search
Back to results

Phase II Study of Fruquintinib Combined With Sintilimab and TACE for Inoperable Primary Hepatocellular Carcinoma

Primary Purpose

Hepatocellular Carcinoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Fruquintinib
Sintilimab
Transcatheter arterial chemoembolization(TACE)
Sponsored by
Zhejiang Cancer Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma

Eligibility Criteria

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

Inclusion Criteria: Age 18-75 years, male or female; Patients diagnosed with primary hepatocellular carcinoma (HCC) based on clinical diagnosis or pathology; Patients diagnosed with Chinese stage IIb-IIIa according to the Primary Liver Cancer Diagnostic and Treatment Protocol (2019 version), and evaluated by the investigator to be unable to undergo surgical treatment, such as resection, ablation or liver transplantation; Imaging reports within 14 days prior to the intervention showed the presence of at least 1 target lesion measurable by CT or MRI, and the lesion is suitable for repeated accurate measurements; Child-Pugh liver function rating: grade A or better B (≤7 points); ECOG score: 0-1; all lesions amenable to phase 1 or 2 (fractionated TACE) TACE therapy; Good organ and bone marrow function. Blood count: WBC>4. 0 × 109/L, Hb>80g/L, PLT>75 ×109/L, NEUT>/ 1.5 × 109/L; coagulation function:International normalized (prothrombin time) ratio(INR) <1.2; liver function indexes: serum albumin (ALB) >3.5 g/dl, serum total bilirubin(TBIL) <1.5 times the upper limit of normal value (excluding biliary obstruction), serum transaminases (ALT and AST)<3 times the upper limit of normal value; renal function: serum myelin (CR) <1.5 times the upper limit of normal value; Patients with positive hepatitis B surface antigen need to have received anti-hepatitis B treatment prior to inclusion in the study; Signed an informed consent form, were compliant and cooperated with the follow-up. Exclusion Criteria: Hepatobiliary cell carcinoma, sarcomatoid hepatocellular carcinoma, mixed cell carcinoma and fibrous lamellar hepatocellular carcinoma; With portal trunk or vena cava invasion; Having received interventional treatment such as TACE within 2 years Combined with medical contraindications that preclude any contrast-enhanced imaging (CT or MRI); Previous systemic therapy; Uncontrollable ascites, hepatic encephalopathy or bleeding esophagogastric fundic varices; Hypertension that cannot be reduced to within normal limits with antihypertensive medication (systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg); Suffering from myocardial ischemia or myocardial infarction of grade II or higher, poorly controlled arrhythmia of grade II or higher myocardial ischemia or infarction, poorly controlled arrhythmia (QTc interval greater than or equal to 450 ms, QTc interval calculated in Fridericia metric). (calculated in Fridericia formula); History of gastrointestinal bleeding within the past 3 months or a clear tendency of gastrointestinal bleeding, such as: esophageal varices at risk of bleeding, locally active ulcer lesions, fecal occult blood (++); Pregnant or breastfeeding women; patients of childbearing potential who are unwilling or unable to use effective contraceptive measures HIV-infected patients; Those suspected of being allergic to the study drug; Other circumstances that, in the judgment of the investigator, may affect the conduct of the clinical study and the determination of the study results.

Sites / Locations

  • Guoliang ShaoRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

treatment

Arm Description

Fruquintinib+sintilimab+TACE

Outcomes

Primary Outcome Measures

Progression-free survival(PFS)
Progression free survival period refers to the period from the beginning of treatment to the time when patients with cancer progress is observed or death occurs for any reason.

Secondary Outcome Measures

Object response rate(ORR)
The proportion of patients whose tumor volume reduction reaches the predetermined value and can maintain the minimum time limit. It is the sum of the proportion of complete response (CR) and partial response(PR).
Time to response(TTR)
Time to response
Disease control rate(DCR)
It is the sum of the proportion of complete response (CR), partial response(PR) and stable disease(SD).
Overall survival(OS)
(OS) is defined as the time from the patient's first dose of study drug until any cause of their death.
Time to progression(TTP)
Time from the beginning of treatment to the objective progression of tumor

Full Information

First Posted
July 10, 2023
Last Updated
August 1, 2023
Sponsor
Zhejiang Cancer Hospital
search

