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Hepatic Artery Infusion Chemotherapy Plus Donafenib in Patients With Hepatocellular Carcinoma After Surgery

Primary Purpose

Carcinoma, Carcinoma, Hepatocellular, Liver Neoplasms

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Hepatic arterial infusion chemotherapy
Folfox Protocol
Donafenib
Sponsored by
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Carcinoma focused on measuring Hepatocellular Carcinoma, Hepatic arterial infusion chemotherapy, Donafenib

Eligibility Criteria

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

Inclusion Criteria:

  1. Aged 18-75 years, male or female;
  2. Naive patients with hepatocellular carcinoma pathologically diagnosed who have Underwent radical hepatectomy 4-8 weeks before enrollment;
  3. HCC patients with a solitary tumor≥5 cm and Microvascular invasion;
  4. Child-Pugh score A/B(≤7);
  5. ECOG PS score 0-1;
  6. No residual tumor lesions were confirmed on imaging more than 4 weeks after surgery;
  7. The main organ functions meet the following criteria within 14 days before enrollment; (1)Hemoglobin(HB)≥100 g/L (2)neutrophils(ANC)≥1.5×10^9 /L, (3)platelet count(PLT)≥75×10^9/L; (4)ALB≥28g/L (5)alanine aminotransferase(ALT), aspartate aminotransferase(AST)<5×ULN (6)Total bilirubin (TBIL)<1.5×ULN (7)Plasma creatinine ≤1.5×ULN with a creatinine clearance≥50mL/min (8)Activation Partial Thrombin Activation Time (APTT) and International Normalized Ratio (INR)≤1.5×ULN
  8. Subjects voluntarily enrolled in the study, signed an informed consent form, followed well and cooperated with the follow-up

Exclusion Criteria:

  1. Patients who have received any hepatocellular carcinoma-related systemic therapy before enrollment; including targeted therapy such as sorafenib, lenvatinib, and regorafenib, or immunomodulators such as anti-PD-1, anti-PD-L1, and anti-CTLA-4 Treatment, excluding antiviral treatment; if the patient has used traditional Chinese medicine with anti-tumor indications, it must be> 2 weeks or 5 drug half-lives (whichever is longer). Patients whose adverse events caused by treatment have not recovered to ≤ CTCAE Grade 1;
  2. Patients who have received other adjuvant treatments (except antiviral therapy) after radical hepatectomy, including adjuvant local treatments (such as transarterial chemoembolization [TACE]);
  3. Hepatic veins, portal veins, bile ducts, or inferior vena cava can be visually or microscopically seen with tumor thrombi
  4. Diagnosed with lymph node invasion or extrahepatic metastasis;
  5. Number of tumors≥2;
  6. A history of other malignant tumours within the last five years, except for cured skin basal cell carcinoma, skin squamous cell carcinoma, superficial bladder cancer, cervical carcinoma in situ or other carcinoma in situ;
  7. Pregnant or breastfeeding women; males or females of childbearing age who are unwilling or unable to take effective contraceptive measures
  8. Known history of alcohol, psychotropic drug or other drug abuse within 6 months before entry into the study 9.Those the researcher deems inappropriate for inclusion.

Sites / Locations

  • Lei Zhang

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

HAIC+Donafenib

Arm Description

Donafenib combined with Hepatic arterial infusion chemotherapy with Folfox Protocol

Outcomes

Primary Outcome Measures

2-year cumulative recurrence-free survival rate
This is defined as the length of time (days) that the patient survives since study registration without any signs or symptoms of locoregional HCC assessed by structured clinical and radiological (clinical) follow-up . If at close-out date of the study, there are no signs of locoregional recurrence, the patient will be censored to the date of the most recent follow-up examination. The 2-year cumulative incidence rates will be estimated from the curves and its associated 95% confidence intervals will be calculated.

Secondary Outcome Measures

1-year recurrence-free survival rate
This is defined as the length of time (days) that the patient survives since study registration without any signs or symptoms of locoregional HCC assessed by structured clinical and radiological (clinical) follow-up . If at close-out date of the study, there are no signs of locoregional recurrence, the patient will be censored to the date of the most recent follow-up examination. The 1-year cumulative incidence rates will be estimated from the curves and its associated 95% confidence intervals will be calculated.
Disease-free survival
from the date of enrollment to tumor recurrence or Death
Overall Survival
from the date of enrollment to Death
Adverse Events
Number of adverse events. Postoperative adverse events were graded based on CTCAE v5.0

Full Information

First Posted
July 6, 2021
Last Updated
June 21, 2023
Sponsor
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Collaborators
Meng Chao Hepatobiliary Hospital of Fujian Medical University, Huashan Hospital, The Second Affiliated Hospital of Harbin Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT04962958
Brief Title
Hepatic Artery Infusion Chemotherapy Plus Donafenib in Patients With Hepatocellular Carcinoma After Surgery
Official Title
Prospective, Single-arm, Multicenter Clinical Study of Hepatic Artery Infusion Chemotherapy With Donafenib for Adjuvant Treatment of HCC Patients With High Risk of Recurrence After Hepatectomy.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
July 1, 2023 (Anticipated)
Primary Completion Date
March 2024 (Anticipated)
Study Completion Date
August 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Collaborators
Meng Chao Hepatobiliary Hospital of Fujian Medical University, Huashan Hospital, The Second Affiliated Hospital of Harbin Medical University

