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Clemizole HCl for Subjects With Hepatocellular Carcinoma

Primary Purpose

Hepatocellular Carcinoma

Status
Unknown status
Phase
Phase 2
Locations
Turkey
Study Type
Interventional
Intervention
Clemizole Hydrochloride
Sponsored by
Eiger Group International, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  1. Males or females, at least 18 years of age.
  2. Subjects should have a diagnosis (histologically proven) of hepatocellular carcinoma (that is measurable on CT or MR with contrast) and are either awaiting transplantation or have an unresectable lesion for which they have not received prior experimental systemic treatments for HCC and no additional therapy is planned.
  3. Eastern Cooperative Oncology Group performance status of 2 or less.
  4. Child-Pugh (CP) score of A or B.
  5. Life expectancy of at least 12 weeks.
  6. Elevated alphafetoprotein (AFP) level .
  7. Adequate hematologic (platelet count, ≥60 ; hemoglobin, ≥8.5 g per deciliter; and prothrombin time international normalized ratio, ≤2.3; or prothrombin time, ≤6 seconds above control), hepatic (albumin, ≥2.8 g per deciliter; total bilirubin, ≤3 mg per deciliter [51.3 μmol per liter]; and alanine aminotransferase and aspartate aminotransferase, ≤5 times the upper limit of the normal range), and renal (serum creatinine, ≤1.5 times the upper limit of the normal range) function.
  8. Electrocardiogram (ECG) showing no acute ischemia or clinically significant abnormality and a QT/QTc interval <450 milliseconds for males or <470 milliseconds for females using Bazett's correction (QTc =QT/RR0.5;ICH Guidance E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs)
  9. Females of childbearing potential (intact uterus and within one year since the last menstrual period) should be non-lactating and have a negative serum pregnancy test. In addition, all subjects (male and female) and their sexually active partners should agree to use one of the following acceptable birth control methods throughout the study:

    1. surgical sterilization (bilateral tubal ligation, hysterectomy, bilateral oophorectomy) six month minimum
    2. IUD in place for at least three months
    3. barrier methods (condom or diaphragm) with spermicide
    4. surgical sterilization of the partner (vasectomy for six months)
    5. hormonal contraceptives for at least three months prior to the first dose of study drug
  10. Willing and able to comply with study procedures and provide written informed consent

Exclusion Criteria:

  1. Participation in a clinical trial with or use of any investigational agent within 30 days of Study Visit 1
  2. Patients co-infected with HIV
  3. Patients with screening tests positive for anti-HIV Ab
  4. Patients with tumors of mixed histology or fibrolamellar variant,
  5. Pregnant or lactating women,
  6. Patients requiring systemic anticancer therapy, or biologic-response modifiers
  7. Medical/psychological/social problems that might affect study participation or evaluations
  8. Eating disorder or alcohol abuse within the past two years, excessive alcohol intake (>20 g per day for females (1.5 standard alcohol drinks) or >30 g per day for males (2.0 standard alcohol drinks) (a standard drink contains 14 g of alcohol: 12 oz of beer, 5 oz of wine or 1.5 oz of spirits) (1.0 fluid oz (US) = 29.57 mL) or if in the opinion of the investigator, an alcohol use pattern that will interfere with study conduct
  9. Drug abuse within the last six months
  10. Patients with absolute neutrophil count (ANC) <1500 cells/mm3;
  11. Abnormal TSH, T4 or T3
  12. History or clinical evidence of any of the following:

    1. variceal bleeding, difficult to treat ascites, hepatic encephalopathy, CTP score >8,
    2. immunologically mediated disease (e.g, rheumatoid arthritis, inflammatory bowel disease, severe psoriasis, systemic lupus erythematosus) requiring more than intermittent non-steroidal anti-inflammatory medications for management or that requires frequent or prolonged use of corticosteroids (inhaled asthma medications are allowed)
    3. significant or unstable cardiac disease (e.g., angina, congestive heart failure, uncontrolled hypertension, history of arrhythmia)
    4. chronic pulmonary disease (e.g., chronic obstructive pulmonary disease) associated with functional impairment
    5. severe or uncontrolled psychiatric disease, including severe depression, history of suicidal ideation, suicidal attempts or psychosis requiring medication and/or hospitalization
  13. Patients with a body mass index of >30 kg/m2
  14. Chronic use of concomitant drugs known to prolong the QT interval (See Appendix E)
  15. Concomitant use of immunosuppressive or immune modulating agents
  16. Patients with any serious condition that, in the opinion of the investigator, would preclude evaluation of response or make it unlikely that the contemplated course of therapy and follow-up could be completed or increase the risk to the subject of participation in the trial

Sites / Locations

  • University of Ankara

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

200 mg TID

300 mg TID

400 mg TID

500 mg TID

Arm Description

200 mg clemizole hydrochloride will be administered orally thrice a day for 24 weeks.

300 mg clemizole hydrochloride will be administered orally thrice a day for 24 weeks.

400 mg clemizole hydrochloride will be administered orally thrice a day for 24 weeks.

500 mg clemizole hydrochloride will be administered orally thrice a day for 24 weeks.

Outcomes

Primary Outcome Measures

Number of participants with adverse events
Safety and tolerability of up to six months of treatment with clemizole hydrochloride thrice daily by mouth in subjects diagnosed with hepatocellular carcinoma that are either awaiting transplantation or have an unresectable lesion, determined by the number of participants with abnormal laboratory values and/or adverse events that are related to treatment
Overall tumor response according to radiologic assessments associated with clemizole HCl.
Number of participants with stable disease, complete response (CR), partial response (PR), or minor response (MR), as defined by Response Evaluation Criteria in Solid Tumors (RECIST), associated with clemizole HCl.
AUC Pharmacokinetic (PK) assessment of clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg by mouth)
Area under the plasma concentration versus time curve (AUC) of clemizole HCl following oral administration of 200 mg vs. 300 mg vs. 400 mg vs. 500 mg.
Cmax Pharmacokinetic (PK) assessment of clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg by mouth)
Peak plasma concentration (Cmax) of clemizole HCl following oral administration of 200 mg vs. 300 mg vs. 400 mg vs. 500 mg.

Secondary Outcome Measures

Duration of response associated with clemizole hydrochloride
Duration of response associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth)
Time to progression associated with clemizole hydrochloride
Time to progression associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth)
Duration of stable disease associated with clemizole hydrochloride
Duration of stable disease associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth)
Overall survival associated with clemizole hydrochloride
Overall survival associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth)

Full Information

First Posted
February 14, 2017
Last Updated
February 27, 2017
Sponsor
Eiger Group International, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03069508
Brief Title
Clemizole HCl for Subjects With Hepatocellular Carcinoma
Official Title
A Phase IIa, Open Label Pilot Study of Clemizole Hydrochloride Given Orally Thrice a Day, for Subjects With Hepatocellular Carcinoma That Are Either Awaiting Transplantation or Have an Unresectable Lesion
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Unknown status
Study Start Date
February 13, 2017 (Actual)
Primary Completion Date
December 31, 2017 (Anticipated)
Study Completion Date
January 31, 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eiger Group International, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is a phase IIa open label pilot study of up to six months treatment with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 vs. 500 mg mg) given orally TID to subjects with hepatocellular carcinoma that are either awaiting transplantation or have an unresectable lesion.
Detailed Description
The primary objectives of the study are to: Evaluate the safety and tolerability of up to six months of treatment with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg TID by mouth) in subjects diagnosed with hepatocellular carcinoma that are either awaiting transplantation or have an unresectable lesion. Evaluate the overall tumor response according to radiologic assessments of stable disease, complete response (CR), partial response (PR), or minor response (MR), as defined by Response Evaluation Criteria in Solid Tumors (RECIST), associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth) Evaluate the pharmacokinetic (PK) activity of clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth) The secondary objectives of the study are to: • Evaluate the duration of response, time to progression, duration of stable disease (SD), and overall survival associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth)