1. Study Identification

Unique Protocol Identification Number
NCT05971199
Brief Title
Phase II Study of Fruquintinib Combined With Sintilimab and TACE for Inoperable Primary Hepatocellular Carcinoma
Official Title
Phase II Study of Fruquintinib Combined With Sintilimab and TACE for Inoperable Primary Hepatocellular Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 23, 2021 (Actual)
Primary Completion Date
December 23, 2024 (Anticipated)
Study Completion Date
December 23, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Zhejiang Cancer Hospital

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 goal of this prospective, interventional clinical trial is to evaluation of fruquintinib in combination with sintulimab and TACE for inoperable primary hepatocellular carcinoma for progression-free survival (PFS).
Detailed Description
Hepatocellular carcinoma (HCC) is the second most common cause of cancer death worldwide, accounting for approximately 745,000 deaths annually and 9.1% of all cancer-related deaths worldwide, with only about 30% of HCC patients having access to curative therapies. Most patients have intermediate to advanced disease and are usually treated with palliative therapy using TACE or systemic therapy (e.g., sorafenib, lenvatinib). The efficacy of either sorafenib or lenvatinib as a single agent in the treatment of hepatocellular liver cancer remains limited, therefore, exploring combination therapy is one of the current research hotspots. A recent randomized, open, multicenter clinical study (TACTICS) enrolling patients with unresectable HCC showed that PFS was significantly prolonged to 25.2 months in the TACE combined with sorafenib treatment group, compared to 25.2 months in the TACE alone group. PFS was only 13.5 months in the TACE treatment group (HR=0. 59, 95%CI: 0.41-0. 87, P=0. 006). Median TTP was 24.1 months in the combination treatment group and 13.5 months in the TACE treatment group alone (HR=0. 56, 95%CL 0. 38-0. 83, P=0. 004). Sintilimab, a recombinant fully human IgG4-type PD-1 monoclonal antibody, is an innovative drug developed by Sintilimab (Suzhou) Co. At the end of 2018, Sintilimab was officially approved by the NMPA of china for the treatment of relapsed or refractory classic Hodgkin's lymphoma (cHL) after at least second-line systemic chemotherapy. As a biosimilar to pembrolizumab, sintilimab has great potential to play a role similar to that played by pembrolizumab in primary hepatocellular carcinoma. Fruquintinib is a potent small molecule VEGFR inhibitor developed by Hutchmed Ltd. with full intellectual property rights, with high kinase selectivity and inhibitory activity only for the VEGFR kinase family (VEGFR1, 2 and 3).On September 5, 2018, the NMPA of china officially approved fruquintinib for patients who have previously received fluorouracil-based, oxaliplatin and irinotecan-based chemotherapy, and for patients with metastatic colorectal cancer (mCRC) who have received prior or are not suitable for prior anti-vascular endothelial growth factor (VEGF) therapy, anti-epidermal growth factor receptor (EGFR) therapy (RAS wild type). Therefore, based on previous studies, this study intended to select patients with unresectable primary hepatocellular carcinoma, and prospectively observe the efficacy and safety of fruquintinib in combination with sintilimab and TACE in the treatment of unresectable CNLC(China liver cancer staging) 2b-3a patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
fruquintinib+sintilimab+TACE
Masking
None (Open Label)
Allocation
N/A
Enrollment
27 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
treatment
Arm Type
Experimental
Arm Description
Fruquintinib+sintilimab+TACE
Intervention Type
Drug
Intervention Name(s)
Fruquintinib
Intervention Description
Fruquintinib:5 mg capsule orally once daily on day 1-21 in 28-day cycles;
Intervention Type
Drug
Intervention Name(s)
Sintilimab
Intervention Description
Sintilimab: 200 mg i.v. every 3 weeks
Intervention Type
Device
Intervention Name(s)
Transcatheter arterial chemoembolization(TACE)
Intervention Description
Transcatheter arterial chemoembolization(TACE)
Primary Outcome Measure Information:
Title
Progression-free survival(PFS)
Description
Progression free survival period refers to the period from the beginning of treatment to the time when patients with cancer progress is observed or death occurs for any reason.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Object response rate(ORR)
Description
