A Phase III PI-88 in the Adjuvant Treatment of Subjects With Hepatitis Virus Related HCC After Surgical Resection (PATRON)
Primary Purpose
Cancer, Liver Cancer, Hepatocellular Carcinoma
Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
PI-88
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Cancer focused on measuring Hepatocellular Carcinoma, PI-88, Phase III, Adjuvant Therapy, Hepatoma, Liver Cancer
Eligibility Criteria
Key inclusion criteria:
- Histologically-proven primary hepatocellular carcinoma with curative resection performed in the 4 - 6 weeks prior to randomization.
- Age ≥ 18 years.
- Written, signed and dated informed consent to participate in study
- ECOG performance status 0 to 1
- Child Pugh score ≤ 8
- Platelet count ≥ 80 x 109 cells/liter
- PT-INR ≤ 1.3
- aPTT ≤ upper limit of normal
Key exclusion criteria:
- Pathological confirmation of single tumor < 2 cm in diameter which obtained from the most recent hepatectomy.
- History of immune-mediated thrombocytopenia other platelet abnormalities or other hereditary or acquired coagulopathies, or laboratory evidence of anti-heparin antibodies, or any previous history of having tested positive for anti-heparin antibodies.
- Any evidence of tumor metastasis or co-existing malignant disease
- Any prior recurrence of HCC or any liver resection prior to the most recent procedure
- Clinically significant non-malignant disease including, but not limited to, surgery within 6 weeks of randomization (apart from liver resection and re-operation for complications of liver resection), active clinically significant infection within 6 weeks prior to randomization, myocardial infarction within 6 months prior to randomization, cerebrovascular event within 12 months prior to randomization or clinically-significant gastrointestinal bleeding within 12 months prior to randomization. Subjects who have experienced post-operative complications of liver resection may be enrolled providing that such complications are fully resolved at the time of screening.
- Subjects with uncontrolled infection or serious infection within the past 4 weeks.
- History of prior HCC therapy including chemotherapy, radiotherapy, molecular targeting agents, vaccines, transarterial embolization (TAE), transarterial chemoembolization (TACE), liver transplantation or surgical resection prior to the most recent hepatectomy, at any time prior to randomization. This includes pre-, peri- and post-operative treatments. Pre-operative portal vein embolization is permitted. Subjects should not be enrolled if, at the time of randomization, it is planned that they will subsequently undergo liver transplantation regardless of tumor recurrence.
- Concomitant use of aspirin (> 150 mg/day), vitamin K antagonists (other than low-dose prophylactic use), heparin within two weeks prior to randomization, or other anti-platelet drugs (e.g. abciximab, clopidogrel, dipyridamole, ticlopidine and tirofiban). Low dose aspirin (≤ 150 mg/day) and low-dose prophylactic vitamin K antagonists (e.g. warfarin ≤ 1 mg/day) are permitted as concomitant medications.
- History of allergic, anaphylactic or other significant adverse reaction to radiographic contrast media (iodinated or non-iodinated), which cannot be managed by pre-treatment with agents such as steroids or anti-histamines, and which, in the opinion of the investigator, renders the subject unsuitable for routine CT scanning. Subjects who are contra-indicated for CT scanning for other reasons (e.g. ferromagnetic implants, profound claustrophobia), should not be enrolled.
- Subjects with history of inflammatory bowel disease, any other abnormal bleeding tendency, or subjects at risk of bleeding due to open wounds or planned surgery.
- Women who are pregnant or breast-feeding or women of child-bearing potential who are unable or unwilling to practice a highly effective means of contraception.
- Active substance abuse, including alcohol, which, in the opinion of the investigator, risks impairing the ability of the subject to comply with the protocol.
- Subjects who received other investigational or anti-neoplastic medication within the past 4 weeks.
- Current participation in any other clinical study or research project which involves administration of a pharmaceutical product or experimental treatment, or which involves protocol-specified laboratory tests, imaging studies or other investigations.