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
200 mg TID
Arm Type
Experimental
Arm Description
200 mg clemizole hydrochloride will be administered orally thrice a day for 24 weeks.
Arm Title
300 mg TID
Arm Type
Experimental
Arm Description
300 mg clemizole hydrochloride will be administered orally thrice a day for 24 weeks.
Arm Title
400 mg TID
Arm Type
Experimental
Arm Description
400 mg clemizole hydrochloride will be administered orally thrice a day for 24 weeks.
Arm Title
500 mg TID
Arm Type
Experimental
Arm Description
500 mg clemizole hydrochloride will be administered orally thrice a day for 24 weeks.
Intervention Type
Drug
Intervention Name(s)
Clemizole Hydrochloride
Other Intervention Name(s)
Clemizole
Intervention Description
Clemizole Hydrochloride will be administered orally for up to 24 weeks
Primary Outcome Measure Information:
Title
Number of participants with adverse events
Description
Safety and tolerability of up to six months of treatment with clemizole hydrochloride thrice daily by mouth in subjects diagnosed with hepatocellular carcinoma that are either awaiting transplantation or have an unresectable lesion, determined by the number of participants with abnormal laboratory values and/or adverse events that are related to treatment
Time Frame
Number of recorded adverse events at six months
Title
Overall tumor response according to radiologic assessments associated with clemizole HCl.
Description
Number of participants with stable disease, complete response (CR), partial response (PR), or minor response (MR), as defined by Response Evaluation Criteria in Solid Tumors (RECIST), associated with clemizole HCl.
Time Frame
Change from baseline up to 24 weeks
Title
AUC Pharmacokinetic (PK) assessment of clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg by mouth)
Description
Area under the plasma concentration versus time curve (AUC) of clemizole HCl following oral administration of 200 mg vs. 300 mg vs. 400 mg vs. 500 mg.
Time Frame
0-pre-dose, post dose: 15 min, 30 min, 60 min, 90 min, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours post oral administration of clemizole HCl for those subjects participating in the PK portion of this trial
Title
Cmax Pharmacokinetic (PK) assessment of clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg by mouth)
Description
Peak plasma concentration (Cmax) of clemizole HCl following oral administration of 200 mg vs. 300 mg vs. 400 mg vs. 500 mg.
Time Frame
0-pre-dose, post dose: 15 min, 30 min, 60 min, 90 min, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours post oral administration of clemizole HCl for those subjects participating in the PK portion of this trial
Secondary Outcome Measure Information:
Title
Duration of response associated with clemizole hydrochloride
Description
Duration of response associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth)
Time Frame
First administration of study drug until progressive disease in patients with objective responses up to 24 weeks.
Title
Time to progression associated with clemizole hydrochloride
Description
Time to progression associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth)
Time Frame
First administration of study drug until progressive disease up to 24 weeks.
Title
Duration of stable disease associated with clemizole hydrochloride
Description
Duration of stable disease associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth)
Time Frame
First day of receiving clemizole until progressive disease or response up to 24 weeks.
Title
Overall survival associated with clemizole hydrochloride
Description
Overall survival associated with clemizole hydrochloride (200 mg vs. 300 mg vs. 400 mg vs. 500 mg, TID by mouth)
Time Frame
