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A Study of HX008 Plus Transcatheter Arterial Chemoembolization (TACE) in the First-Line Treatment of Subjects With Stage IV (M1c) Melanoma That is Metastatic to the Liver

Primary Purpose

Melanoma Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms Neoplasms

Status
Not yet recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
HX008 + TACE
Temozolomide + TACE
Pembrolizumab
Sponsored by
Taizhou Hanzhong biomedical co. LTD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms Neoplasms

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Voluntarily sign the Informed Consent Form(ICF), understand the study, be willing to follow and be able to complete all test procedures; Males or females, aged 18 to 75 are eligible on the day of signing the informed consent form; Subjects with stage IV (M1c) melanoma confirmed by histology with liver metastasis approved by Pathology; No prior systemic treatment for Stage IV (M1c) Melanoma with liver Metastatic; except: Melanoma with BRAF V600 mutation-positive may receive targeted therapy(e.g., BRAF/MEK inhibitor, alone or in combination) as first-line treatment for advanced or metastatic disease; Prior targeted therapy or immunotherapy (e.g., anti-PD-1 monoclonal antibody, anti-CTLA-4 monoclonal antibody or interferon, BRAF/MEK inhibitors, alone or in combination) as adjuvant or neoadjuvant therapy, if no recurrence or metastasis occurred during treatment or within 6 months of treatment termination. Prior adjuvant temozolomide and cisplatin chemotherapy of primary mucosa melanoma, without recurrence or metastasis during treatment or within 6 months of treatment termination. Subjects must have a BRAF-V600 mutation or agree to carry out BRAF-V600 mutation detection during the screening phase ; At least one measurable lesion of the subject's liver according to RECIST version 1.1 (Lesions with the longest diameter ≥ 10mm) Target lesion has not received prior local treatment, including transarterial embolization (TAE), TACE, transarterial radioembolization (TARE), surgery, radiofrequency ablation (RFA), microwave ablation (MWA), other thermal ablation, percutaneous ethanol injection (PEI), radiation therapy, etc. Subjects who have received prior local treatment for non-target lesions are eligible for the study. Local treatment must be completed at least 4 weeks before randomization. Liver function classified as Child-Pugh class A or B with a score ≤ 7, and no history of hepatic encephalopathy; Suitability for the TACE procedures and chemotherapeutic agents pre-specified by the research center, without any contraindications; Eastern Cooperative Oncology Group (ECOG) of 0 or 1; Estimated life expectancy of ≥12 weeks; Has sufficient organ and bone marrow function((no blood transfusions allowed for 14 days prior to blood routine, no any cell growth factors or/and platelet-raising drugs) to meet the following laboratory examination standards: Absolute neutrophil count (NUT#)≥1.5×10^9/L White blood cell count (WBC)≥3×10^9/L Platelet count (PLT)≥100×10^9/ L Hemoglobin (HGB)≥90 g/L f. Serum creatinine (Scr) ≤1.5×ULN g. ALT、AST ≤5×ULN h. TBIL≤1.5×ULN i.International normalized ratio (INR) ≤ 1.5×ULN; or activated partial thromboplastin time (APTT)≤ 1.5×ULN;(except for patients on anticoagulant therapy); Women of childbearing age must have a negative pregnancy test within 72 hours before the first dose of trial treatment. Reproductive men and women of childbearing age are willing to take adequate contraceptive measures (e.g., oral contraceptives, intrauterine contraceptives, sexual abstinence or barrier contraceptives combined with spermicide) from signing the informed consent form to 12 months after the last administration of the trial drug; The informed consent was voluntarily signed and the expected compliance was good. Exclusion Criteria: Malignant melanoma of ocular origin; Investigator-identified contraindications to TACE (e.g., portal vein obstruction without formation of collateral vessels, etc.); Liver lesions ≥ 10 cm in any dimension, more than 10 lesions on imaging evaluation, or liver lesions representing ≥ 50% of the liver volume. Subjects diagnosed with