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Thymalfasin Adjuvant Therapy in Hepatitis B Virus (HBV)-Related Hepatocellular Carcinoma (HCC) After Curative Resection

Primary Purpose

Curable Hepatitis B Virus-Related Hepatocellular Carcinoma

Status
Unknown status
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
curative resection
thymalfasin
nucleoside analog (suggest to use entecavir)
Sponsored by
Jia Fan
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Curable Hepatitis B Virus-Related Hepatocellular Carcinoma

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Inclusion criteria during perioperative period

  • Male or female patients with age between 18-70 years.
  • Life expectance ≥ 3 months.
  • Diagnosis of Hepatocellular Carcinoma confirmed by Histological or Cytological examination.
  • Hepatitis B history with current HBsAg positive and/or HBV DNA positive
  • Will undergo hepatic curative resection.
  • Tumor feature a. with cancer embolus b. a solitary nodule measuring between 3-8 cm or 2 nodule, a total combined measurement between 3-8 cm
  • East Cooperative Oncology Group performance score of 0-2
  • Normal liver function or sufficient liver function, defined as Chlid's-Pugh A

Inclusion criteria at baseline post-operation (4weeks ± 7days post-operation)

  • No documented evidence of disease recurrence with computed tomography (CT) scan and CT angiography.
  • Grade A of Chlid's-Pugh score
  • hematological test white blood cell (WBC)>3.5X109/L, red blood cell (RBC)>30%, platelet count (PLT)>50,000/Ul, neutrophil (NEU)>1.0X109/L, Cr<1.5 mg/dl
  • signed informed consent

Exclusion Criteria:

  • Any anti-cancer therapy, including liver transplant, transarterial Chemo-embolization (TACE), image-guided tumor ablation, radiotherapy, chemotherapy, molecular targeted therapy and immunotherapy, etc. prior to the liver surgery procedure.
  • Taking the hepatotoxic drug or immunosuppressant drug.
  • Invasion of portal vascular and its first branch, hepatic duct and its first branch, inferior vena cava and hepatic vein.
  • Organ transplant recipient.
  • Extra-hepatic organs and lymph node metastasis.
  • Uncontrolled Hypertension, unstable angina within 3 months, congestive heart failure (New York Heart Association (NYHA) Class II or greater), history of myocardial infarction within 6 months prior to randomization and severe arrhythmia need to be treated.
  • History of malignancy other than a successfully treated non-metastatic cutaneous squamous cell or basal cell carcinoma and/or localized carcinoma in situ of the cervix
  • Known human immune deficiency virus (HIV) infection
  • hepatitis C virus (HCV) infection
  • History of stroke or transient ischemic attack within 6 months prior to randomization
  • Active or untreated central nervous system (CNS) metastasis
  • History of clinically significant drug or alcohol abuse
  • Prior treatment with immunomodulator (e.g. interferon, Thymalfasin) or traditional Chinese medicine within 30 days prior to randomization
  • Know postoperative complications (e.g. infection, bleeding, bile leak) at baseline
  • Known allergic reaction to the investigational product and its excipient.
  • Female subjects who are pregnant or breast-feeding or considering becoming pregnant during the study.
  • The investigator considers the subject, for any reason, to be unacceptable for study participation.
  • Participating in other clinical trials of the drug or medical device within 30 days prior to randomization.

Sites / Locations

  • Zhongshan Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

treatment (T)

control (C)

Arm Description

The patients of treatment arm will be administered subcutaneously Thymalfasin at dose of 1.6mg twice a week for 12 months after curative resection, followed by 12 months observation. Nucleoside analog plan to give to HBV DNA positive patients.

The patients of control arm will be followed up for 2 years periodically after curative resection, without the investigational product (Thymalfasin) therapy. Nucleoside analog plan to give to HBV DNA positive patients.

Outcomes

Primary Outcome Measures

Recurrence-free Survival

Secondary Outcome Measures

Recurrence-free Survival (RFS)
Overall survival (OS)
Overall survival (OS)
Mean recurrence time
Tumor sample immune cell counts
immune cell counts includes T cell counts(CD3, CD4, CD8), Treg count(FoxP3), Th17 cell count(IL-17), natural killer(NK) cell count(CD56), neutrophil count(CD66b), Mφ count(CD68), dendritic cell(DC) count (CD1a,CD83), MVD(CD31)
incidence and types of Adverse Events (AE) and serious adverse event (SAE)
AE and SAE will be reported. The number of patients with AE and the number of patients with SAE will be calculated.
number of patients with abnormal laboratory value, vital signs and ECG result
The number of patients with abnormal laboratory value, vital signs and ECG result during the study will also be calculated.

Full Information

First Posted
October 15, 2014
Last Updated
November 20, 2014
Sponsor
Jia Fan
Collaborators
SciClone Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02281266
Brief Title
Thymalfasin Adjuvant Therapy in Hepatitis B Virus (HBV)-Related Hepatocellular Carcinoma (HCC) After Curative Resection
Official Title
Investigator Initiated Study of Thymosin in HBV-related HCC
Study Type
Interventional

