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HAIC With Oxaliplatin, 5-FU and Bevacizumab Plus Intravenous Toripalimab for Advanced BTC

Primary Purpose

Advanced Biliary Tract Cancer

Status
Completed
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
OXA, 5-FU and bevacizumab plus Toripalimab
Sponsored by
Peking University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Biliary Tract Cancer focused on measuring hepatic arterial infusion chemotherapy, oxaliplatin, 5-fluorouracil, bevacizumab, Toripalimab, advanced biliary tract cancer

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Biliary tract cancer proved by histology or cytology
  2. Metastatic advanced or locally advanced unresectable biliary tract cancer, including gallbladder cancer, intrahepatic cholangiocarcinoma and perihilar cholangiocarcinoma, decided by hepatobiliary doctor and radiologist.
  3. At least one measurable lesion within liver;
  4. No prior intra-arterial/systemic chemotherapy or other systemic therapies
  5. Prior resection, TACE or ablation will be allowed.
  6. Age from 18 years old to 80 years old.
  7. the performance of Eastern Cooperative Oncology Group (ECOG) <2
  8. Child-Pugh A or Child-Pugh B (≤ score 7).
  9. Expectant survival time ≥ 3 months.
  10. Baseline blood count test and blood biochemical must meet following criteria:

    1. Hemoglobin ≥ 90 g/L;
    2. Absolute neutrophil count ≥ 1.5×10^9/L;
    3. Blood platelet count ≥ 100×10^9/L;
    4. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤ 2.5 times of upper limit of normal (ULN);
    5. Total bilirubin ≤ 2 times of ULN;
    6. Serum creatinine ≤ 1.5 times of ULN;
    7. Albumin ≥ 30 g/L.
  11. Patients sign informed consent.

Exclusion Criteria:

  1. Distal cholangiocarcinoma.
  2. Allergic to contrast agent.
  3. Pregnant or lactational.
  4. Allergic to 5-fluorouracil, or have metabolic disorder of 5-fluorouracil.
  5. More than 80 years old.
  6. Previous systematic chemotherapy or radiotherapy.
  7. Child-Pugh C or Child-Pugh B (≥ score 8).
  8. Coinstantaneous a lot of malignant hydrothorax or ascites.
  9. History of organ transplantation (including bone marrow auto-transplantation and peripheral stem cell transplantation).
  10. Coinstantaneous infection and need anti-infection therapy.
  11. Hepatitis B virus DNA load ≥ 100 IU/ml (patients whose hepatitis B virus DNA load decreased to < 100 IU/ml after anti-virus therapy could be enrolled).
  12. Coinstantaneous peripheral nervous system disorder or with history of obvious mental disorder and central nervous system disorder.
  13. Diagnosed other kinds of malignant within 5 years, except for non-melanoma skin cancer and carcinoma in situ of cervix.
  14. Without legal capacity.
  15. Impact the study because of medical or ethical reasons.
  16. Uncorrectable coagulation disorder.
  17. Obvious abnormal in ECG or obvious clinical symptoms of heart disease, like congestive heart failure (CHF), coronary heart disease with obvious clinical symptoms, unmanageable arrhythmia and hypertension.
  18. History of myocardial infarction within 12 months, or Grade III/IV of heart function.
  19. Severe liver disease (like cirrhosis), renal disease, respiratory disease, unmanageable diabetes or other kinds of systematic disease.

Sites / Locations

  • Peking University Cancer Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

OXA, 5-FU and Bev plus Toripalimab

Arm Description

the patients enrolled in this arm would receive hepatic arterial infusion chemotherapy with oxaliplatin, 5-fluorouracil and bevacizumab plus intravenous Toripalimab

Outcomes

Primary Outcome Measures

Overall response rate
CR plus PR according to imRECIST

Secondary Outcome Measures

Overall survival
date from the start of treatment until death or lost to follow-up, whichever happen first, assessed at least 6 months
Adverse events
type and incidence of adverse events
Progression-free survival
date from the first treatment to the date of disease progression, lost to follow-up or death, whichever happen first

Full Information

First Posted
January 1, 2020
Last Updated
June 22, 2023
Sponsor
Peking University
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1. Study Identification

