Study of the Combination of TACE With Apatinib in Patients With Hepatocellular Carcinoma
Primary Purpose
Hepatocellular Carcinoma
Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
TACE and Apatinib
TACE
Sponsored by

About this trial
This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring Hepatocellular Carcinoma, Apatinib
Eligibility Criteria
Inclusion Criteria:
- Aged 18 - 75 years old;
- Must be strictly in accordance with the "guidelines for primary liver cancer diagnosis and treatment" (2011 edition). According to clinical diagnosis standard or confirmed by histopathology or cytology, the patients with advanced primary liver cancer who can't be?removed surgically, and can't accept palliative surgery or radiation therapy, and have at least one measurable lesions;The biggest tumor 10 cm or less;
- Refuse the treatment of sorafenib;
- The Child - Pugh( liver function grade): grade A or better grade of B (≤7 points);
- BCLC stage for B or C;
- Within 1 week before into the study,ECOG PS0-1;
- The expected lifetime of patients should be equal to or more than 12 weeks;
The main viscera function of patients must be normal, and should meet the following requirements:
- Blood routine examination must meet: HB≥90 g/L, ANC≥1.5×10^9/L, PLT≥60×10^9/L;
- Biochemical examination should meet the following criteria: ALB ≥29 g/L, ALT and AST<5xULN, TBIL ≤1.5xULN, creatinine≤1.5xULN (Only one of albumin and bilirubin can be 2 points in the rating of Child-Pugh);
- The patients are willing to join in this study, and have signed the informed consent. The patients have good adherence, and are willing to cooperate with the follow-up.
Exclusion Criteria:
- Patients have received radiotherapy or chemotherapy within four weeks before the study;
- In the past (within 5 years) or at the same time,patients were diagnosed with other malignant tumor which have not been cured. As for skin basal cell carcinoma and cervical carcinoma in situ,they can be excepted;
- Patients who are diagnosed with hypertension which cant be reduced to normal range via antihypertensive drug treatment(systolic blood pressure> 140 mmHg / diastolic blood pressure> 90 mmHg);
- Patients who are diagnosed with II or higher level of myocardial ischemia, myocardial infarction, uncontrolled arrhythmia(including QTc interval prolongation men> 450 ms, female> 470 ms);
- There are many factors which can influence the oral drug absorption (such as unable to swallow, chronic diarrhea and intestinal obstruction, which can significantly affect the drug taking and absorption);
- Within 6 months in the past,the patients have a history of gastrointestinal bleeding or a gastrointestinal bleeding tendency, for example,there is a risk of bleeding of esophageal varicose veins, local active ulcerative lesions, defecate occult blood ≥ (+ +)(+) shall not be admitted into the study;
- within 28 days before being admitted into the study, there is abdominal fistula, gastrointestinal perforation or abdominal abscess;
- Blood coagulation function is abnormal (INR>1.5 or PT> ULN+4s), and the patients are able to be faced with a bleeding tendency or being treated with thrombolysis and anticoagulation;
- Has been diagnosed with ?the central nervous system metastases or the brain metastases has been known;
- There are past medical history or history of present illness of pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, radioactive pneumonia, drug related pneumonia,pulmonary function test suggests there is objective evidence of severely damaged lung function;
- Urine routine inspection suggests that the urine protein ≥++;24 hours urine protein examination>1.0 g;
- Within 7 days before being admitted into the study,patients have received a potent CYP3A4 inhibitor treatment, or within 12 days before being admitted into the study,patients have received potent CYP3A4 inducers treatment;
- Pregnant or lactating women;Patients with fertility are unwilling or unable to take effective contraceptive measures;
- With a mental illness, or has a history of psychiatric drugs abuse;
- Patients with HIV infection.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
study group
control group
Arm Description
TACE and Apatinib
TACE alone
Outcomes
Primary Outcome Measures
PFS
progression free survival
Secondary Outcome Measures
TTP
Time To Progress
OS
Overall Survival
DCR
Disease Control Rate
ORR
Objective Response Rate
QoL
Quality of Life
Full Information
NCT ID
NCT03066557
First Posted
February 20, 2017
Last Updated
February 23, 2017
Sponsor
Jiangsu Cancer Institute & Hospital
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT03066557
Brief Title
Study of the Combination of TACE With Apatinib in Patients With Hepatocellular Carcinoma
Official Title
Study of the Combination of Transcatheter Arterial Chemoembolization (TACE) With Apatinib in Patients With Hepatocellular Carcinoma Trial
Study Type
Interventional
2. Study Status
Record Verification Date
February 2017
Overall Recruitment Status
Unknown status
Study Start Date
March 15, 2017 (Anticipated)
Primary Completion Date
June 30, 2018 (Anticipated)
Study Completion Date
December 31, 2018 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Jiangsu Cancer Institute & Hospital
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. It is lack of effective drugs for systemic treatment of HCC. Currently, Sorafenib is the only choice approved by FDA for advanced HCC, although it prolongs the survival for less than 3 months. The treatment of advanced HCC still has a long way to go.
At present, the relevant phase II and phase III clinical studies of apatinib on advanced HCC are ongoing. Based on our important discovery of previous clinical studies, we intend to enlarge the sample size and make further observation for the efficacy and safety of apatinib in patients with advanced HCC.
Detailed Description
Hepatocellular carcinoma (HCC) is one of the lethal human cancers worldwide and its incidence matches mortality, reflecting the poor prognosis of this disease. The surgical resection rate of HCC is low, and the prognosis is poor. Although transarterial chemoembolization (TACE) is the main treatment for HCC patients who are not candidates for surgical resection, it is not considered a curative procedure. For HCC, poor TACE efficacy or TACE failure may be related to tumor angiogenesis of the residual disease. Among the many regulatory factors in tumor angiogenesis, hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) play vital roles in this process.
