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A Clinical Trial for the Safety and Efficacy of CD-801 in Patients With Advanced Hepatocellular Carcinoma

Primary Purpose

Advanced Hepatocellular Carcinoma

Status
Not yet recruiting
Phase
Early Phase 1
Locations
Study Type
Interventional
Intervention
CD-801
Sponsored by
Shanghai Changzheng Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Hepatocellular Carcinoma focused on measuring Hepatocellular carcinoma, HNF4α

Eligibility Criteria

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

Inclusion Criteria: Males or females, aged 18 years or older. Subjects must have confirmed diagnosis of HCC according to the American Association for the Study of Liver Diseases criteria. Unresectable HCC. Subjects are unsuitable for local or systemic anti-tumor therapy or had tumor progression after receiving at least one kind of conventional treatment. According to mRECIST, subjects should be with at least 1 measurable target lesion. Life expectancy of 12 weeks or more. Subjects must have an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 to 2. Male with fertility and females of childbearing potential are willing to use a highly effective method of contraception for the entire study period and for 6 months after study drug discontinuation. Females of childbearing age, including premenopausal females and within 2 years after menopause, must have a negative serum pregnancy test result within 7 days prior to the first dose of study treatment. Subjects who have voluntary agreement to provide written informed consent and the willingness and ability to comply with all aspects of the protocol. Exclusion Criteria: ALB < 28 g/L, or Bilirubin >5.0 mg/dL, or aspartate aminotransferase (AST), alkaline phosphatase (ALP), or alanine aminotransferase (ALT) >5×ULN. Inadequate renal function defined as creatinine >1.5 times the upper limit of normal (ULN) or calculated creatinine clearance < 40 mL/min. Absolute neutrophil count (ANC) < 1.0×109/L, or Platelets < 30×109/L, or Hemoglobin < 8.5 g/dL. International Normalized Ratio (INR) > 2.3. Subjects with a history of liver transplantation. Subjects with poorly controlled hypertension, diabetes or other serious heart or lung diseases, or with serious dysfunction. Subjects with extrahepatic metastasis who had potential benefit from first-line systemic therapies. Subjects who had prior anticancer treatment with any locoregional therapies, antiangiogenic targeted therapies, immune checkpoint inhibitors or chemotherapy within 4 weeks (within 2 weeks in case of sorafenib), radiotherapy within 3 weeks, or active traditional Chinese medicine within 2 weeks before the first dose of study treatment, except for the treatments after which the disease still progressed according to mRECIST. All toxicities related to prior locoregional or systemic anti-tumor treatments are still grade 2 or more (except for hair loss and other events that have been judged tolerable by researchers). Subjects with complication histories of liver cirrhosis or HCC such as gastrointestinal hemorrhage, overt hepatic encephalopathy, or uncontrollable ascites within 2 weeks prior to the first dose of study treatment. Uncontrolled active infection (eg, lung infections, or abdominal infections). Subjects with moderate to severe hepatic artery- portal vein fistula or hepatic artery - vein fistula which could not be avoided even through the artery super selection by DSA. History of malignancy other than HCC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death (e.g., 5-year OS rate > 90%), such as adequately treated early gastric carcinoma, carcinoma in situ of the cervix, non-melanoma skin carcinoma, or localized prostate cancer. HBV DNA greater than 500 copies/mL, or HCV RNA greater than 15 U/mL. Subject is positive for Human Immunodeficiency Virus (HIV). Any subject who is allergic to MRI contrast agents. Pregnant/lactating women, or women who have the possibility of pregnancy. Participation in other investigational drug trials within 4 weeks prior to initiation of this study treatment. Any medical or other condition which, in the opinion of the investigator, would preclude participation in this clinical trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    CD-801 treatment

    Arm Description

    The subjects with advanced HCC will be treated by CD-801 through the hepatic artery injection.