any other malignancy within 3 years before randomization, except for malignancies with a low risk of metastasis and death (5-year survival rate > 90%), such as adequately basal cell or squamous cell skin cancer or carcinoma in situ of the cervix and other carcinomas in situ; Had active autoimmune disease (except for psoriasis), that has required systemic treatment in the past 2 years((e.g., corticosteroids or immunosuppressive drugs). Except for alternative therapies (eg, thyroxine, insulin, or physiological corticosteroid replacement therapy for adrenal or pituitary insufficiency); Need to receive systemic corticosteroids (dose equivalent to > 10 mg prednisone/day) or other immunosuppressive drugs within 14 days before enrollment or during the study period. Those under the following conditions are eligible: Locally external use or inhaled corticosteroids; short-term (≤7 days) use of glucocorticoids for the prevention or treatment of nonautoimmune allergic diseases; Had received anti-tumor treatment within 4 weeks before randomization, or have not recovered from the toxicity of the last treatment (except for hair loss of Grade 2 and neurotoxicity of Grade 1); Had received radiotherapy within 2 weeks before randomization, or had prior radiation therapy, or who has not recovered (≤ Grade 1 or at Baseline) from AEs due to previous radiation therapy; Had received major surgery, open biopsy, or severe trauma within 4 weeks before randomization; Definition of major surgery: the minimum of 3 weeks of post-operative recovery time is required to undergo this study; Had severe infection within 4 weeks or active infection requiring IV infusion or oral administration of antibiotics within 2 weeks before randomization; Had participated in other drug or device clinical trials within 4 weeks before randomization; Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis or found during the screening phase. Subjects with previously treated brain metastases may participate provided they are clinically stable for at least 4 weeks, have no evidence of new or enlarging brain metastases, and also are off steroids 14 days before dosing with study medication may participate. Subjects with known untreated, asymptomatic brain metastases (ie, Lesions with numbers ≤ 3, and Lesions with the longest diameter ≤ 1 cm, ) may participate; Has pleural effusion, pericardial effusion, or uncontrolled ascites requiring repeated drainage (once a month or more); Has incomplete intestinal obstruction, active gastrointestinal bleeding, or perforation; Has a history or current interstitial pneumonia, or current non--infectious pneumonitis treatment with corticosteroids; Has uncontrolled cardiovascular disease, including but not limited to: heart failure greater than New York Heart Association (NYHA) class II unstable angina pectoris has myocardial infarction within 1 year supraventricular or ventricular arrhythmias with clinical significance poorly controlled without or despite clinical intervention; Has uncontrolled systemic diseases, for instance, diabetes(Fasting Plasma Glucose ≥ 8.9 mmol/L or hypertension(systolic blood pressure ≥ 160 mmHg and / or diastolic blood pressure ≥ 100 mmHg); Subjects with active tuberculosis; History of human immunodeficiency virus infection, acquired or congenital immunodeficiency disease, organ transplantation, or stem cell transplantation; Subjects with chronic hepatitis B or active hepatitis C. Except for Hepatitis B virus carriers or those with stable hepatitis B after drug treatment with DNA titer no higher than 500 IU/ml or copy number <2500 copies/ml, and cured hepatitis C patients (HCV RNA test negative); Known to be allergic to macromolecular protein agents or monoclonal antibodies. Known to have a history of severe allergies to any of the chemotherapy drugs in the study ; Alcohol dependence or drug abuse within the past 1 year; Has received a live vaccine within 30 days before the first dose of trial treatment. Subjects are permitted to receive inactivated vaccines including those for seasonal influenza, intranasal influenza vaccines are not allowed; Other reasons disqualifying the entering of this study are based on the investigators' evaluation.