2. Study Status

Record Verification Date
November 2014
Overall Recruitment Status
Unknown status
Study Start Date
January 2015 (undefined)
Primary Completion Date
June 2018 (Anticipated)
Study Completion Date
October 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Jia Fan
Collaborators
SciClone Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Efficacy and safety of Thymalfasin adjuvant therapy in HBV-related HCC after curative resection.
Detailed Description
Multi-center, Randomized, Controlled Clinical Trial to Evaluate the Efficacy and Safety of Adjuvant Thymalfasin Therapy in Hepatitis B Virus (HBV)-Related Hepatocellular Carcinoma After Curative Resection.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Curable Hepatitis B Virus-Related Hepatocellular Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
360 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
treatment (T)
Arm Type
Experimental
Arm Description
The patients of treatment arm will be administered subcutaneously Thymalfasin at dose of 1.6mg twice a week for 12 months after curative resection, followed by 12 months observation. Nucleoside analog plan to give to HBV DNA positive patients.
Arm Title
control (C)
Arm Type
Other
Arm Description
The patients of control arm will be followed up for 2 years periodically after curative resection, without the investigational product (Thymalfasin) therapy. Nucleoside analog plan to give to HBV DNA positive patients.
Intervention Type
Procedure
Intervention Name(s)
curative resection
Intervention Type
Drug
Intervention Name(s)
thymalfasin
Other Intervention Name(s)
ZADAXIN
Intervention Description
1.6mg twice a week, 12 months
Intervention Type
Drug
Intervention Name(s)
nucleoside analog (suggest to use entecavir)
Primary Outcome Measure Information:
Title
Recurrence-free Survival
Time Frame
2-year
Secondary Outcome Measure Information:
Title
Recurrence-free Survival (RFS)
Time Frame
1-year
Title
Overall survival (OS)
Time Frame
1-year
Title
Overall survival (OS)
Time Frame
2-year
Title
Mean recurrence time
Time Frame
up to 2 years
Title
Tumor sample immune cell counts
Description
immune cell counts includes T cell counts(CD3, CD4, CD8), Treg count(FoxP3), Th17 cell count(IL-17), natural killer(NK) cell count(CD56), neutrophil count(CD66b), Mφ count(CD68), dendritic cell(DC) count (CD1a,CD83), MVD(CD31)
Time Frame
tumor sample will be collected at baseline and when relapse
Title
incidence and types of Adverse Events (AE) and serious adverse event (SAE)
Description
AE and SAE will be reported. The number of patients with AE and the number of patients with SAE will be calculated.
Time Frame
2-year
Title
number of patients with abnormal laboratory value, vital signs and ECG result
Description
The number of patients with abnormal laboratory value, vital signs and ECG result during the study will also be calculated.
Time Frame
2-year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Inclusion criteria during perioperative period Male or female patients with age between 18-70 years. Life expectance ≥ 3 months. Diagnosis of Hepatocellular Carcinoma confirmed by Histological or Cytological examination. Hepatitis B history with current HBsAg positive and/or HBV DNA positive Will undergo hepatic curative resection. Tumor feature a. with cancer embolus b. a solitary nodule measuring between 3-8 cm or 2 nodule, a total combined measurement between 3-8 cm East Cooperative Oncology Group performance score of 0-2 Normal liver function or sufficient liver function, defined as Chlid's-Pugh A Inclusion criteria at baseline post-operation (4weeks ± 7days post-operation) No documented evidence of disease recurrence with computed tomography (CT) scan and CT angiography. Grade A of Chlid's-Pugh score hematological test white blood cell (WBC)>3.5X109/L, red blood cell (RBC)>30%, platelet count (PLT)>50,000/Ul, neutrophil (NEU)>1.0X109/L, Cr<1.5 mg/dl signed informed consent Exclusion Criteria: Any anti-cancer therapy, including liver transplant, transarterial Chemo-embolization (TACE), image-guided tumor ablation, radiotherapy, chemotherapy, molecular targeted therapy and immunotherapy, etc. prior to the liver surgery procedure. Taking the hepatotoxic drug or immunosuppressant drug. Invasion of portal vascular and its first branch, hepatic duct and its first branch, inferior vena cava and hepatic vein. Organ transplant recipient. Extra-hepatic organs and lymph node metastasis. Uncontrolled Hypertension, unstable angina within 3 months, congestive heart failure (New York Heart Association (NYHA) Class II or greater), history of myocardial infarction within 6 months prior to randomization and severe arrhythmia need to be treated. History of malignancy other than a successfully treated non-metastatic cutaneous squamous cell or basal cell carcinoma and/or localized carcinoma in situ of the cervix Known human immune deficiency virus (HIV) infection hepatitis C virus (HCV) infection History of stroke or transient ischemic attack within 6 months prior to randomization Active or untreated central nervous system (CNS) metastasis History of clinically significant drug or alcohol abuse Prior treatment with immunomodulator (e.g. interferon, Thymalfasin) or traditional Chinese medicine within 30 days prior to randomization Know postoperative complications (e.g. infection, bleeding, bile leak) at baseline Known allergic reaction to the investigational product and its excipient. Female subjects who are pregnant or breast-feeding or considering becoming pregnant during the study. The investigator considers the subject, for any reason, to be unacceptable for study participation. Participating in other clinical trials of the drug or medical device within 30 days prior to randomization.
Facility Information:
Facility Name
Zhongshan Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
26632544
Citation
Ge S, Huang D. Systemic therapies for hepatocellular carcinoma. Drug Discov Ther. 2015 Oct;9(5):352-62. doi: 10.5582/ddt.2015.01047.
Results Reference
derived
PubMed Identifier
26094695
Citation
Qiu SJ, Zhou ZG, Shen F, Li AJ, Chen MS, Ying MG, Chen Z, Zhang YX, Sun HC, Fan J. A multicenter, randomized, observation-controlled clinical trial to evaluate the efficacy and safety of thymalfasin adjuvant therapy in patients with HBV-related HCC after curative resection - first announcement of the protocol. Expert Opin Biol Ther. 2015;15 Suppl 1:S133-7. doi: 10.1517/14712598.2015.1039979. Epub 2015 Jun 22.
Results Reference
derived

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Thymalfasin Adjuvant Therapy in Hepatitis B Virus (HBV)-Related Hepatocellular Carcinoma (HCC) After Curative Resection

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