ grade 2 NCI-CTCAE version 3.0)
- Subjects with seizure disorder requiring medication (such as steroids or anti-epileptics)
- History of organ allograft Subjects with evidence or history of bleeding diathesis
- Subjects undergoing renal dialysis
- Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors [Ta, Tis & T1] or any cancer curatively treated ≥ 3 years prior to study entry as defined by the signing of informed consent.
- Uncontrolled ascites (defined as not easily controlled with diuretic treatment)
- Encephalopathy History of GI bleeding within 30 days of randomization.
- Subjects with a history of esophageal varices bleeding which has not been followed by effective therapy and/or treatment to prevent bleeding recurrence.
- Prior anti cancer therapy for treatment of HCC (including sorafenib or any other molecular therapy) is excluded.
- Major surgery within 4 weeks of start of study as defined by the signing of informed consent, except for surgical resection or local ablation of HCC.
- Autologous bone marrow transplant or stem cell rescue within 4 months of study entry as defined by the signing of informed consent.
- Use of biologic response modifiers, such as colony stimulating factor(G-CSF), within 3 week of study entry, as defined by the signing of informed consent.
- Investigational drug therapy outside of this trial during or within 4 weeks of study entry, as defined by the signing of informed consent.
- Pregnant or breast-feeding subjects.
- Substance abuse, medical, psychological or social conditions that may interfere with the subject's participation in the study or evaluation of the study results
- Known or suspected allergy to contrast media for angiography.
- Any condition that is unstable or could jeopardize the safety of the subject and their compliance in the study
- This applies to subjects with severe obstruction of the upper GI tract that require gavage.
Sites / Locations
- Beijing Cancer HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
No Intervention
Arm Label
HAIC treatment group
No HAIC treatment group
Arm Description
HAIC treatment after resection Intervention: Drug: Oxaliplatin, 5-fluorouracil (5-FU) Procedure/Surgery: Hepatic arterial catheter implantation
Best support care and follow up
Outcomes
Primary Outcome Measures
Recurrence Free Survival
Secondary Outcome Measures
Time to recurrence
Overall survival
Visual Analog Score for pain
Physicians Global Assessment to measure quality of life
Number of Participants With Abnormal Laboratory Values
Adverse Events That Are Related to Treatment
Full Information
NCT ID
NCT02767375
First Posted
April 3, 2016
Last Updated
August 9, 2017
Sponsor
Peking University Cancer Hospital & Institute
1. Study Identification
Unique Protocol Identification Number
NCT02767375
Brief Title
Hepatic Arterial Infusion Chemotherapy(HAIC) for Hepatoma After Resection
Acronym
HAICAT
Official Title
Hepatic Arterial Infusion Chemotherapy as Adjuvant Treatment in the Prevention of Recurrence of Hepatocellular Carcinoma(HCC): A Prospective Randomized Controlled Clinical Trial
Study Type
Interventional
2. Study Status
Record Verification Date
August 2017
Overall Recruitment Status
Unknown status
Study Start Date
February 2015 (undefined)
Primary Completion Date
December 2017 (Anticipated)
Study Completion Date
December 2018 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking University Cancer Hospital & Institute
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
To study if the addition of HAIC following complete removal of early stage liver cancer of HCC will prevent or delay the recurrence of the disease. Half of the participant will receive two cycles of the HAIC after the hepatectomy, while the other half will return to the baseline surveillance schedule.
Detailed Description
The high incidence of HCC recurrence following liver resection is a serious issue. The recurrent rate is as high as 50-60% at 3 years and 70-100% at 5 years.
So to reduce the recurrence rate of HCC, some interventions had been tried in clinic, including transarterial chemoembolization (TACE), immunotherapy, and interferon treatment etc. But few of these adjuvant therapies had been proved effective and the long term efficacy and clinical application remained further explored.
HAIC had been prove to be effective adjuvant treatment in patients with liver metastasis of colorectal cancers in randomized controlled trials and meta-analysis, but the role of adjuvant HAIC after liver resection is controversial. The results getting from different randomized control trials varied significantly because of the bias of patient selection, different study design,the small size of sample, different drug used in chemotherapy and lack of proper stratification,so a big sample size, well patients selected and well designed randomized controlled trial is needed to further confirm the role of the postoperative HAIC.
Patients with HCC who received curative liver resection (R0) were randomly assigned 1:1 by the doctors to receive no adjuvant HAIC(control group) or HAIC (treatment group). All patients in the treatment group will receive 2 cycles of adjuvant HAIC within 3 months after liver resection. The outcomes of patients were evaluated during the 5-years follow up.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma
Keywords
Hepatocellular Carcinoma, Hepatic arterial infusion chemotherapy
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
192 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
HAIC treatment group
Arm Type
Active Comparator
Arm Description
HAIC treatment after resection Intervention: Drug: Oxaliplatin, 5-fluorouracil (5-FU) Procedure/Surgery: Hepatic arterial catheter implantation
Arm Title
No HAIC treatment group
Arm Type
No Intervention
Arm Description
Best support care and follow up
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin(OXA), 5-fluorouracil (5-FU)
Other Intervention Name(s)
OXA,5-FU
Intervention Description
for the HAIC treatment group OXA 85mg/m2, d1,0-4h 5-FU 1500mg/m2 d1, 4-24h 24 hours in d1 & 2 , IA,q4-6 Weeks
Intervention Type
Procedure
Intervention Name(s)
Hepatic arterial catheter implantation
Other Intervention Name(s)
HAIC
Intervention Description
for the the HAIC treatment group: Hepatic arterial catheter implantation for HAIC
Primary Outcome Measure Information:
Title
Recurrence Free Survival
Time Frame
approximately 70 months from first patient first visit
Secondary Outcome Measure Information:
Title
Time to recurrence
Time Frame
approximately 60 months from first patient first visit
Title
Overall survival
Time Frame
approximately 60 months from first patient first visit
Title
Visual Analog Score for pain
Time Frame
approximately 60 months from first patient first visit
Title
Physicians Global Assessment to measure quality of life
Time Frame
approximately 60 months from first patient first visit
Title
Number of Participants With Abnormal Laboratory Values
Time Frame
approximately 60 months from first patient first visit
Title
Adverse Events That Are Related to Treatment
Time Frame
approximately 60 months from first patient first visit
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
18 years and older
Informed consent Confirmation of diagnosis of HCC: For subjects undergoing surgical resection histological confirmation is mandatory (a post surgery pathology report is required for both histological confirmation and risk stratification).
