Combination Camrelizumab (SHR-1210) and Apatinib for Downstaging/Bridging of HCC Before Liver Transplant
Primary Purpose
Hepatocellular Carcinoma, Liver Transplant
Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Camrelizumab plus apatinib
Sponsored by
About this trial
This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring Camrelizumab, Apatinib, HCC, Liver transplantation
Eligibility Criteria
Inclusion Criteria:
- 18-75 years
- Pathology: hepatocellular carcinoma
- Exceed Hangzhou Criteria (Type A: diameter of tumor ≤ 8 cm or diameter of tumor and AFP ≤ 100 ng/mL; Type B: diameter of tumor >8 cm, but 100 ng/mL < AFP <400 ng/mL)
- No interventional therapy (TACE, RFA or I131) within 2 month
- Expected survival for more than 3 months
- Child-pugh grade A or grade B (≤ 7 points)
- Absolute neutrophil count ≥ 1.5×10^9 /L, Hb ≥ 9 g/L, PLT ≥ 100×10^9 /L; TSH ≤ ULN; total bilirubin ≤ 1.5 ULN, albumin ≥ 28 g/L, AST, ALT ≤ 3 ULN; serum creatinine ≤ 1.5 ULN
- ECOG: 0-2
- Patients participate in the study voluntarily and sign informed consent
Exclusion Criteria:
- Regional lymph node metastases or extrahepatic metastases
- Allergic to Camrelizumab or Apatinib
- Patients who have had or are currently complicated with other malignant tumors
- Active hepatitis (hepatitis B: HBsAg positive or HBV- DNA≥10⁴copies/ml; hepatitis C: HCV antibodies and HCV-RNA positive)
- Activ pulmonary tuberculosis or pulmonary tuberculosis history
- Active, diagnosed, or suspected autoimmune disease (including but not limited to: uveitis, enteritis, hepatitis, pituitary, nephritis, vasculitis, hyperthyroidism, hypothyroidism and asthma)
- Interstitial lung disease history or non-infectious pneumonia requiring oral or intravenous steroid therapy
- Long-term systemic hormone therapy (dose > 10mg prednisone/day) or any other form of immunosuppressive therapy
- Myocardial ischemia or myocardial infarction above grade II, hypertension and inability to reach the normal range after medication (systolic blood pressure >140mmHg, diastolic blood pressure >90mmHg)
- Abnormal coagulation function (PT>16s, APTT>43s, TT>21s, Fbg<2g/L); history of gastrointestinal bleeding within 6 months; obvious bleeding tendency or undergoing thrombolytic or anticoagulant treatment
- Pregnant or lactating women
- Patients who participated in other clinical trials within 1 month
- Active infections which require systemic treatment
- HIV positive
- Other factors that may affect patients' safety or compliance
Sites / Locations
- The First Affiliated Hospital of Medical School of Zhejiang UniversityRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Camrelizumab plus apatinib
Arm Description
Outcomes
Primary Outcome Measures
Objective remission rate
The proportion of patients with CR, PR, and SD in the group
Recurrence-free survival
The period from enrollment surgery to recurrence of HCC
Secondary Outcome Measures
Overall survival
The survival rate in a year
Time to progress
The period from enrollment to disease progression
Adverse effect
Any adverse effects occur during the project
Full Information
NCT ID
NCT04035876
First Posted
July 20, 2019
Last Updated
July 26, 2019
Sponsor
Zhejiang University
Collaborators
Shulan (Hangzhou) Hospital, West China Hospital, Huashan Hospital, Third Affiliated Hospital, Sun Yat-Sen University, The First Affiliated Hospital of Zhengzhou University, The First Hospital of Jilin University, Tianjin First Central Hospital, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
1. Study Identification
Unique Protocol Identification Number
NCT04035876
Brief Title
Combination Camrelizumab (SHR-1210) and Apatinib for Downstaging/Bridging of HCC Before Liver Transplant
Official Title
A Single Group, Open Label, Multi-center Clinical Study of Combination Camrelizumab (SHR-1210) and Apatinib for Downstaging/Bridging of Hepatocellular Cancer Before Liver Transplant
Study Type
Interventional
2. Study Status
Record Verification Date
July 2019
Overall Recruitment Status
Unknown status
Study Start Date
July 16, 2019 (Anticipated)
Primary Completion Date
December 31, 2021 (Anticipated)
Study Completion Date
December 31, 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Zhejiang University
Collaborators
Shulan (Hangzhou) Hospital, West China Hospital, Huashan Hospital, Third Affiliated Hospital, Sun Yat-Sen University, The First Affiliated Hospital of Zhengzhou University, The First Hospital of Jilin University, Tianjin First Central Hospital, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
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
To assess the primary effects and safety of camrelizumab (SHR-1210) plus apatinib for downstaging/bridging of HCC before liver transplantation.