Unique Protocol Identification Number
NCT04217954
Brief Title
HAIC With Oxaliplatin, 5-FU and Bevacizumab Plus Intravenous Toripalimab for Advanced BTC
Official Title
Hepatic Arterial Infusion Chemotherapy With Oxaliplatin, 5-fluorouracil and Bevacizumab Plus Intravenous Toripalimab for Advanced Biliary Tract Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
July 28, 2020 (Actual)
Primary Completion Date
May 19, 2023 (Actual)
Study Completion Date
June 1, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
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
Hepatic arterial infusion chemotherapy (HAIC) deliver high concentration of chemotherapeutic agents directly to the liver tumor, was proved to be effective for intrahepatic and perihilar cholangiocarcinoma. Based on the potential synergistic effect of bevacizumab, chemotherapy and PD-1 inhibitor, this phase II clinical study want to test the efficacy and safety using intra-arterial infusion of oxaliplatin, 5-fluorouracil and bevacizumab combined with intravenous infusion of PD-1 inhibitor (Toripalimab) in the treatment of unresectable biliary malignant tumors.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Biliary Tract Cancer
Keywords
hepatic arterial infusion chemotherapy, oxaliplatin, 5-fluorouracil, bevacizumab, Toripalimab, advanced biliary tract cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
OXA, 5-FU and Bev plus Toripalimab
Arm Type
Experimental
Arm Description
the patients enrolled in this arm would receive hepatic arterial infusion chemotherapy with oxaliplatin, 5-fluorouracil and bevacizumab plus intravenous Toripalimab
Intervention Type
Drug
Intervention Name(s)
OXA, 5-FU and bevacizumab plus Toripalimab
Other Intervention Name(s)
FOLFOX
Intervention Description
concomitant treatment: A. HAIC: oxaliplatin (40 mg/m2 for 2 hours), 5-fluorouracil (800 mg/ m2 for 22 hours) on days 1-3, and arterial bevacizumab 300mg for 2 hours on d1 before oxaliplatin through a percutaneously implanted port-catheter system. B. Intravenous PD-1 inhibitor (Toripalimab) 240 mg for 30-60 minutes on d1 before the HAIC. The concomitant treatment repeat every three week, up to 6 cycles. Maintenance treatment: Bevacizumab (300mg) + PD-1 inhibitor (Toripalimab 240mg) will be given intravenously, every 3 weeks.
Primary Outcome Measure Information:
Title
Overall response rate
Description
CR plus PR according to imRECIST
Time Frame
From the start of treatment until the end of treatment, up to approximately 3 years
Secondary Outcome Measure Information:
Title
Overall survival
Description
date from the start of treatment until death or lost to follow-up, whichever happen first, assessed at least 6 months
Time Frame
From the start of treatment until death or lost to follow-up, up to approximately 3 years
Title
Adverse events
Description
type and incidence of adverse events
Time Frame
From the start of treatment until the end of treatment, up to approximately 3 years
Title
Progression-free survival
Description
date from the first treatment to the date of disease progression, lost to follow-up or death, whichever happen first
Time Frame
From the start of the treatment until first documented progression or death from any cause, whichever came first, assessed up to approximately 3 yearsse date of disease progression

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: Biliary tract cancer proved by histology or cytology Metastatic advanced or locally advanced unresectable biliary tract cancer, including gallbladder cancer, intrahepatic cholangiocarcinoma and perihilar cholangiocarcinoma, decided by hepatobiliary doctor and radiologist. At least one measurable lesion within liver; No prior intra-arterial/systemic chemotherapy or other systemic therapies Prior resection, TACE or ablation will be allowed. Age from 18 years old to 80 years old. the performance of Eastern Cooperative Oncology Group (ECOG) <2 Child-Pugh A or Child-Pugh B (≤ score 7). Expectant survival time ≥ 3 months. Baseline blood count test and blood biochemical must meet following criteria: Hemoglobin ≥ 90 g/L; Absolute neutrophil count ≥ 1.5×10^9/L; Blood platelet count ≥ 100×10^9/L; Alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤ 2.5 times of upper limit of normal (ULN); Total bilirubin ≤ 2 times of ULN; Serum creatinine ≤ 1.5 times of ULN; Albumin ≥ 30 g/L. Patients sign informed consent. Exclusion Criteria: Distal cholangiocarcinoma. Allergic to contrast agent. Pregnant or lactational. Allergic to 5-fluorouracil, or have metabolic disorder of 5-fluorouracil. More than 80 years old. Previous systematic chemotherapy or radiotherapy. Child-Pugh C or Child-Pugh B (≥ score 8). Coinstantaneous a lot of malignant hydrothorax or ascites. History of organ transplantation (including bone marrow auto-transplantation and peripheral stem cell transplantation). Coinstantaneous infection and need anti-infection therapy. Hepatitis B virus DNA load ≥ 100 IU/ml (patients whose hepatitis B virus DNA load decreased to < 100 IU/ml after anti-virus therapy could be enrolled). Coinstantaneous peripheral nervous system disorder or with history of obvious mental disorder and central nervous system disorder. Diagnosed other kinds of malignant within 5 years, except for non-melanoma skin cancer and carcinoma in situ of cervix. Without legal capacity. Impact the study because of medical or ethical reasons. Uncorrectable coagulation disorder. Obvious abnormal in ECG or obvious clinical symptoms of heart disease, like congestive heart failure (CHF), coronary heart disease with obvious clinical symptoms, unmanageable arrhythmia and hypertension. History of myocardial infarction within 12 months, or Grade III/IV of heart function. Severe liver disease (like cirrhosis), renal disease, respiratory disease, unmanageable diabetes or other kinds of systematic disease.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xiaodong Wang, MD
Organizational Affiliation
Department of Interventional Therapy, Peking University Cancer Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Peking University Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
signed informed consent with patients
Citations:
PubMed Identifier
20431764
Citation
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Results Reference
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Results Reference
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PubMed Identifier
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Boehm LM, Jayakrishnan TT, Miura JT, Zacharias AJ, Johnston FM, Turaga KK, Gamblin TC. Comparative effectiveness of hepatic artery based therapies for unresectable intrahepatic cholangiocarcinoma. J Surg Oncol. 2015 Feb;111(2):213-20. doi: 10.1002/jso.23781. Epub 2014 Sep 1.
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Gao F, Yang C. Anti-VEGF/VEGFR2 Monoclonal Antibodies and their Combinations with PD-1/PD-L1 Inhibitors in Clinic. Curr Cancer Drug Targets. 2020;20(1):3-18. doi: 10.2174/1568009619666191114110359.
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HAIC With Oxaliplatin, 5-FU and Bevacizumab Plus Intravenous Toripalimab for Advanced BTC

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