First day of receiving study medication to death up to 24 weeks.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or females, at least 18 years of age. Subjects should have a diagnosis (histologically proven) of hepatocellular carcinoma (that is measurable on CT or MR with contrast) and are either awaiting transplantation or have an unresectable lesion for which they have not received prior experimental systemic treatments for HCC and no additional therapy is planned. Eastern Cooperative Oncology Group performance status of 2 or less. Child-Pugh (CP) score of A or B. Life expectancy of at least 12 weeks. Elevated alphafetoprotein (AFP) level . Adequate hematologic (platelet count, ≥60 ; hemoglobin, ≥8.5 g per deciliter; and prothrombin time international normalized ratio, ≤2.3; or prothrombin time, ≤6 seconds above control), hepatic (albumin, ≥2.8 g per deciliter; total bilirubin, ≤3 mg per deciliter [51.3 μmol per liter]; and alanine aminotransferase and aspartate aminotransferase, ≤5 times the upper limit of the normal range), and renal (serum creatinine, ≤1.5 times the upper limit of the normal range) function. Electrocardiogram (ECG) showing no acute ischemia or clinically significant abnormality and a QT/QTc interval <450 milliseconds for males or <470 milliseconds for females using Bazett's correction (QTc =QT/RR0.5;ICH Guidance E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs) Females of childbearing potential (intact uterus and within one year since the last menstrual period) should be non-lactating and have a negative serum pregnancy test. In addition, all subjects (male and female) and their sexually active partners should agree to use one of the following acceptable birth control methods throughout the study: surgical sterilization (bilateral tubal ligation, hysterectomy, bilateral oophorectomy) six month minimum IUD in place for at least three months barrier methods (condom or diaphragm) with spermicide surgical sterilization of the partner (vasectomy for six months) hormonal contraceptives for at least three months prior to the first dose of study drug Willing and able to comply with study procedures and provide written informed consent Exclusion Criteria: Participation in a clinical trial with or use of any investigational agent within 30 days of Study Visit 1 Patients co-infected with HIV Patients with screening tests positive for anti-HIV Ab Patients with tumors of mixed histology or fibrolamellar variant, Pregnant or lactating women, Patients requiring systemic anticancer therapy, or biologic-response modifiers Medical/psychological/social problems that might affect study participation or evaluations Eating disorder or alcohol abuse within the past two years, excessive alcohol intake (>20 g per day for females (1.5 standard alcohol drinks) or >30 g per day for males (2.0 standard alcohol drinks) (a standard drink contains 14 g of alcohol: 12 oz of beer, 5 oz of wine or 1.5 oz of spirits) (1.0 fluid oz (US) = 29.57 mL) or if in the opinion of the investigator, an alcohol use pattern that will interfere with study conduct Drug abuse within the last six months Patients with absolute neutrophil count (ANC) <1500 cells/mm3; Abnormal TSH, T4 or T3 History or clinical evidence of any of the following: variceal bleeding, difficult to treat ascites, hepatic encephalopathy, CTP score >8, immunologically mediated disease (e.g, rheumatoid arthritis, inflammatory bowel disease, severe psoriasis, systemic lupus erythematosus) requiring more than intermittent non-steroidal anti-inflammatory medications for management or that requires frequent or prolonged use of corticosteroids (inhaled asthma medications are allowed) significant or unstable cardiac disease (e.g., angina, congestive heart failure, uncontrolled hypertension, history of arrhythmia) chronic pulmonary disease (e.g., chronic obstructive pulmonary disease) associated with functional impairment severe or uncontrolled psychiatric disease, including severe depression, history of suicidal ideation, suicidal attempts or psychosis requiring medication and/or hospitalization Patients with a body mass index of >30 kg/m2 Chronic use of concomitant drugs known to prolong the QT interval (See Appendix E) Concomitant use of immunosuppressive or immune modulating agents Patients with any serious condition that, in the opinion of the investigator, would preclude evaluation of response or make it unlikely that the contemplated course of therapy and follow-up could be completed or increase the risk to the subject of participation in the trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Cihan Yurdaydin, MD
Organizational Affiliation
University of Ankara
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Ankara
City
Ankara
Country
Turkey

12. IPD Sharing Statement

Plan to Share IPD
No

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Clemizole HCl for Subjects With Hepatocellular Carcinoma

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