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Study of Sorafenib In Combination With Low-dose 5-fluorouracil/Cisplatin (FP) Intraarterial Infusion Chemotherapy (SILIUS)

Primary Purpose

Hepatocellular Carcinoma

Status
Completed
Phase
Phase 1
Locations
Japan
Study Type
Interventional
Intervention
sorafenib, cisplatin, fluorouracil
Sponsored by
Kindai University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring sorafenib, intraarterial infusion chemotherapy, Low dose FP, cisplatin, fluorouracil

Eligibility Criteria

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

Inclusion Criteria:

  1. 20 Years and older.
  2. Life expectancy of at least 12 weeks at the pre-treatment evaluation.
  3. Advanced hepatocellular carcinoma with histological evidence on a biopsy specimen, or typical findings by dynamic CT or CT during hepatic arteriography/arterioportography.
  4. Not suitable for resection or local ablation therapy or transcatheter arterial chemoembolization.
  5. One treatment of hepatic arterial infusion chemotherapy without implanted catheter system is allowed.
  6. ECOG Performance status of 0 or 1.
  7. Cirrhotic status of Child-Pugh class A or B.
  8. Adequate bone marrow, liver and renal function, as assessed by the following laboratory requirements:

    • Hemoglobin 8.5 g/dl
    • Granulocytes 1500/μL
    • Platelet count 50,000 /μL
    • PT-INR 2.3 or PT 6 seconds above control
    • Total serum bilirubin 2 mg/dl
    • AST(SGOT) and ALT(SGPT) 5 × upper limit of normal
    • Serum creatinine 1.5 × upper limit of normal
    • Amylase 5 × upper limit of normal
  9. Written Informed Consent must be obtained.

Exclusion Criteria:

  1. Previous malignancy (except for cervical carcinoma in situ, adequate treated basal cell carcinoma, or superficial bladder tumors [Ta, Tis and T1], early gastric cancer, or other malignancies curatively treated > 3 years prior to entry
  2. Renal failure
  3. Any heart disease as follows

    • Congestive heart failure defined as NYHA class III or IV
    • Active coronary artery disease or ischemic heart disease such as cardiac infarction within 6 months prior to screening
    • Serious cardiac arrhythmia
    • Serious hypertension
  4. Active clinically serious infections.
  5. Active chicken pox.
  6. Auditory disorder.
  7. Known history of HIV infection.
  8. Known metastatic or meningeal tumors.
  9. Extrahepatic tumor spread.
  10. History of seizure disorder.
  11. Clinically significant gastrointestinal bleeding within 4 weeks prior to study entry.
  12. Embolization or infarction such as transient ischemic disease, deep vein thrombosis, pulmonary embolization).
  13. Any history of treatment as follows:

    • Treatment with the agent which induces CYP3A4
    • Surgical procedure within 4 weeks prior to start of study drug
    • History of organ allograft
  14. Patients unable to swallow oral medications.
  15. Gastrointestinal disease that may affect to the absorption of drug or pharmacokinetics.
  16. Medication that may affect to the absorption of drug or pharmacokinetics.
  17. Any disease or disorder that may affect the evaluation of study drug.
  18. Entry to the other clinical trial within 4 weeks prior to entry to this study.
  19. Pregnant or breast-feeding patients.
  20. Known allergy to the investigational agent or any agent given in association with this trial.
  21. Substance abuse, medical, psychological or social conditions that, in the judgment of the investigator, is likely to interfere with the patient's participation in the study or evaluation of the stuy results.
  22. Any condition that is unstable or could jeopardize the safety of the patient and its compliance in the study, in the investigator's judgment.

Sites / Locations

  • Kurume University Medical Center
  • Ogaki Municipal Hospital
  • Kinki University School of Medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sorafenib with Low-dose FP

Arm Description

Outcomes

Primary Outcome Measures

Dose limiting toxicity in phase I and Time to progression in Phase II

Secondary Outcome Measures

Phase I and II: Overall survival (OS)
Phase I and II: Progression free survival (PFS)
Phase I: Time to progression (TTP)
Phase I and II: Response Rate (RR)
Phase I and II: Adverse effect (AE)

Full Information

First Posted
July 1, 2009
Last Updated
November 24, 2010
Sponsor
Kindai University
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1. Study Identification

Unique Protocol Identification Number
NCT00933816
Brief Title
Study of Sorafenib In Combination With Low-dose 5-fluorouracil/Cisplatin (FP) Intraarterial Infusion Chemotherapy
Acronym
SILIUS
Official Title
Phase I/II Study of Sorafenib In Combination With Low-dose FP Intraarterial Infusion Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
November 2010
Overall Recruitment Status
Completed
Study Start Date
July 2009 (undefined)
Primary Completion Date
October 2010 (Actual)
Study Completion Date
October 2010 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Kindai University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the recommended dose of the combination therapy of sorafenib with hepatic arterial infusion of low dose cisplatin and fluorouracil on patients with advanced hepatocellular carcinoma (Phase I), and to evaluate the efficacy of this combination therapy in the recommended dose (Phase II).
Detailed Description
In Phase I, there will be 9 to 18 patients enrolled. Cohorts of 3 to 6 patients will receive escalated dose of cisplatin and fluorouracil until the MTD is reached. There will be no intra-patient dose escalation. Sorafenib will be administered orally at a dose of 400mg bid for 28 days in the all patients. Cisplatin at the dose of 10-20mg/m2 will be administered at day 1 and day8, and fluorouracil at the dose of 170-330mg/m2 will be administered continuously at day1-day5, and day8-day12 via the implanted catheter system. A cycle is defined as 28 days and 3 cycles of this combination therapy will be continued. At the end of each cycle, adverse effect will be evaluated and dose escalation will be determined. In Phase II, there will be 28 patients enrolled. Time to progression of this combination therapy at the recommended dose will be evaluated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma
Keywords
sorafenib, intraarterial infusion chemotherapy, Low dose FP, cisplatin, fluorouracil