Sites / Locations
- The Third Xiangya Hospital of Central South University
- Peking Union Medical College Hospital
- The General Hospital of People's Liberation Army (301 hospital)
- Fudan University Zhongshan Hospital
- Queen Mary Hospital
- Kyungpook National University Hospital (KNUH)
- Pusan National University Hospital (PNUH)
- Pusan National University Yangsan Hospital (PNUYH)
- Asan Medical Center
- Gangnam Severance Hospital
- Korea University Guro Hospital
- Samsung Medical Center
- Seoul National University Hospital
- Seoul St. Mary Hospital
- Severance Hospital, Yonsei University Health System
- Ajou University Hospital
- Changhua Christian Hospital
- E-Da Hospital
- Chang Gung Memorial Hospital
- China Medical University Hospital
- Taichung Veterans General Hospital
- National Cheng Kung University Hospital
- Taipei Veterans General Hospital
- National Taiwan University Hospital
- Chang Gung Memorial Hospital-Linkou Medical Centre
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
PI-88
Placebo
Arm Description
Arm 1
Arm 2
Outcomes
Primary Outcome Measures
Disease-Free Survival (DFS)
To evaluate the efficacy of daily administration of PI-88 versus placebo for the adjuvant treatment of study subjects as measured by DFS during study period.
As the median DFS could not be estimated, the overall 25 th percentile DFS was reported.
Secondary Outcome Measures
Time to Recurrence (TTR)
As no subjects died without a preceding tumor recurrence , no median time to TTR could be estimated in the present study. And therefore the overall 25th percentile DFS was reported.
The results of time to recurrence (TTR) were the same as that of DFS, as no subjects died without a preceding tumor recurrence.
Overall Survival (OS)
Overall survival was defined as the time, in weeks, from randomization to death from any cause during the study period.
Tumor Recurrence Rate (TR Rate)
TR rate was to calculate number of subjects with recurrence among the analyzed population.
Full Information
NCT ID
NCT01402908
First Posted
July 25, 2011
Last Updated
June 21, 2022
Sponsor
Cellxpert Biotechnology Corp.
Collaborators
Medigen Biotechnology Corporation
1. Study Identification
Unique Protocol Identification Number
NCT01402908
Brief Title
A Phase III PI-88 in the Adjuvant Treatment of Subjects With Hepatitis Virus Related HCC After Surgical Resection
Acronym
PATRON
Official Title
A Prospective, Randomized, Double-blind, Placebo Controlled, Parallel-group, International Multicenter Phase III Trial of PI-88 in the Adjuvant Treatment of Subjects With Hepatitis Virus Related HCC After Surgical Resection
Study Type
Interventional
2. Study Status
Record Verification Date
June 2022
Overall Recruitment Status
Terminated
Why Stopped
Due to Interim Analysis and business concerns
Study Start Date
August 2011 (undefined)
Primary Completion Date
July 2014 (Actual)
Study Completion Date
January 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cellxpert Biotechnology Corp.
Collaborators
Medigen Biotechnology Corporation
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to determine if PI-88 is effective and safe in patients who have had surgery to remove primary liver cancer.
Detailed Description
Primary liver cancer (hepatocellular carcinoma or HCC) is the fifth most common cancer worldwide. Surgery to remove the tumour remains the principal form of treatment for liver cancer, however recurrence of the disease after surgery is common and survival after recurrence is poor. At the moment there is no recommended standard treatment for HCC immediately after the tumour has been removed surgically. PI-88 is a new experimental drug which blocks the growth of new blood vessels in tumours to stop the tumour growing (starves it of food) and also stops tumour cells spreading. Previous experience with PI-88 has shown it has been well tolerated and has shown some benefit in delaying the time it takes for the hepatocellular carcinoma to reappear after surgery. The purpose of this study is to determine if PI-88 is effective and safe in patients who have had surgery to remove primary liver cancer.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cancer, Liver Cancer, Hepatocellular Carcinoma
Keywords
Hepatocellular Carcinoma, PI-88, Phase III, Adjuvant Therapy, Hepatoma, Liver Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
520 (Actual)
8. Arms, Groups, and Interventions
Arm Title
PI-88
Arm Type
Experimental
Arm Description
Arm 1
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Arm 2
Intervention Type
Drug
Intervention Name(s)
PI-88
Other Intervention Name(s)
Muparfostat
Intervention Description
Lyophilized powder reconstituted to provide 160 mg of PI-88
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Lactose lyophilized powder
Primary Outcome Measure Information:
Title
Disease-Free Survival (DFS)
Description
To evaluate the efficacy of daily administration of PI-88 versus placebo for the adjuvant treatment of study subjects as measured by DFS during study period.
