Adjuvant Therapy With Anlotinib for HCC
Primary Purpose
Hepatocellular Carcinoma
Status
Withdrawn
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Anlotinib Hydrochloride
Sponsored by

About this trial
This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring hepatocellular carcinoma, anlotinib, adjuvant, surgery
Eligibility Criteria
Inclusion Criteria:
- Aged from 18-75 years.
- HCC diagnosis was confirmed by pathological examination and those who did not receive anti-tumor treatment (anti-tumor treatment including but not limited to: local ablation therapy, TACE, radiation therapy, chemotherapy, targeted drug therapy, immunotherapy, and etc.)
- Underwent curative resection for HCC with high risk of tumor recurrence, which was defined by Shanghai Score ≥ 4.922 (Sun, et al. Chin Med J (Engl) 2017)
- Child-Pugh class: A or B7
- The ECOG Performance Status: 0-1 points
- The expected survival time ≥ 6 months
- No disease recurrence 4-6 weeks after surgery as evaluated by abdominal contrast-enhanced CT/MRI and chest CT.
- Adequate organs function
- Complete blood counting HB ≥ 90 g/L ANC ≥ 1.5×10^9 /L PLT ≥ 75×10^9/L
- Blood biochemistry ALB ≥ 28 g/L ALT and AST< 5×ULN TBIL ≤ 2×ULN Serum creatinine ≤ 1×ULN
- Women of childbearing age must have pregnancy tests within 7 days prior to admission, and the results are negative and are willing to use appropriate methods of contraception at 8 weeks after the trial and at the end of the trial. For men, surgical sterilization should be applied, or consent to use appropriate methods of contraception 8 weeks after the trial and at the end of the trial.
- Subjects voluntarily participated in the study, signed informed consent, good compliance in drug therapy and followed up.
Exclusion Criteria:
- Cholangiocarcinoma, the combination of cholangiocarcinoma of HCC, or fibrolamellar HCC diagnosed by pathology examination.
- Past or current diagnosed with other malignancy, except skin basal cell carcinoma and cervical carcinoma in situ.
- Those treated with liver or other organ transplantation or willing to undergo liver transplantation.
- The conditions not suitable for oral medications, including difficulty swallowing, chronic diarrhoea, or bowel obstruction.
Vascular events within 6 months, including stroke and transient ischemic attack
, deep venous thrombosis or pulmonary artery embolism.
- Alimentary tract hemorrhage or high risk of alimentary tract hemorrhage due to esophageal varices, active ulcerative lesions or ulcerative colitis; or fecal occult blood test ≥ ++, or for those with fecal occult blood test (+), gastroscopy is required.
- Abnormal coagulation function (international normalized ratio > 2, prothrombin time > 16 s, thrombin time >21s, activated partial thromboplastin time > 21 s, or fibrinogen < 2 g/L); or other conditions with bleeding tendency or undergoing thrombolysis or anticoagulant therapy.
- Other severe or uncontrolled comorbidities:
- hypertension and the blood pressure was not well managed by medications (systolic pressure ≥ 150 mmHg or diastolic pressure ≥ 90 mmHg); level 2 or higher myocardial ischemia or myocardial infarction, uncontrolled arrhythmia (including QTc interval ≥ 480 ms); level 1 heart dysfunction; or LVEF < 50%.
- active or uncontrolled infection.
- uncontrolled diabetes (fasting blood glucose > 10 mmol/L).
- Urinary protein ≥ ++ or 24 hours urine protein > 1 g.
- Unhealed wounds, ulcer, or bone fracture.
- Those with mental illness or a history of psychotropic substance abuse; HIV infection.
- Other conditions that the investigators considered that not suitable for trial inclusion.
