HepATocellular Cancer Hcv Therapy Study (HATCHeT)
Primary Purpose
Hepatocellular Carcinoma, Hepatoma, Liver Cell Carcinoma
Status
Withdrawn
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Elbasvir / Grazoprevir Oral Tablet
Sponsored by
About this trial
This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring hepatitis C, Elbasvir/grazoprevir, Hepatocellular carcinoma
Eligibility Criteria
Inclusion Criteria:
- Hepatitis C diagnosed as the HCV RNA (≥ 10,000 IU/mL in peripheral blood) at the time of screening
- Genotype inclusions
- Have documented chronic HCV GT1 or GT4, (with no evidence of nontypeable or mixed genotype) infection
- HCC diagnosed on the basis of histology or according to AASLD radiological criteria,
- Written informed consent granted prior to initiation of any study-specific screening procedures
- Patients aged 18 to 70 years-old;
- Child-Pugh ≤≤ A6
- BCLC stage 0, A HCC or no detectable HCC in a patient who has undergone a curative form of treatment (liver transplantation, surgical resection of local ablative therapy with curative intent) OR BCLC-B disease but clinically stable with non-evidence of disease progression as demonstrated by either Triphasic CT or contrast MRI at least 3 months after the last HCC treatment.
Exclusion Criteria:
Enrolment in other investigation / experimental therapies
- Prior or current use of Sorafenib or other systemic chemotherapy
- Life expectancy < 12 months (unless transplantation eligible)
- Unable to provide informed consent
- Previous or concurrent cancer that is distinct from HCC in primary site or histology, EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, and superficial bladder tumors (Ta, Tis & T1). Any cancer curatively treated > 3 years prior to enrollment is permitted.
- Any condition that in the opinion of the investigator would impair participation in the trial.
- Coinfected with human immunodeficiency virus (HIV) infection or Hepatitis B virus (e.g. HBsAg positive).
- History of congestive heart failure defined as Class II to IV per New York Heart Association (NYHA) classification within 6 months prior to study entry; active coronary artery disease (CAD); clinically significant bradycardia or other uncontrolled, cardiac arrhythmia defined as ≥ Grade 3 according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 4.03, or uncontrolled hypertension; myocardial infarction occurring within 6 months prior to study entry (myocardial infarction occurring > 6 months prior to study entry is permitted)
- Active clinically serious infections defined as ≥ Grade 3 according to NCI CTCAE, version 4.03 6. Any medical, psychological, or social conditions, particularly if unstable, including substance abuse, that may, in the opinion of the Investigator, interfere with the subject's safety or participation in the study, protocol compliance, or evaluation of the study results
- Concomitant interferon therapy or therapies for active Hepatitis C Virus (HCV) infection. Prior interferon and/or ribavirin therapy is not a contraindication to enrolment however previous treatment with direct acting antiviral treatment is an exclusion
- Pregnancy or breast-feeding
- Inability to swallow oral medications
- Clinically significant gastrointestinal bleeding occurring ≤ 3 months prior to study entry or Large gastric-esophageal varices (larger than 5 cm) or previous history of gastric-esophageal bleeding due to varices.
Fulfills exclusion criteria on biochemistry results:
- Creatinine Clearance <50 mL/min
- Hemoglobin <11 g/dL for females and <12 g/dL for males
- Platelets <75 x 103/μL
- Serum Albumin < 3.0 g/dL
- INR >1.7
- HbA1c >10%
- ALT >10XULN, AST >10XULNtherapy
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Immediate treatment
Delayed treatment
Arm Description
This group will undergo immediate treatment of the HCV once HCC complete response (CR) has been confirmed
This group will delay commencement of the HCV treatment until 6 months after HCC complete response (CR) has been confirmed
Outcomes
Primary Outcome Measures
Viral eradication
Eradication of Hepatitis C virus determined by undetectable viral load
Secondary Outcome Measures
HCC recurrence rate following HCC treatment
impact of DAA therapy on 6 and 12 month HCC recurrence rate following HCC treatment
Recurrence free survival
Recurrence free survival
Disease free survival
Disease free survival
Time to HCC recurrence / progression
Time to HCC recurrence / progression
Adverse events
Safety and tolerability of Elbasvir/grazoprevir determined by adverse events
Full Information
NCT ID
NCT04546802
First Posted
October 14, 2018
Last Updated
September 6, 2020
Sponsor
Bayside Health
Collaborators
Merck Sharp & Dohme LLC, Austin Hospital, Melbourne Australia
1. Study Identification
Unique Protocol Identification Number
NCT04546802
Brief Title
HepATocellular Cancer Hcv Therapy Study
Acronym
HATCHeT
Official Title
Open Label Trial to Study the Efficacy and Safety of MK-5172 and MK-8742 +/- Ribavirin (RBV) in the Treatment of Hepatitis C G1 and 4, in Patients Eligible for Liver Transplant (HCC) or Curative Therapy or Clinically Stable Disease Post Local Resection, Embolization or Ablative Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
September 2020
Overall Recruitment Status
Withdrawn
Why Stopped
Recruitment will be too difficult due to available PBS funded treatment and recent Australian clinical guidelines will conflict with the premise of the study.
Study Start Date
September 2019 (Anticipated)
Primary Completion Date
June 2021 (Anticipated)
Study Completion Date
June 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Bayside Health
Collaborators
Merck Sharp & Dohme LLC, Austin Hospital, Melbourne Australia
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
Subjects with Hepatitis C Virus (HCV) infection, genotype 1 or 4 and with hepatocellular carcinoma (HCC) and a complete response to HCC therapy will be randomised to immediate or delayed (6 months) HCV therapy with Elbasvir (MK-8742) and Grazoprevir (MK-5172) [EBR/GZR].