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
37 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Sorafenib with Low-dose FP
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
sorafenib, cisplatin, fluorouracil
Other Intervention Name(s)
sorafenib with hepatic arterial infusion of low dose FP
Intervention Description
Sorafenib will be administered orally at a dose of 400 mg bid for 28 days in the all patients. Cisplatin at the dose of 10-20 mg/m2 will be administered at day 1 and day8, and fluorouracil at the dose of 170-330 mg/m2 will be administered continuously at day 1-day 5, and day8-day12 via the implanted catheter system. A cycle is defined as 28 days and 3 cycles of this combination therapy will be continued.
Primary Outcome Measure Information:
Title
Dose limiting toxicity in phase I and Time to progression in Phase II
Time Frame
Every 4 weeks
Secondary Outcome Measure Information:
Title
Phase I and II: Overall survival (OS)
Time Frame
Every day
Title
Phase I and II: Progression free survival (PFS)
Time Frame
Every four weeks
Title
Phase I: Time to progression (TTP)
Time Frame
Every four weeks
Title
Phase I and II: Response Rate (RR)
Time Frame
Every four weeks
Title
Phase I and II: Adverse effect (AE)
Time Frame
Every four weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 20 Years and older. Life expectancy of at least 12 weeks at the pre-treatment evaluation. Advanced hepatocellular carcinoma with histological evidence on a biopsy specimen, or typical findings by dynamic CT or CT during hepatic arteriography/arterioportography. Not suitable for resection or local ablation therapy or transcatheter arterial chemoembolization. One treatment of hepatic arterial infusion chemotherapy without implanted catheter system is allowed. ECOG Performance status of 0 or 1. Cirrhotic status of Child-Pugh class A or B. Adequate bone marrow, liver and renal function, as assessed by the following laboratory requirements: Hemoglobin 8.5 g/dl Granulocytes 1500/μL Platelet count 50,000 /μL PT-INR 2.3 or PT 6 seconds above control Total serum bilirubin 2 mg/dl AST(SGOT) and ALT(SGPT) 5 × upper limit of normal Serum creatinine 1.5 × upper limit of normal Amylase 5 × upper limit of normal Written Informed Consent must be obtained. Exclusion Criteria: Previous malignancy (except for cervical carcinoma in situ, adequate treated basal cell carcinoma, or superficial bladder tumors [Ta, Tis and T1], early gastric cancer, or other malignancies curatively treated > 3 years prior to entry Renal failure Any heart disease as follows Congestive heart failure defined as NYHA class III or IV Active coronary artery disease or ischemic heart disease such as cardiac infarction within 6 months prior to screening Serious cardiac arrhythmia Serious hypertension Active clinically serious infections. Active chicken pox. Auditory disorder. Known history of HIV infection. Known metastatic or meningeal tumors. Extrahepatic tumor spread. History of seizure disorder. Clinically significant gastrointestinal bleeding within 4 weeks prior to study entry. Embolization or infarction such as transient ischemic disease, deep vein thrombosis, pulmonary embolization). Any history of treatment as follows: Treatment with the agent which induces CYP3A4 Surgical procedure within 4 weeks prior to start of study drug History of organ allograft Patients unable to swallow oral medications. Gastrointestinal disease that may affect to the absorption of drug or pharmacokinetics. Medication that may affect to the absorption of drug or pharmacokinetics. Any disease or disorder that may affect the evaluation of study drug. Entry to the other clinical trial within 4 weeks prior to entry to this study. Pregnant or breast-feeding patients. Known allergy to the investigational agent or any agent given in association with this trial. Substance abuse, medical, psychological or social conditions that, in the judgment of the investigator, is likely to interfere with the patient's participation in the study or evaluation of the stuy results. Any condition that is unstable or could jeopardize the safety of the patient and its compliance in the study, in the investigator's judgment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Masatoshi Kudo
Organizational Affiliation
Kindai University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kurume University Medical Center
City
Kurume
State/Province
Fukuoka
ZIP/Postal Code
839-0863
Country
Japan
Facility Name
Ogaki Municipal Hospital
City
Oogaki
State/Province
Gifu
ZIP/Postal Code
503-8502
Country
Japan
Facility Name
Kinki University School of Medicine
City
Osaka-Sayama
State/Province
Osaka
ZIP/Postal Code
589-8511
Country
Japan

12. IPD Sharing Statement

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Study of Sorafenib In Combination With Low-dose 5-fluorouracil/Cisplatin (FP) Intraarterial Infusion Chemotherapy

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