After qualifying at the time of scanning, by independent radiology review diagnosed CR (no residual tumor deposit radical therapy Assess their level of risk of disease recurrence by tumor characteristics as moderate or high risk
Subjects who have undergone surgical resection for treatment of HCC with curative intent within 4 months from staging to potentially curative treatment.
At least 3 weeks (21 days) but not more than 7 weeks (49 days), from resection course, to CT/MRI scan date. A timeframe of 4 weeks after surgical resection is recommended.
Male or female subjects ≥ 18 years of age Confirmation of complete response(CR)- (absence of residual tumor after curative treatment), on the eligibility scan by independent radiological review.
For subjects undergoing surgical resection pathology proven complete removal of tumor. Intermediate or High Risk of recurrence as assessed by tumor characteristics.
Child-Pugh score 5 -7 points. A Child-Pugh score of 7 points is allowed only in the absence of ascites.
Eastern Cooperative Oncology Group (ECOG) Performance Status of 0.
Adequate bone marrow, liver and renal function as assessed by central lab by means of the following laboratory requirements from samples within 14 days prior to randomization: Alpha fetoprotein ≤ 400 ng/mL
Women of childbearing potential must have a negative serum pregnancy test performed within 14 days prior to the start of treatment (assessed centrally).
Exclusion Criteria:
Recurrent HCC Child-Pugh score 7 points with presence of ascites.
The following tumor characteristics: Low risk of recurrence after curative treatment defined as any of the following: for local ablation patients: single lesions ≤ 2 cm for surgical resection patients: single lesions ≤ 2 cm without microscopic vascular invasion, without tumor satellites and histologically well differentiated. ≥ 3 lesions or 2-3 lesions of which any are ≥ 3 cm in size (largest diameter, unidimensional measurement) prior curative treatment (surgical resection or local ablation) single lesion ≥ 5 cm (largest diameter, unidimensional measurement) in size prior local ablation.
Macrovascular invasion Extrahepatic spread (including regional lymph nodes and invasion into adjacent structures)
History of cardiovascular disease:
History of HIV infection Active clinically serious infections (≥ grade 2 NCI-CTCAE version 3.0)
Subjects with seizure disorder requiring medication (such as steroids or anti-epileptics)
History of organ allograft Subjects with evidence or history of bleeding diathesis
Subjects undergoing renal dialysis
Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors [Ta, Tis & T1] or any cancer curatively treated ≥ 3 years prior to study entry as defined by the signing of informed consent.
Uncontrolled ascites (defined as not easily controlled with diuretic treatment)
Encephalopathy History of GI bleeding within 30 days of randomization.
Subjects with a history of esophageal varices bleeding which has not been followed by effective therapy and/or treatment to prevent bleeding recurrence.
Prior anti cancer therapy for treatment of HCC (including sorafenib or any other molecular therapy) is excluded.
Major surgery within 4 weeks of start of study as defined by the signing of informed consent, except for surgical resection or local ablation of HCC.
Autologous bone marrow transplant or stem cell rescue within 4 months of study entry as defined by the signing of informed consent.
Use of biologic response modifiers, such as colony stimulating factor(G-CSF), within 3 week of study entry, as defined by the signing of informed consent.
Investigational drug therapy outside of this trial during or within 4 weeks of study entry, as defined by the signing of informed consent.
Pregnant or breast-feeding subjects.
Substance abuse, medical, psychological or social conditions that may interfere with the subject's participation in the study or evaluation of the study results
Known or suspected allergy to contrast media for angiography.
Any condition that is unstable or could jeopardize the safety of the subject and their compliance in the study
This applies to subjects with severe obstruction of the upper GI tract that require gavage.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Guang Cao, Doctor
Phone
86-138-1165-2497
Email
caoguang1207@bjmu.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Wei Liu, Doctor
Phone
86-138-1083-9736
Email
huoxinglaotai@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Baocai Xing, Doctor
Organizational Affiliation
1st Department of HBP Surgery.Beijing Cancer Hospital
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Xu Zhu, Doctor
Organizational Affiliation
Interventional therapy department of Beijing Cancer Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Beijing Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Guang Cao, Doctor
Phone
86-138-1165-2497
Email
caoguang1207@bjmu.edu.cn
First Name & Middle Initial & Last Name & Degree
Wei Liu, Doctor
Phone
86-138-1083-9736
Email
huoxinglaotai@163.com
First Name & Middle Initial & Last Name & Degree
Guang Cao, Doctor
First Name & Middle Initial & Last Name & Degree
Wei Liu, Doctor
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
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26020031
Citation
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Hepatic Arterial Infusion Chemotherapy(HAIC) for Hepatoma After Resection
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