Detailed Description
Two cohorts (A and B) of patients with chronic HCV infection will be enrolled. Patients will be eligible for enrollment if they fulfill the study inclusion and exclusion criteria and have achieved a complete tumour response (CR) 3 months (+/- 14 days) following HCC treatment
Cohort A: Patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 or A HCC who have received curative therapy defined as either; liver transplantation, surgical resection or local ablation with curative intent and attained a radiologically confirmed CR. (N=50)
Cohort B: Patients who are non-eligible for curative therapy but have attained a radiologically confirmed CR. post embolization or ablative therapy and have chronic HCV infection. (N=50) Given the existing uncertainty regarding the impact of direct acting antiviral (DAA) therapy on HCC recurrence, study participants will be randomized to receive DAA treatment as "immediate" ie upon study enrollment or "delayed" ie treatment commenced ≥ 6months following documentation of complete response based on radiological assessment indicating no residual arterial enhancing disease..
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma, Hepatoma, Liver Cell Carcinoma, Hepatitis C
Keywords
hepatitis C, Elbasvir/grazoprevir, Hepatocellular carcinoma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Immediate treatment
Arm Type
Active Comparator
Arm Description
This group will undergo immediate treatment of the HCV once HCC complete response (CR) has been confirmed
Arm Title
Delayed treatment
Arm Type
Active Comparator
Arm Description
This group will delay commencement of the HCV treatment until 6 months after HCC complete response (CR) has been confirmed
Intervention Type
Drug
Intervention Name(s)
Elbasvir / Grazoprevir Oral Tablet
Intervention Description
Elbasvir / Grazoprevir
Primary Outcome Measure Information:
Title
Viral eradication
Description
Eradication of Hepatitis C virus determined by undetectable viral load
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
HCC recurrence rate following HCC treatment
Description
impact of DAA therapy on 6 and 12 month HCC recurrence rate following HCC treatment
Time Frame
6 and 12 month
Title
Recurrence free survival
Description
Recurrence free survival
Time Frame
5 years
Title
Disease free survival
Description
Disease free survival
Time Frame
5 years
Title
Time to HCC recurrence / progression
Description
Time to HCC recurrence / progression
Time Frame
5 years
Title
Adverse events
Description
Safety and tolerability of Elbasvir/grazoprevir determined by adverse events
Time Frame
Up to 5 years
Other Pre-specified Outcome Measures:
Title
Overall survival
Description
Overall survival determined by proportion surviving
Time Frame
Up to 5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Hepatitis C diagnosed as the HCV RNA (≥ 10,000 IU/mL in peripheral blood) at the time of screening
Genotype inclusions
Have documented chronic HCV GT1 or GT4, (with no evidence of nontypeable or mixed genotype) infection
HCC diagnosed on the basis of histology or according to AASLD radiological criteria,
Written informed consent granted prior to initiation of any study-specific screening procedures
Patients aged 18 to 70 years-old;
Child-Pugh ≤≤ A6
BCLC stage 0, A HCC or no detectable HCC in a patient who has undergone a curative form of treatment (liver transplantation, surgical resection of local ablative therapy with curative intent) OR BCLC-B disease but clinically stable with non-evidence of disease progression as demonstrated by either Triphasic CT or contrast MRI at least 3 months after the last HCC treatment.
Exclusion Criteria:
Enrolment in other investigation / experimental therapies
Prior or current use of Sorafenib or other systemic chemotherapy
Life expectancy < 12 months (unless transplantation eligible)
Unable to provide informed consent
Previous or concurrent cancer that is distinct from HCC in primary site or histology, EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, and superficial bladder tumors (Ta, Tis & T1). Any cancer curatively treated > 3 years prior to enrollment is permitted.
Any condition that in the opinion of the investigator would impair participation in the trial.
Coinfected with human immunodeficiency virus (HIV) infection or Hepatitis B virus (e.g. HBsAg positive).
History of congestive heart failure defined as Class II to IV per New York Heart Association (NYHA) classification within 6 months prior to study entry; active coronary artery disease (CAD); clinically significant bradycardia or other uncontrolled, cardiac arrhythmia defined as ≥ Grade 3 according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 4.03, or uncontrolled hypertension; myocardial infarction occurring within 6 months prior to study entry (myocardial infarction occurring > 6 months prior to study entry is permitted)
Active clinically serious infections defined as ≥ Grade 3 according to NCI CTCAE, version 4.03 6. Any medical, psychological, or social conditions, particularly if unstable, including substance abuse, that may, in the opinion of the Investigator, interfere with the subject's safety or participation in the study, protocol compliance, or evaluation of the study results
Concomitant interferon therapy or therapies for active Hepatitis C Virus (HCV) infection. Prior interferon and/or ribavirin therapy is not a contraindication to enrolment however previous treatment with direct acting antiviral treatment is an exclusion
Pregnancy or breast-feeding
Inability to swallow oral medications
Clinically significant gastrointestinal bleeding occurring ≤ 3 months prior to study entry or Large gastric-esophageal varices (larger than 5 cm) or previous history of gastric-esophageal bleeding due to varices.
Fulfills exclusion criteria on biochemistry results:
Creatinine Clearance <50 mL/min
Hemoglobin <11 g/dL for females and <12 g/dL for males
Platelets <75 x 103/μL
Serum Albumin < 3.0 g/dL
INR >1.7
HbA1c >10%
ALT >10XULN, AST >10XULNtherapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William kemp, MBBSFRACPPhD
Organizational Affiliation
The Alfred
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
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HepATocellular Cancer Hcv Therapy Study
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