Sites / Locations

  • Beijing Cancer hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Active Comparator

Arm Label

HX008 Plus Transcatheter Arterial Chemoembolization(TACE)

Temozolomide Plus Transcatheter Arterial Chemoembolization (TACE)

Pembrolizumab

Arm Description

Outcomes

Primary Outcome Measures

Progression-free Survival (PFS) by Independent Review Committee(IRC)
PFS, defined as the time from randomization to the first documented disease.(HX008 + TACE vs Temozolomide + TACE)
Overall Survival (OS)
OS, defined as the duration from the start of treatment to death of any cause.(HX008 + TACE vs Temozolomide + TACE)

Secondary Outcome Measures

Progression-free Survival (PFS) by Investigators
PFS, defined as the time from randomization to the first documented disease.(HX008 + TACE vs Temozolomide + TACE)
Objective Response Rate (ORR)
ORR, defined as the percentage of subjects achieving complete response (CR) and partial response (PR).
Disease Control Rate (DCR)
DCR, defined as the proportion of subjects achieving CR, PR, and Stable disease(SD) after treatment.
Duration of Response (DOR)
DOR, defined as the duration from the initial recording of objective disease response to the first onset of tumor progression, or death of any cause.
Progression-free Survival (PFS) by IRC or investigators
PFS, defined as the time from randomization to the first documented disease.(HX008 + TACE vs Pembrolizumab)
Overall Survival (OS)
OS, defined as the duration from the start of treatment to death of any cause.(HX008 + TACE vs Pembrolizumab)
Adverse events
Number of subjects with treatment-related adverse events as assessed by CTCAE v5.0,etc.

Full Information

First Posted
November 28, 2022
Last Updated
December 8, 2022
Sponsor
Taizhou Hanzhong biomedical co. LTD
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1. Study Identification

Unique Protocol Identification Number
NCT05647954
Brief Title
A Study of HX008 Plus Transcatheter Arterial Chemoembolization (TACE) in the First-Line Treatment of Subjects With Stage IV (M1c) Melanoma That is Metastatic to the Liver
Official Title
A Randomized, Open-Label, Multicenter, Phase III Study of HX008 (a Humanized Monoclonal Antibody Against PD-1) Plus Transcatheter Arterial Chemoembolization (TACE) in the First-Line Treatment of Subjects With Stage IV (M1c) Melanoma That is Metastatic to the Liver
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
December 31, 2022 (Anticipated)
Primary Completion Date
December 30, 2024 (Anticipated)
Study Completion Date
June 30, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Taizhou Hanzhong biomedical co. LTD

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The main purpose of this study is to compare the clinical benefit, as measured by Progression-Free Survival (PFS) and Overall Survival(OS), achieved by HX008 Plus Transcatheter Arterial Chemoembolization (TACE) or Temozolomide Plus Transcatheter Arterial Chemoembolization (TACE) in the First-Line Treatment of Subjects With Stage IV (M1c) Melanoma That is Metastatic to the Liver.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms Germ Cell and Embryonal Neoplasms by Histologic Type Neoplasms Neoplasms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
350 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
HX008 Plus Transcatheter Arterial Chemoembolization(TACE)
Arm Type
Experimental
Arm Title
Temozolomide Plus Transcatheter Arterial Chemoembolization (TACE)
Arm Type
Active Comparator
Arm Title
Pembrolizumab
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
HX008 + TACE
Intervention Description
HX008 Subjects receive HX008 200 mg intravenous (IV) ,day1,every 3 weeks (Q3W) Procedure: TACE cisplatin 75 mg/sqm, day1, every 6 weeks; fotemustine 100 mg/sqm, day2, every 6 weeks; lipiodol is usually 5-10 ml (According to the location and number of lesions).
Intervention Type
Drug
Intervention Name(s)
Temozolomide + TACE
Intervention Description
Temozolomide Subjects receive Temozolomide 200 mg/sqm intravenous (IV),day1-5, every 3 weeks (Q3W) Procedure: TACE : cisplatin 75 mg/sqm, day1, every 6 weeks; fotemustine 100 mg/sqm, day2, every 6 weeks; lipiodol is usually 5-10 ml (According to the location and number of lesions).
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Intervention Description
Subjects receive Pembrolizumab 2 mg/kg intravenous (IV),day1, every 3 weeks (Q3W)
Primary Outcome Measure Information:
Title
Progression-free Survival (PFS) by Independent Review Committee(IRC)
Description
PFS, defined as the time from randomization to the first documented disease.(HX008 + TACE vs Temozolomide + TACE)
Time Frame
2 years
Title
Overall Survival (OS)
Description
OS, defined as the duration from the start of treatment to death of any cause.(HX008 + TACE vs Temozolomide + TACE)
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Progression-free Survival (PFS) by Investigators
Description
PFS, defined as the time from randomization to the first documented disease.(HX008 + TACE vs Temozolomide + TACE)
Time Frame
2 years
Title
Objective Response Rate (ORR)
Description
ORR, defined as the percentage of subjects achieving complete response (CR) and partial response (PR).
Time Frame
2 years
Title
Disease Control Rate (DCR)
Description
DCR, defined as the proportion of subjects achieving CR, PR, and Stable disease(SD) after treatment.
Time Frame
2 years
Title
Duration of Response (DOR)
Description
DOR, defined as the duration from the initial recording of objective disease response to the first onset of tumor progression, or death of any cause.
Time Frame
2 years
Title
Progression-free Survival (PFS) by IRC or investigators
Description
PFS, defined as the time from randomization to the first documented disease.(HX008 + TACE vs Pembrolizumab)
Time Frame
2 years
Title
Overall Survival (OS)
Description
OS, defined as the duration from the start of treatment to death of any cause.(HX008 + TACE vs Pembrolizumab)
Time Frame
2 years
Title
Adverse events
Description
Number of subjects with treatment-related adverse events as assessed by CTCAE v5.0,etc.
Time Frame
2 years