    Outcomes

    Primary Outcome Measures

    The objective response rate based on mRECIST
    To assess the proportion of subjects who have best overall response of complete response or partial response at the time of data cutoff based on mRECIST

    Secondary Outcome Measures

    Adverse events as assessed by CTCAE v5.0
    To assess the incidence and severity of AE after CD-801 treatment in subjects with advanced hepatocellular carcinoma by CTCAE v5.0
    The objective response rate based on RECIST v1.1
    To assess the proportion of subjects who have best overall response of complete response or partial response at the time of data cutoff based on RECIST v1.1
    Duration of response based on mRECIST and RECIST v1.1
    To assess the time from the first documentation of complete response or partial response to the date of first documentation of disease progression or death (whichever occurs first) based on mRECIST and RECIST v1.1
    Progression-free survival based on mRECIST and RECIST v1.1
    To assess the time from the first study dose date to the date of first documentation of disease progression or death (whichever occurs first) based on mRECIST and RECIST v1.1
    Time to progression based on mRECIST and RECIST v1.1
    To assess the time from the first study dose date to the date of first documentation of disease progression based on mRECIST and RECIST v1.1
    Time to response based on mRECIST and RECIST v1.1
    To assess the time from the date of first study dose to the date of first documentation of complete response or partial response based on mRECIST and RECIST v1.1
    Disease control rate based on mRECIST and RECIST v1.1
    To assess the proportion of subjects who have best overall response of complete response or partial response or stable disease (minimum duration from C1D1 to stable disease ≥5 weeks) based on mRECIST and RECIST v1.1
    Clinical benefit rate based on mRECIST and RECIST v1.1
    To assess the proportion of subjects who have best overall response of complete response or partial response or durable stable disease (duration of stable disease ≥ 23 weeks) based on mRECIST and RECIST v1.1
    Overall Survival
    To assess the time from the first study dose date until date of death from any cause . Subjects who are lost to follow-up and the subjects who are alive at the date of data cutoff will be censored at the date the subject was last known alive or the cut-off date, whichever comes earlier.

    Full Information

    First Posted
    October 7, 2023
    Last Updated
    October 13, 2023
    Sponsor
    Shanghai Changzheng Hospital
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06092112
    Brief Title
    A Clinical Trial for the Safety and Efficacy of CD-801 in Patients With Advanced Hepatocellular Carcinoma
    Official Title
    A Clinical Trial for the Safety and Efficacy of CD-801 in Patients With Advanced Hepatocellular Carcinoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    October 2023 (Anticipated)
    Primary Completion Date
    March 2024 (Anticipated)
    Study Completion Date
    December 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Shanghai Changzheng 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
    The goal of this investigator-initiated, a single-arm, open-label, pilot study is to investigate the safety, tolerability, and efficacy of CD-801 treatment in subjects with advanced hepatocellular carcinoma. Condition of disease: advanced hepatocellular carcinoma . Intervention:treatment with 100μg CD-801 through the hepatic artery at two-week intervals. The dosing interval will be adjusted based on subject tolerability, safety, and efficacy. For example, it may be adjusted to administer the medication once every three weeks or four weeks. Drug: CD-801, a drug designed specifically to enhance the expression of HNF4α and selectively target liver cancer cells.
    Detailed Description
    Hepatocellular carcinoma (HCC) is the most common form of liver cancer. Recent advancements in understanding tumor biology and the tumor microenvironment have dramatically transformed the treatment landscape for advanced stage HCC. However, the survival for advanced HCC patients still remains unsatisfactory. Differentiation therapy in oncology is defined as a therapeutic strategy that reactivates endogenous differentiation programs and reverts malignant phenotypes. Its hallmark success is the treatment of acute promyelocytic leukemia (APL) by the combination of all-trans retinoic acid (ATRA) and arsenic. Unfortunately, this approach has achieved limited success in solid tumors. Hepatocyte nuclear factor 4α (HNF4α) is a transcription factor (TF) belonging to the nuclear receptor family. HNF4α is highly enriched in mature hepatocytes and serves as a master regulator of hepatocyte differentiation and hepatic metabolism. Previous studies, including the investigators' and others, have demonstrated that the reduced expression of HNF4α plays a critical role in hepatocarcinogenesis. Restoring HNF4α expression induces the differentiation of HCC cells into mature hepatocytes and has shown significant therapeutic effects in various animal models of HCC. In this study, the investigators developed CD-801, a drug designed specifically to enhance the expression of HNF4α and selectively target liver cancer cells, for the treatment of HCC patients. Preclinical studies have shown that CD-801 effectively inhibits the growth of subcutaneous and orthotopic liver tumors in mice. Acute toxicity tests in SD rats have demonstrated that a single intravenous injection of CD-801 injection at a dose of 150 μg/animal is well-tolerated, with no significant toxicity, indicating good safety profiles. Furthermore, in the dose escalation phase of the clinical trial which the investigators have completed, CD-801(25, 50 and 100 μg) was found to be well-tolerated. None of the patients experienced dose-limiting toxicities (DLTs) during the DLT phase. This trial is a single-arm, open-label, exploratory clinical study aimed at further evaluating the efficacy, safety, and tolerability of 100 μg CD-801 administered through the hepatic artery in the treatment of advanced-stage HCC at two-week intervals (The dosing interval will be adjusted based on subject tolerability, safety, and efficacy. For example, it may be adjusted to administer the medication once every three weeks or four weeks).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Advanced Hepatocellular Carcinoma
    Keywords
    Hepatocellular carcinoma, HNF4α