Sites / Locations
- Zhongshan Hospital, Fudan University
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Anlotinib Hydrochloride
Arm Description
Oral anlotinib 12 mg/d
Outcomes
Primary Outcome Measures
Adverse events rate
The rates of severity and seriousness of the adverse events. Adverse events are graded according to the NCI-CTCAE (Version 5.0)
Secondary Outcome Measures
Recurrence-free survival
From the date of liver surgery to the date of diagnosis of tumor recurrence or death from any cause
Overall survival
From the date of liver surgery to the date of death from any cause
Full Information
NCT ID
NCT04947371
First Posted
June 9, 2021
Last Updated
June 23, 2021
Sponsor
Shanghai Zhongshan Hospital
1. Study Identification
Unique Protocol Identification Number
NCT04947371
Brief Title
Adjuvant Therapy With Anlotinib for HCC
Official Title
Adjuvant Therapy With Anlotinib Hydrochloride for Patients With Hepatocellular Carcinoma Who Underwent Curative Resection: a Single Arm Study
Study Type
Interventional
2. Study Status
Record Verification Date
June 2021
Overall Recruitment Status
Withdrawn
Why Stopped
The standard of care of adjuvant therapy for liver cancer was changed.
Study Start Date
December 15, 2018 (Actual)
Primary Completion Date
March 30, 2019 (Actual)
Study Completion Date
March 30, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shanghai Zhongshan Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Patients with high risk of disease recurrence after curative resection for hepatocellular carcinoma (HCC) deserve active intervention. However, there's limited treatment choice for these patients. Anlotinib hydrochloride, a multitarget tyrosine kinase inhibitor for both tumor angiogenesis and proliferative signaling in cancer cells, is approved in China for the 3rd line treatment of advanced non-small cell lung cancer. In the current study, we are to evaluate the safety and effects of adjuvant anlotinib therapy for the patients who underwent curative resection for HCC with high risk of tumor recurrence, which is defined by Shanghai Score (Sun, et al. Chin Med J (Engl) 2017).
Detailed Description
Patients with high risk of disease recurrence after curative resection for hepatocellular carcinoma (HCC) deserve active intervention. However, there's limited treatment choice for these patients. Anlotinib hydrochloride, a multitarget tyrosine kinase inhibitor for both tumor angiogenesis and proliferative signaling in cancer cells, is approved in China for the 3rd line treatment of advanced non-small cell lung cancer. In the current study, we are to evaluate the safety and effects of adjuvant anlotinib therapy for the patients who underwent curative resection for HCC with high risk of tumor recurrence, which is defined by Shanghai Score (Sun, et al. Chin Med J (Engl) 2017).
The primary outcome of this study is treatment safety, and the secondary outcome is recurrence-free survival and overall survival.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma
Keywords
hepatocellular carcinoma, anlotinib, adjuvant, surgery
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Anlotinib Hydrochloride
Arm Type
Experimental
Arm Description
Oral anlotinib 12 mg/d
Intervention Type
Drug
Intervention Name(s)
Anlotinib Hydrochloride
Other Intervention Name(s)
AL3818
Intervention Description
Oral anlotinib hydrochloride 12 mg/d
Primary Outcome Measure Information:
Title
Adverse events rate
Description
The rates of severity and seriousness of the adverse events. Adverse events are graded according to the NCI-CTCAE (Version 5.0)
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Recurrence-free survival
Description
From the date of liver surgery to the date of diagnosis of tumor recurrence or death from any cause
Time Frame
24 months
Title
Overall survival
Description
From the date of liver surgery to the date of death from any cause
Time Frame
24 months
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 from 18-75 years.
HCC diagnosis was confirmed by pathological examination and those who did not receive anti-tumor treatment (anti-tumor treatment including but not limited to: local ablation therapy, TACE, radiation therapy, chemotherapy, targeted drug therapy, immunotherapy, and etc.)
Underwent curative resection for HCC with high risk of tumor recurrence, which was defined by Shanghai Score ≥ 4.922 (Sun, et al. Chin Med J (Engl) 2017)
Child-Pugh class: A or B7
The ECOG Performance Status: 0-1 points
The expected survival time ≥ 6 months
No disease recurrence 4-6 weeks after surgery as evaluated by abdominal contrast-enhanced CT/MRI and chest CT.