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: Voluntarily sign the Informed Consent Form(ICF), understand the study, be willing to follow and be able to complete all test procedures; Males or females, aged 18 to 75 are eligible on the day of signing the informed consent form; Subjects with stage IV (M1c) melanoma confirmed by histology with liver metastasis approved by Pathology; No prior systemic treatment for Stage IV (M1c) Melanoma with liver Metastatic; except: Melanoma with BRAF V600 mutation-positive may receive targeted therapy(e.g., BRAF/MEK inhibitor, alone or in combination) as first-line treatment for advanced or metastatic disease; Prior targeted therapy or immunotherapy (e.g., anti-PD-1 monoclonal antibody, anti-CTLA-4 monoclonal antibody or interferon, BRAF/MEK inhibitors, alone or in combination) as adjuvant or neoadjuvant therapy, if no recurrence or metastasis occurred during treatment or within 6 months of treatment termination. Prior adjuvant temozolomide and cisplatin chemotherapy of primary mucosa melanoma, without recurrence or metastasis during treatment or within 6 months of treatment termination. Subjects must have a BRAF-V600 mutation or agree to carry out BRAF-V600 mutation detection during the screening phase ; At least one measurable lesion of the subject's liver according to RECIST version 1.1 (Lesions with the longest diameter ≥ 10mm) Target lesion has not received prior local treatment, including transarterial embolization (TAE), TACE, transarterial radioembolization (TARE), surgery, radiofrequency ablation (RFA), microwave ablation (MWA), other thermal ablation, percutaneous ethanol injection (PEI), radiation therapy, etc. Subjects who have received prior local treatment for non-target lesions are eligible for the study. Local treatment must be completed at least 4 weeks before randomization. Liver function classified as Child-Pugh class A or B with a score ≤ 7, and no history of hepatic encephalopathy; Suitability for the TACE procedures and chemotherapeutic agents pre-specified by the research center, without any contraindications; Eastern Cooperative Oncology Group (ECOG) of 0 or 1; Estimated life expectancy of ≥12 weeks; Has sufficient organ and bone marrow function((no blood transfusions allowed for 14 days prior to blood routine, no any cell growth factors or/and platelet-raising drugs) to meet the following laboratory examination standards: Absolute neutrophil count (NUT#)≥1.5×10^9/L White blood cell count (WBC)≥3×10^9/L Platelet count (PLT)≥100×10^9/ L Hemoglobin (HGB)≥90 g/L f. Serum creatinine (Scr) ≤1.5×ULN g. ALT、AST ≤5×ULN h. TBIL≤1.5×ULN i.International normalized ratio (INR) ≤ 1.5×ULN; or activated partial thromboplastin time (APTT)≤ 1.5×ULN;(except for patients on anticoagulant therapy); Women of childbearing age must have a negative pregnancy test within 72 hours before the first dose of trial treatment. Reproductive men and women of childbearing age are willing to take adequate contraceptive measures (e.g., oral contraceptives, intrauterine contraceptives, sexual abstinence or barrier contraceptives combined with spermicide) from signing the informed consent form to 12 months after the last administration of the trial drug; The informed consent was voluntarily signed and the expected compliance was good. Exclusion Criteria: Malignant melanoma of ocular origin; Investigator-identified contraindications to TACE (e.g., portal vein obstruction without formation of collateral vessels, etc.); Liver lesions ≥ 10 cm in any dimension, more than 10 lesions on imaging evaluation, or liver lesions representing ≥ 50% of the liver volume. Subjects diagnosed with any other malignancy within 3 years before randomization, except for malignancies with a low risk of metastasis and death (5-year survival rate > 90%), such as adequately basal cell or squamous cell skin cancer or carcinoma in situ of the cervix and other carcinomas in situ; Had active autoimmune disease (except for psoriasis), that has required systemic treatment in the past 2 years((e.g., corticosteroids or immunosuppressive drugs). Except for alternative therapies (eg, thyroxine, insulin, or physiological corticosteroid replacement therapy for adrenal or pituitary