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Early Phase 1
    Interventional Study Model
    Single Group Assignment
    Model Description
    The subjects with advanced HCC will be treated by CD-801 through the hepatic artery injection
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    20 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    CD-801 treatment
    Arm Type
    Experimental
    Arm Description
    The subjects with advanced HCC will be treated by CD-801 through the hepatic artery injection.
    Intervention Type
    Drug
    Intervention Name(s)
    CD-801
    Intervention Description
    The subjects with advanced HCC will be treated by 100 μg CD-801 through the hepatic artery injection at two-week intervals. The dosing interval will be adjusted based on subject tolerability, safety, and efficacy. For example, it may be adjusted to administer the medication once every three weeks or four weeks.
    Primary Outcome Measure Information:
    Title
    The objective response rate based on mRECIST
    Description
    To assess the proportion of subjects who have best overall response of complete response or partial response at the time of data cutoff based on mRECIST
    Time Frame
    From the first study dose date until the date of documented complete response or partial response, assessed up to 24 months
    Secondary Outcome Measure Information:
    Title
    Adverse events as assessed by CTCAE v5.0
    Description
    To assess the incidence and severity of AE after CD-801 treatment in subjects with advanced hepatocellular carcinoma by CTCAE v5.0
    Time Frame
    Through study completion, an average of 2 years
    Title
    The objective response rate based on RECIST v1.1
    Description
    To assess the proportion of subjects who have best overall response of complete response or partial response at the time of data cutoff based on RECIST v1.1
    Time Frame
    From the first study dose date until the date of documented complete response or partial response, assessed up to 24 months
    Title
    Duration of response based on mRECIST and RECIST v1.1
    Description
    To assess the time from the first documentation of complete response or partial response to the date of first documentation of disease progression or death (whichever occurs first) based on mRECIST and RECIST v1.1
    Time Frame
    up to 24 months
    Title
    Progression-free survival based on mRECIST and RECIST v1.1
    Description
    To assess the time from the first study dose date to the date of first documentation of disease progression or death (whichever occurs first) based on mRECIST and RECIST v1.1
    Time Frame
    up to 24 months
    Title
    Time to progression based on mRECIST and RECIST v1.1
    Description
    To assess the time from the first study dose date to the date of first documentation of disease progression based on mRECIST and RECIST v1.1
    Time Frame
    up to 24 months
    Title
    Time to response based on mRECIST and RECIST v1.1
    Description
    To assess the time from the date of first study dose to the date of first documentation of complete response or partial response based on mRECIST and RECIST v1.1
    Time Frame
    up to 24 months
    Title
    Disease control rate based on mRECIST and RECIST v1.1
    Description
    To assess the proportion of subjects who have best overall response of complete response or partial response or stable disease (minimum duration from C1D1 to stable disease ≥5 weeks) based on mRECIST and RECIST v1.1
    Time Frame
    up to 24 months
    Title
    Clinical benefit rate based on mRECIST and RECIST v1.1
    Description
    To assess the proportion of subjects who have best overall response of complete response or partial response or durable stable disease (duration of stable disease ≥ 23 weeks) based on mRECIST and RECIST v1.1
    Time Frame
    up to 24 months
    Title
    Overall Survival
    Description
    To assess the time from the first study dose date until date of death from any cause . Subjects who are lost to follow-up and the subjects who are alive at the date of data cutoff will be censored at the date the subject was last known alive or the cut-off date, whichever comes earlier.
    Time Frame
    Throughout the entire course of treatment until the end of the follow-up period, an average of 2 years
    Other Pre-specified Outcome Measures:
    Title
    Health Related Quality of Life based on the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30.
    Description
    To evaluate the impact of CD-801 treatment on Health Related Quality of Life for subjects treated using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30.
    Time Frame
    Through study completion, an average of 2 years
    Title
    Health Related Quality of Life based on HCC-specific EORTC QLQ-HCC18 questionnaire.
    Description
    To evaluate the impact of CD-801 treatment on Health Related Quality of Life for subjects treated using HCC-specific EORTC QLQ-HCC18 questionnaire.
    Time Frame
    Through study completion, an average of 2 years