Sorafenib is the first systemic treatment drug, which has been approved by the FDA for advanced HCC. In order to find an new VEGFR-inhibitor with better effect and lower toxicity, Jiangsu Hengrui Medicine Co., Ltd. developed Apatinib, a high-performance VEGFR-2 tyrosine kinase inhibitor. Apatinib plays anti angiogenic effect in the treatment of malignant tumor mainly through inhibition of VEGFR-2, in vivo and in vitro experiments showed good tumor growth inhibitory activity on Hepatocellular carcinoma, this study aims to further verify the efficacy and safety of Apatinib for hepatocellular carcinoma patients who are not candidates for curative surgery, the primary endpoint is Progression Free Survival (PFS).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma
Keywords
Hepatocellular Carcinoma, Apatinib
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
80 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
study group
Arm Type
Active Comparator
Arm Description
TACE and Apatinib
Arm Title
control group
Arm Type
Experimental
Arm Description
TACE alone
Intervention Type
Procedure
Intervention Name(s)
TACE and Apatinib
Other Intervention Name(s)
Aitan
Intervention Description
TACE and Apatinib 250mg po qd
Intervention Type
Procedure
Intervention Name(s)
TACE
Intervention Description
TACE
Primary Outcome Measure Information:
Title
PFS
Description
progression free survival
Time Frame
2 years
Secondary Outcome Measure Information:
Title
TTP
Description
Time To Progress
Time Frame
2 years
Title
OS
Description
Overall Survival
Time Frame
2 years
Title
DCR
Description
Disease Control Rate
Time Frame
2 years
Title
ORR
Description
Objective Response Rate
Time Frame
2 years
Title
QoL
Description
Quality of Life
Time Frame
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:
Aged 18 - 75 years old;
Must be strictly in accordance with the "guidelines for primary liver cancer diagnosis and treatment" (2011 edition). According to clinical diagnosis standard or confirmed by histopathology or cytology, the patients with advanced primary liver cancer who can't be?removed surgically, and can't accept palliative surgery or radiation therapy, and have at least one measurable lesions;The biggest tumor 10 cm or less;
Refuse the treatment of sorafenib;
The Child - Pugh( liver function grade): grade A or better grade of B (≤7 points);
BCLC stage for B or C;
Within 1 week before into the study,ECOG PS0-1;
The expected lifetime of patients should be equal to or more than 12 weeks;
The main viscera function of patients must be normal, and should meet the following requirements:
Blood routine examination must meet: HB≥90 g/L, ANC≥1.5×10^9/L, PLT≥60×10^9/L;
Biochemical examination should meet the following criteria: ALB ≥29 g/L, ALT and AST<5xULN, TBIL ≤1.5xULN, creatinine≤1.5xULN (Only one of albumin and bilirubin can be 2 points in the rating of Child-Pugh);
The patients are willing to join in this study, and have signed the informed consent. The patients have good adherence, and are willing to cooperate with the follow-up.
Exclusion Criteria:
Patients have received radiotherapy or chemotherapy within four weeks before the study;
In the past (within 5 years) or at the same time,patients were diagnosed with other malignant tumor which have not been cured. As for skin basal cell carcinoma and cervical carcinoma in situ,they can be excepted;
Patients who are diagnosed with hypertension which cant be reduced to normal range via antihypertensive drug treatment(systolic blood pressure> 140 mmHg / diastolic blood pressure> 90 mmHg);
Patients who are diagnosed with II or higher level of myocardial ischemia, myocardial infarction, uncontrolled arrhythmia(including QTc interval prolongation men> 450 ms, female> 470 ms);
There are many factors which can influence the oral drug absorption (such as unable to swallow, chronic diarrhea and intestinal obstruction, which can significantly affect the drug taking and absorption);
Within 6 months in the past,the patients have a history of gastrointestinal bleeding or a gastrointestinal bleeding tendency, for example,there is a risk of bleeding of esophageal varicose veins, local active ulcerative lesions, defecate occult blood ≥ (+ +)(+) shall not be admitted into the study;
within 28 days before being admitted into the study, there is abdominal fistula, gastrointestinal perforation or abdominal abscess;
Blood coagulation function is abnormal (INR>1.5 or PT> ULN+4s), and the patients are able to be faced with a bleeding tendency or being treated with thrombolysis and anticoagulation;
Has been diagnosed with ?the central nervous system metastases or the brain metastases has been known;
There are past medical history or history of present illness of pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, radioactive pneumonia, drug related pneumonia,pulmonary function test suggests there is objective evidence of severely damaged lung function;
Urine routine inspection suggests that the urine protein ≥++;24 hours urine protein examination>1.0 g;
Within 7 days before being admitted into the study,patients have received a potent CYP3A4 inhibitor treatment, or within 12 days before being admitted into the study,patients have received potent CYP3A4 inducers treatment;
Pregnant or lactating women;Patients with fertility are unwilling or unable to take effective contraceptive measures;
With a mental illness, or has a history of psychiatric drugs abuse;
Patients with HIV infection.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Chen Shixi, Bachelor
Phone
+86-13505192984
Email
chenshixi2007@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yin Guowen
Phone
+86-13951841177
Email
jsnjygw@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Feng Jifeng, Doctor
Organizational Affiliation
Jiangsu Cancer Institute & Hospital
Official's Role
Study Chair
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Within six months after the trial complete
Learn more about this trial
Study of the Combination of TACE With Apatinib in Patients With Hepatocellular Carcinoma
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