As the median DFS could not be estimated, the overall 25 th percentile DFS was reported.
Time Frame
End of study
Secondary Outcome Measure Information:
Title
Time to Recurrence (TTR)
Description
As no subjects died without a preceding tumor recurrence , no median time to TTR could be estimated in the present study. And therefore the overall 25th percentile DFS was reported.
The results of time to recurrence (TTR) were the same as that of DFS, as no subjects died without a preceding tumor recurrence.
Time Frame
Time to recurrence (TTR) was defined as the time from randomization to the first time that tumor recurrence was observed or suspected during the study period (3 years).
Title
Overall Survival (OS)
Description
Overall survival was defined as the time, in weeks, from randomization to death from any cause during the study period.
Time Frame
Overall survival was defined as the time, in weeks, from randomization to death from any cause during the study period (3 years).
Title
Tumor Recurrence Rate (TR Rate)
Description
TR rate was to calculate number of subjects with recurrence among the analyzed population.
Time Frame
The cumulative tumor recurrence rate at weeks 5, 53, 101 and 149 was reported here.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key inclusion criteria:
Histologically-proven primary hepatocellular carcinoma with curative resection performed in the 4 - 6 weeks prior to randomization.
Age ≥ 18 years.
Written, signed and dated informed consent to participate in study
ECOG performance status 0 to 1
Child Pugh score ≤ 8
Platelet count ≥ 80 x 109 cells/liter
PT-INR ≤ 1.3
aPTT ≤ upper limit of normal
Key exclusion criteria:
Pathological confirmation of single tumor < 2 cm in diameter which obtained from the most recent hepatectomy.
History of immune-mediated thrombocytopenia other platelet abnormalities or other hereditary or acquired coagulopathies, or laboratory evidence of anti-heparin antibodies, or any previous history of having tested positive for anti-heparin antibodies.
Any evidence of tumor metastasis or co-existing malignant disease
Any prior recurrence of HCC or any liver resection prior to the most recent procedure
Clinically significant non-malignant disease including, but not limited to, surgery within 6 weeks of randomization (apart from liver resection and re-operation for complications of liver resection), active clinically significant infection within 6 weeks prior to randomization, myocardial infarction within 6 months prior to randomization, cerebrovascular event within 12 months prior to randomization or clinically-significant gastrointestinal bleeding within 12 months prior to randomization. Subjects who have experienced post-operative complications of liver resection may be enrolled providing that such complications are fully resolved at the time of screening.
Subjects with uncontrolled infection or serious infection within the past 4 weeks.
History of prior HCC therapy including chemotherapy, radiotherapy, molecular targeting agents, vaccines, transarterial embolization (TAE), transarterial chemoembolization (TACE), liver transplantation or surgical resection prior to the most recent hepatectomy, at any time prior to randomization. This includes pre-, peri- and post-operative treatments. Pre-operative portal vein embolization is permitted. Subjects should not be enrolled if, at the time of randomization, it is planned that they will subsequently undergo liver transplantation regardless of tumor recurrence.
Concomitant use of aspirin (> 150 mg/day), vitamin K antagonists (other than low-dose prophylactic use), heparin within two weeks prior to randomization, or other anti-platelet drugs (e.g. abciximab, clopidogrel, dipyridamole, ticlopidine and tirofiban). Low dose aspirin (≤ 150 mg/day) and low-dose prophylactic vitamin K antagonists (e.g. warfarin ≤ 1 mg/day) are permitted as concomitant medications.