insufficiency); Need to receive systemic corticosteroids (dose equivalent to > 10 mg prednisone/day) or other immunosuppressive drugs within 14 days before enrollment or during the study period. Those under the following conditions are eligible: Locally external use or inhaled corticosteroids; short-term (≤7 days) use of glucocorticoids for the prevention or treatment of nonautoimmune allergic diseases; Had received anti-tumor treatment within 4 weeks before randomization, or have not recovered from the toxicity of the last treatment (except for hair loss of Grade 2 and neurotoxicity of Grade 1); Had received radiotherapy within 2 weeks before randomization, or had prior radiation therapy, or who has not recovered (≤ Grade 1 or at Baseline) from AEs due to previous radiation therapy; Had received major surgery, open biopsy, or severe trauma within 4 weeks before randomization; Definition of major surgery: the minimum of 3 weeks of post-operative recovery time is required to undergo this study; Had severe infection within 4 weeks or active infection requiring IV infusion or oral administration of antibiotics within 2 weeks before randomization; Had participated in other drug or device clinical trials within 4 weeks before randomization; Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis or found during the screening phase. Subjects with previously treated brain metastases may participate provided they are clinically stable for at least 4 weeks, have no evidence of new or enlarging brain metastases, and also are off steroids 14 days before dosing with study medication may participate. Subjects with known untreated, asymptomatic brain metastases (ie, Lesions with numbers ≤ 3, and Lesions with the longest diameter ≤ 1 cm, ) may participate; Has pleural effusion, pericardial effusion, or uncontrolled ascites requiring repeated drainage (once a month or more); Has incomplete intestinal obstruction, active gastrointestinal bleeding, or perforation; Has a history or current interstitial pneumonia, or current non--infectious pneumonitis treatment with corticosteroids; Has uncontrolled cardiovascular disease, including but not limited to: heart failure greater than New York Heart Association (NYHA) class II unstable angina pectoris has myocardial infarction within 1 year supraventricular or ventricular arrhythmias with clinical significance poorly controlled without or despite clinical intervention; Has uncontrolled systemic diseases, for instance, diabetes(Fasting Plasma Glucose ≥ 8.9 mmol/L or hypertension(systolic blood pressure ≥ 160 mmHg and / or diastolic blood pressure ≥ 100 mmHg); Subjects with active tuberculosis; History of human immunodeficiency virus infection, acquired or congenital immunodeficiency disease, organ transplantation, or stem cell transplantation; Subjects with chronic hepatitis B or active hepatitis C. Except for Hepatitis B virus carriers or those with stable hepatitis B after drug treatment with DNA titer no higher than 500 IU/ml or copy number <2500 copies/ml, and cured hepatitis C patients (HCV RNA test negative); Known to be allergic to macromolecular protein agents or monoclonal antibodies. Known to have a history of severe allergies to any of the chemotherapy drugs in the study ; Alcohol dependence or drug abuse within the past 1 year; Has received a live vaccine within 30 days before the first dose of trial treatment. Subjects are permitted to receive inactivated vaccines including those for seasonal influenza, intranasal influenza vaccines are not allowed; Other reasons disqualifying the entering of this study are based on the investigators' evaluation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jun Guo, MD
Phone
861088196348
Email
guoj307@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jun Guo, MD
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Cancer hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jun Guo, MD
Phone
+861088196348
Email
guoj307@126.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of HX008 Plus Transcatheter Arterial Chemoembolization (TACE) in the First-Line Treatment of Subjects With Stage IV (M1c) Melanoma That is Metastatic to the Liver

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