Adequate organs function
Complete blood counting HB ≥ 90 g/L ANC ≥ 1.5×10^9 /L PLT ≥ 75×10^9/L
Blood biochemistry ALB ≥ 28 g/L ALT and AST< 5×ULN TBIL ≤ 2×ULN Serum creatinine ≤ 1×ULN
Women of childbearing age must have pregnancy tests within 7 days prior to admission, and the results are negative and are willing to use appropriate methods of contraception at 8 weeks after the trial and at the end of the trial. For men, surgical sterilization should be applied, or consent to use appropriate methods of contraception 8 weeks after the trial and at the end of the trial.
Subjects voluntarily participated in the study, signed informed consent, good compliance in drug therapy and followed up.
Exclusion Criteria:
Cholangiocarcinoma, the combination of cholangiocarcinoma of HCC, or fibrolamellar HCC diagnosed by pathology examination.
Past or current diagnosed with other malignancy, except skin basal cell carcinoma and cervical carcinoma in situ.
Those treated with liver or other organ transplantation or willing to undergo liver transplantation.
The conditions not suitable for oral medications, including difficulty swallowing, chronic diarrhoea, or bowel obstruction.
Vascular events within 6 months, including stroke and transient ischemic attack
, deep venous thrombosis or pulmonary artery embolism.
Alimentary tract hemorrhage or high risk of alimentary tract hemorrhage due to esophageal varices, active ulcerative lesions or ulcerative colitis; or fecal occult blood test ≥ ++, or for those with fecal occult blood test (+), gastroscopy is required.
Abnormal coagulation function (international normalized ratio > 2, prothrombin time > 16 s, thrombin time >21s, activated partial thromboplastin time > 21 s, or fibrinogen < 2 g/L); or other conditions with bleeding tendency or undergoing thrombolysis or anticoagulant therapy.
Other severe or uncontrolled comorbidities:
hypertension and the blood pressure was not well managed by medications (systolic pressure ≥ 150 mmHg or diastolic pressure ≥ 90 mmHg); level 2 or higher myocardial ischemia or myocardial infarction, uncontrolled arrhythmia (including QTc interval ≥ 480 ms); level 1 heart dysfunction; or LVEF < 50%.
active or uncontrolled infection.
uncontrolled diabetes (fasting blood glucose > 10 mmol/L).
Urinary protein ≥ ++ or 24 hours urine protein > 1 g.
Unhealed wounds, ulcer, or bone fracture.
Those with mental illness or a history of psychotropic substance abuse; HIV infection.
Other conditions that the investigators considered that not suitable for trial inclusion.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jia Fan, MD&PhD
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Hui-Chuan Sun, MD&PhD
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Zhongshan Hospital, Fudan University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
30098152
Citation
Han B, Li K, Wang Q, Zhang L, Shi J, Wang Z, Cheng Y, He J, Shi Y, Zhao Y, Yu H, Zhao Y, Chen W, Luo Y, Wu L, Wang X, Pirker R, Nan K, Jin F, Dong J, Li B, Sun Y. Effect of Anlotinib as a Third-Line or Further Treatment on Overall Survival of Patients With Advanced Non-Small Cell Lung Cancer: The ALTER 0303 Phase 3 Randomized Clinical Trial. JAMA Oncol. 2018 Nov 1;4(11):1569-1575. doi: 10.1001/jamaoncol.2018.3039. Erratum In: JAMA Oncol. 2018 Nov 1;4(11):1625.
Results Reference
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PubMed Identifier
29133751
Citation
Sun HC, Xie L, Yang XR, Li W, Yu J, Zhu XD, Xia Y, Zhang T, Xu Y, Hu B, Du LP, Zeng LY, Ouyang J, Zhang W, Song TQ, Li Q, Shi YH, Zhou J, Qiu SJ, Liu Q, Li YX, Tang ZY, Shyr Y, Shen F, Fan J. Shanghai Score: A Prognostic and Adjuvant Treatment-evaluating System Constructed for Chinese Patients with Hepatocellular Carcinoma after Curative Resection. Chin Med J (Engl). 2017 Nov 20;130(22):2650-2660. doi: 10.4103/0366-6999.218019. Erratum In: Chin Med J (Engl). 2017 Dec 20;130(24):3020.
Results Reference
background
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Adjuvant Therapy With Anlotinib for HCC
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