The proportion of patients whose tumor volume reduction reaches the predetermined value and can maintain the minimum time limit. It is the sum of the proportion of complete response (CR) and partial response(PR).
Time Frame
Change from baseline tumor volume at 6 months
Title
Time to response(TTR)
Description
Time to response
Time Frame
through study completion, an average of 1 year
Title
Disease control rate(DCR)
Description
It is the sum of the proportion of complete response (CR), partial response(PR) and stable disease(SD).
Time Frame
1 year
Title
Overall survival(OS)
Description
(OS) is defined as the time from the patient's first dose of study drug until any cause of their death.
Time Frame
1 year
Title
Time to progression(TTP)
Description
Time from the beginning of treatment to the objective progression of tumor
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: Age 18-75 years, male or female; Patients diagnosed with primary hepatocellular carcinoma (HCC) based on clinical diagnosis or pathology; Patients diagnosed with Chinese stage IIb-IIIa according to the Primary Liver Cancer Diagnostic and Treatment Protocol (2019 version), and evaluated by the investigator to be unable to undergo surgical treatment, such as resection, ablation or liver transplantation; Imaging reports within 14 days prior to the intervention showed the presence of at least 1 target lesion measurable by CT or MRI, and the lesion is suitable for repeated accurate measurements; Child-Pugh liver function rating: grade A or better B (≤7 points); ECOG score: 0-1; all lesions amenable to phase 1 or 2 (fractionated TACE) TACE therapy; Good organ and bone marrow function. Blood count: WBC>4. 0 × 109/L, Hb>80g/L, PLT>75 ×109/L, NEUT>/ 1.5 × 109/L; coagulation function:International normalized (prothrombin time) ratio(INR) <1.2; liver function indexes: serum albumin (ALB) >3.5 g/dl, serum total bilirubin(TBIL) <1.5 times the upper limit of normal value (excluding biliary obstruction), serum transaminases (ALT and AST)<3 times the upper limit of normal value; renal function: serum myelin (CR) <1.5 times the upper limit of normal value; Patients with positive hepatitis B surface antigen need to have received anti-hepatitis B treatment prior to inclusion in the study; Signed an informed consent form, were compliant and cooperated with the follow-up. Exclusion Criteria: Hepatobiliary cell carcinoma, sarcomatoid hepatocellular carcinoma, mixed cell carcinoma and fibrous lamellar hepatocellular carcinoma; With portal trunk or vena cava invasion; Having received interventional treatment such as TACE within 2 years Combined with medical contraindications that preclude any contrast-enhanced imaging (CT or MRI); Previous systemic therapy; Uncontrollable ascites, hepatic encephalopathy or bleeding esophagogastric fundic varices; Hypertension that cannot be reduced to within normal limits with antihypertensive medication (systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg); Suffering from myocardial ischemia or myocardial infarction of grade II or higher, poorly controlled arrhythmia of grade II or higher myocardial ischemia or infarction, poorly controlled arrhythmia (QTc interval greater than or equal to 450 ms, QTc interval calculated in Fridericia metric). (calculated in Fridericia formula); History of gastrointestinal bleeding within the past 3 months or a clear tendency of gastrointestinal bleeding, such as: esophageal varices at risk of bleeding, locally active ulcer lesions, fecal occult blood (++); Pregnant or breastfeeding women; patients of childbearing potential who are unwilling or unable to use effective contraceptive measures HIV-infected patients; Those suspected of being allergic to the study drug; Other circumstances that, in the judgment of the investigator, may affect the conduct of the clinical study and the determination of the study results.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Guoliang Shao
Phone
+8613958183472
Email
shaoguoliang666@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Hui Zeng
Phone
+8613989898089
Email
zenghuiray@zjcc.org.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Guoliang Shao
Organizational Affiliation
Zhejiang Cancer Hospital Hangzhou, Zhejiang, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Guoliang Shao
City
Hangzhou
State/Province
Zhejiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Guoliang Shao
Phone
+8613958183472
Email
shaoguoliang666@hotmail.com

12. IPD Sharing Statement

Learn more about this trial

Phase II Study of Fruquintinib Combined With Sintilimab and TACE for Inoperable Primary Hepatocellular Carcinoma

We'll reach out to this number within 24 hrs