History of allergic, anaphylactic or other significant adverse reaction to radiographic contrast media (iodinated or non-iodinated), which cannot be managed by pre-treatment with agents such as steroids or anti-histamines, and which, in the opinion of the investigator, renders the subject unsuitable for routine CT scanning. Subjects who are contra-indicated for CT scanning for other reasons (e.g. ferromagnetic implants, profound claustrophobia), should not be enrolled.
Subjects with history of inflammatory bowel disease, any other abnormal bleeding tendency, or subjects at risk of bleeding due to open wounds or planned surgery.
Women who are pregnant or breast-feeding or women of child-bearing potential who are unable or unwilling to practice a highly effective means of contraception.
Active substance abuse, including alcohol, which, in the opinion of the investigator, risks impairing the ability of the subject to comply with the protocol.
Subjects who received other investigational or anti-neoplastic medication within the past 4 weeks.
Current participation in any other clinical study or research project which involves administration of a pharmaceutical product or experimental treatment, or which involves protocol-specified laboratory tests, imaging studies or other investigations.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pei-Jer Chen, MD
Organizational Affiliation
National Taiwan University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Third Xiangya Hospital of Central South University
City
Changsha
State/Province
Hunan
Country
China
Facility Name
Peking Union Medical College Hospital
City
Beijing
Country
China
Facility Name
The General Hospital of People's Liberation Army (301 hospital)
City
Beijing
Country
China
Facility Name
Fudan University Zhongshan Hospital
City
Shanghai
Country
China
Facility Name
Queen Mary Hospital
City
Hong Kong
Country
Hong Kong
Facility Name
Kyungpook National University Hospital (KNUH)
City
Pusan
Country
Korea, Republic of
Facility Name
Pusan National University Hospital (PNUH)
City
Pusan
Country
Korea, Republic of
Facility Name
Pusan National University Yangsan Hospital (PNUYH)
City
Pusan
Country
Korea, Republic of
Facility Name
Asan Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Gangnam Severance Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Korea University Guro Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Samsung Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul National University Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul St. Mary Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Severance Hospital, Yonsei University Health System
City
Seoul
Country
Korea, Republic of
Facility Name
Ajou University Hospital
City
Suwon
Country
Korea, Republic of
Facility Name
Changhua Christian Hospital
City
Changhua City
Country
Taiwan
Facility Name
E-Da Hospital
City
Kaohsiung City
Country
Taiwan
Facility Name
Chang Gung Memorial Hospital
City
Kaohsiung
Country
Taiwan
Facility Name
China Medical University Hospital
City
Taichung
Country
Taiwan
Facility Name
Taichung Veterans General Hospital
City
Taichung
Country
Taiwan
Facility Name
National Cheng Kung University Hospital
City
Tainan
Country
Taiwan
Facility Name
Taipei Veterans General Hospital
City
Taipei City
Country
Taiwan
Facility Name
National Taiwan University Hospital
City
Taipei
Country
Taiwan
Facility Name
Chang Gung Memorial Hospital-Linkou Medical Centre
City
Taoyuan
Country
Taiwan
12. IPD Sharing Statement
Citations:
PubMed Identifier
26212068
Citation
Gnoni A, Santini D, Scartozzi M, Russo A, Licchetta A, Palmieri V, Lupo L, Faloppi L, Palasciano G, Memeo V, Angarano G, Brunetti O, Guarini A, Pisconti S, Lorusso V, Silvestris N. Hepatocellular carcinoma treatment over sorafenib: epigenetics, microRNAs and microenvironment. Is there a light at the end of the tunnel? Expert Opin Ther Targets. 2015;19(12):1623-35. doi: 10.1517/14728222.2015.1071354. Epub 2015 Jul 27.
Results Reference
derived
Links:
URL
http://www.medigen.com.tw/en/home/
Description
Medigen Biotechnology Corporation Website
Learn more about this trial
A Phase III PI-88 in the Adjuvant Treatment of Subjects With Hepatitis Virus Related HCC After Surgical Resection
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