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
This is an open-label,multi-center ,non-randomized ,single arm exploratory study . This clinical study is an investigator-initiated clinical trial(IIT ). The objective of this study is to evaluate if the addition of hepatic artery infusion chemotherapy (HAIC) and Donafenib after curative resection for hepatocellular carcinoma patients with a solitary tumor≥5 cm and microvascular invasion (MVI) will prevent or delay the recurrence of the disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma, Carcinoma, Hepatocellular, Liver Neoplasms, Digestive System Neoplasms, Antineoplastic Agents, Donafenib, Fluorouracil, Oxaliplatin, Antimetabolites
Keywords
Hepatocellular Carcinoma, Hepatic arterial infusion chemotherapy, Donafenib

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
HAIC+Donafenib
Arm Type
Experimental
Arm Description
Donafenib combined with Hepatic arterial infusion chemotherapy with Folfox Protocol
Intervention Type
Procedure
Intervention Name(s)
Hepatic arterial infusion chemotherapy
Other Intervention Name(s)
HAIC
Intervention Description
administration of Oxaliplatin , fluorouracil, and leucovorin via the tumor feeding arteries
Intervention Type
Drug
Intervention Name(s)
Folfox Protocol
Other Intervention Name(s)
Oxaliplatin , fluorouracil, and leucovorin
Intervention Description
Oxaliplatin , fluorouracil, and leucovorin
Intervention Type
Drug
Intervention Name(s)
Donafenib
Intervention Description
administration of Donafenib
Primary Outcome Measure Information:
Title
2-year cumulative recurrence-free survival rate
Description
This is defined as the length of time (days) that the patient survives since study registration without any signs or symptoms of locoregional HCC assessed by structured clinical and radiological (clinical) follow-up . If at close-out date of the study, there are no signs of locoregional recurrence, the patient will be censored to the date of the most recent follow-up examination. The 2-year cumulative incidence rates will be estimated from the curves and its associated 95% confidence intervals will be calculated.
Time Frame
2-year
Secondary Outcome Measure Information:
Title
1-year recurrence-free survival rate
Description
This is defined as the length of time (days) that the patient survives since study registration without any signs or symptoms of locoregional HCC assessed by structured clinical and radiological (clinical) follow-up . If at close-out date of the study, there are no signs of locoregional recurrence, the patient will be censored to the date of the most recent follow-up examination. The 1-year cumulative incidence rates will be estimated from the curves and its associated 95% confidence intervals will be calculated.
Time Frame
1-year
Title
Disease-free survival
Description
from the date of enrollment to tumor recurrence or Death
Time Frame
2-year
Title
Overall Survival
Description
from the date of enrollment to Death
Time Frame
approximately 60 months from first patient first visit
Title
Adverse Events
Description
Number of adverse events. Postoperative adverse events were graded based on CTCAE v5.0
Time Frame
30 days

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: Aged 18-75 years, male or female; Naive patients with hepatocellular carcinoma pathologically diagnosed who have Underwent radical hepatectomy 4-8 weeks before enrollment; HCC patients with a solitary tumor≥5 cm and Microvascular invasion; Child-Pugh score A/B(≤7); ECOG PS score 0-1; No residual tumor lesions were confirmed on imaging more than 4 weeks after surgery; The main organ functions meet the following criteria within 14 days before enrollment; (1)Hemoglobin(HB)≥100 g/L (2)neutrophils(ANC)≥1.5×10^9 /L, (3)platelet count(PLT)≥75×10^9/L; (4)ALB≥28g/L (5)alanine aminotransferase(ALT), aspartate aminotransferase(AST)<5×ULN (6)Total bilirubin (TBIL)<1.5×ULN (7)Plasma creatinine ≤1.5×ULN with a creatinine clearance≥50mL/min (8)Activation Partial Thrombin Activation Time (APTT) and International Normalized Ratio (INR)≤1.5×ULN Subjects voluntarily enrolled in the study, signed an informed consent form, followed well and cooperated with the follow-up Exclusion Criteria: Patients who have received any hepatocellular carcinoma-related systemic therapy before enrollment; including targeted therapy such as sorafenib, lenvatinib, and regorafenib, or immunomodulators such as anti-PD-1, anti-PD-L1, and anti-CTLA-4 Treatment, excluding antiviral treatment; if the patient has used traditional Chinese medicine with anti-tumor indications, it must be> 2 weeks or 5 drug half-lives (whichever is longer). Patients whose adverse events caused by treatment have not recovered to ≤ CTCAE Grade 1; Patients who have received other adjuvant treatments (except antiviral therapy) after radical hepatectomy, including adjuvant local treatments (such as transarterial chemoembolization [TACE]); Hepatic veins, portal veins, bile ducts, or inferior vena cava can be visually or microscopically seen with tumor thrombi Diagnosed with lymph node invasion or extrahepatic metastasis; Number of tumors≥2; A history of other malignant tumours within the last five years, except for cured skin basal cell carcinoma, skin squamous cell carcinoma, superficial bladder cancer, cervical carcinoma in situ or other carcinoma in situ; Pregnant or breastfeeding women; males or females of childbearing age who are unwilling or unable to take effective contraceptive measures Known history of alcohol, psychotropic drug or other drug abuse within 6 months before entry into the study 9.Those the researcher deems inappropriate for inclusion.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lei Zhang, PHD
Phone
86-136-0273-0646
Email
zhangl9@mail.sysu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lei Zhang, PHD
Organizational Affiliation
Sun Yat-sen Memorial Hospital,Sun Yat-sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Lei Zhang
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
51000
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lei Zhang, PHD
Phone
+8613602730646
Email
zhangl9@mail.sysu.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Hepatic Artery Infusion Chemotherapy Plus Donafenib in Patients With Hepatocellular Carcinoma After Surgery

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