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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Withdrawn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
Bayside Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring hepatitis C, Elbasvir/grazoprevir, Hepatocellular carcinoma

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

    First Posted
    October 14, 2018
    Last Updated
    September 6, 2020
    Sponsor
    Bayside Health
    Collaborators
    Merck Sharp & Dohme LLC, Austin Hospital, Melbourne Australia
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    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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