    Title
    Health Related Quality of Life based on European Quality of Life questionnaire.
    Description
    To evaluate the impact of CD-801 treatment on Health Related Quality of Life for subjects treated using European Quality of Life questionnaire.
    Time Frame
    Through study completion, an average of 2 years
    Title
    The impact of CD-801 treatment on cytokine in serum after treatment.
    Description
    To investigate the changes of cytokine in serum in subjects with advanced hepatocellular carcinoma after CD-801 treatment
    Time Frame
    Through study completion, an average of 2 years
    Title
    The impact of CD-801 treatment on immune cell profiling in serum after treatment.
    Description
    To investigate the changes of immune cell profiling in serum in subjects with advanced hepatocellular carcinoma after CD-801 treatment
    Time Frame
    Through study completion, an average of 2 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Males or females, aged 18 years or older. Subjects must have confirmed diagnosis of HCC according to the American Association for the Study of Liver Diseases criteria. Unresectable HCC. Subjects are unsuitable for local or systemic anti-tumor therapy or had tumor progression after receiving at least one kind of conventional treatment. According to mRECIST, subjects should be with at least 1 measurable target lesion. Life expectancy of 12 weeks or more. Subjects must have an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 to 2. Male with fertility and females of childbearing potential are willing to use a highly effective method of contraception for the entire study period and for 6 months after study drug discontinuation. Females of childbearing age, including premenopausal females and within 2 years after menopause, must have a negative serum pregnancy test result within 7 days prior to the first dose of study treatment. Subjects who have voluntary agreement to provide written informed consent and the willingness and ability to comply with all aspects of the protocol. Exclusion Criteria: ALB < 28 g/L, or Bilirubin >5.0 mg/dL, or aspartate aminotransferase (AST), alkaline phosphatase (ALP), or alanine aminotransferase (ALT) >5×ULN. Inadequate renal function defined as creatinine >1.5 times the upper limit of normal (ULN) or calculated creatinine clearance < 40 mL/min. Absolute neutrophil count (ANC) < 1.0×109/L, or Platelets < 30×109/L, or Hemoglobin < 8.5 g/dL. International Normalized Ratio (INR) > 2.3. Subjects with a history of liver transplantation. Subjects with poorly controlled hypertension, diabetes or other serious heart or lung diseases, or with serious dysfunction. Subjects with extrahepatic metastasis who had potential benefit from first-line systemic therapies. Subjects who had prior anticancer treatment with any locoregional therapies, antiangiogenic targeted therapies, immune checkpoint inhibitors or chemotherapy within 4 weeks (within 2 weeks in case of sorafenib), radiotherapy within 3 weeks, or active traditional Chinese medicine within 2 weeks before the first dose of study treatment, except for the treatments after which the disease still progressed according to mRECIST. All toxicities related to prior locoregional or systemic anti-tumor treatments are still grade 2 or more (except for hair loss and other events that have been judged tolerable by researchers). Subjects with complication histories of liver cirrhosis or HCC such as gastrointestinal hemorrhage, overt hepatic encephalopathy, or uncontrollable ascites within 2 weeks prior to the first dose of study treatment. Uncontrolled active infection (eg, lung infections, or abdominal infections). Subjects with moderate to severe hepatic artery- portal vein fistula or hepatic artery - vein fistula which could not be avoided even through the artery super selection by DSA. History of malignancy other than HCC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death (e.g., 5-year OS rate > 90%), such as adequately treated early gastric carcinoma, carcinoma in situ of the cervix, non-melanoma skin carcinoma, or localized prostate cancer. HBV DNA greater than 500 copies/mL, or HCV RNA greater than 15 U/mL. Subject is positive for Human Immunodeficiency Virus (HIV). Any subject who is allergic to MRI contrast agents. Pregnant/lactating women, or women who have the possibility of pregnancy. Participation in other investigational drug trials within 4 weeks prior to initiation of this study treatment. Any medical or other condition which, in the opinion of the investigator, would preclude participation in this clinical trial.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Chuan Yin, M.D.
    Phone
    +8613482705212
    Email
    ilse1225@163.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Wei-Fen Xie, M.D.
    Organizational Affiliation
    Shanghai Changzheng Hospital
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    A Clinical Trial for the Safety and Efficacy of CD-801 in Patients With Advanced Hepatocellular Carcinoma

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