Detailed Description
HCC patients waiting for liver transplantation will be screened and enrolled according to the inclusion criteria. After screening and enrollment, patients will be administrated camrelizumab 200mg q2w iv and apatinib 250mg qd po regimen every 4 weeks as a cycle. Each patient will receive camrelizumab treatment for at least 2 cycles and discontinue camrelizumab 5 weeks before liver transplantation. Apatinib will be discontinued 1 week before liver transplantation. Once the tumor progression was detected, the program will be terminated and the appropriate optimal treatment will be given. The objective remission rate (ORR), recurrence-free survival (RFS), overall survival (OS), time to progress (TTP) and any adverse effect during the study will be evaluated in order to assess the primary effects and safety of camrelizumab (SHR-1210) plus apatinib for downstaging/bridging of HCC before liver transplantation.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma, Liver Transplant
Keywords
Camrelizumab, Apatinib, HCC, Liver transplantation
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
120 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Camrelizumab plus apatinib
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Camrelizumab plus apatinib
Intervention Description
Camrelizumab 200mg q2w iv and apatinib 250mg qd po.
Primary Outcome Measure Information:
Title
Objective remission rate
Description
The proportion of patients with CR, PR, and SD in the group
Time Frame
From enrollment to disease progression, up to 6 months
Title
Recurrence-free survival
Description
The period from enrollment surgery to recurrence of HCC
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Overall survival
Description
The survival rate in a year
Time Frame
1 year
Title
Time to progress
Description
The period from enrollment to disease progression
Time Frame
From enrollment to disease progression, up to 6 months
Title
Adverse effect
Description
Any adverse effects occur during the project
Time Frame
1 year
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:
18-75 years
Pathology: hepatocellular carcinoma
Exceed Hangzhou Criteria (Type A: diameter of tumor ≤ 8 cm or diameter of tumor and AFP ≤ 100 ng/mL; Type B: diameter of tumor >8 cm, but 100 ng/mL < AFP <400 ng/mL)
No interventional therapy (TACE, RFA or I131) within 2 month
Expected survival for more than 3 months
Child-pugh grade A or grade B (≤ 7 points)
Absolute neutrophil count ≥ 1.5×10^9 /L, Hb ≥ 9 g/L, PLT ≥ 100×10^9 /L; TSH ≤ ULN; total bilirubin ≤ 1.5 ULN, albumin ≥ 28 g/L, AST, ALT ≤ 3 ULN; serum creatinine ≤ 1.5 ULN
ECOG: 0-2
Patients participate in the study voluntarily and sign informed consent
Exclusion Criteria:
Regional lymph node metastases or extrahepatic metastases
Allergic to Camrelizumab or Apatinib
Patients who have had or are currently complicated with other malignant tumors
Active hepatitis (hepatitis B: HBsAg positive or HBV- DNA≥10⁴copies/ml; hepatitis C: HCV antibodies and HCV-RNA positive)
Activ pulmonary tuberculosis or pulmonary tuberculosis history
Active, diagnosed, or suspected autoimmune disease (including but not limited to: uveitis, enteritis, hepatitis, pituitary, nephritis, vasculitis, hyperthyroidism, hypothyroidism and asthma)
Interstitial lung disease history or non-infectious pneumonia requiring oral or intravenous steroid therapy
Long-term systemic hormone therapy (dose > 10mg prednisone/day) or any other form of immunosuppressive therapy
Myocardial ischemia or myocardial infarction above grade II, hypertension and inability to reach the normal range after medication (systolic blood pressure >140mmHg, diastolic blood pressure >90mmHg)
Abnormal coagulation function (PT>16s, APTT>43s, TT>21s, Fbg<2g/L); history of gastrointestinal bleeding within 6 months; obvious bleeding tendency or undergoing thrombolytic or anticoagulant treatment
Pregnant or lactating women
Patients who participated in other clinical trials within 1 month
Active infections which require systemic treatment
HIV positive
Other factors that may affect patients' safety or compliance
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jianguo Wang, PhD
Phone
(+86)15967123327
Email
21118059@zju.edu.cn
Facility Information:
Facility Name
The First Affiliated Hospital of Medical School of Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jianguo Wang, PhD
Phone
(+86)15967123327
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Combination Camrelizumab (SHR-1210) and Apatinib for Downstaging/Bridging of HCC Before Liver Transplant
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