The Study of Atezolizumab, Bevacizumab and Memantine in Patients With Hepatocellular Carcinoma (HCC) ((HCC))
An Open Label Phase II Study of Atezolizumab, Bevacizumab and Memantine in Patients With Hepatocellular Carcinoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Elahe Mollapour
- Phone Number: 571-472-4724
- Email: elahe.mollapour@inova.org
Study Contact Backup
- Name: Keary Jane't
- Phone Number: 571-472-4724
- Email: keary.janet@inova.org
Study Locations
-
-
Virginia
-
Fairfax, Virginia, United States, 22033
- Recruiting
- Inova Schar Cancer Institute - Fair Oaks
-
Contact:
- Keary Jane't
- Phone Number: 571-472-3173
- Email: keary.janet@inova.org
-
Principal Investigator:
- Arthur Winer, MD
-
Falls Church, Virginia, United States, 22042
- Recruiting
- Inova Health Care Service
-
Contact:
- Elahe Mollapour
- Phone Number: 571-472-0615
- Email: elahe.mollapour@inova.org
-
Contact:
- Keary Jane't
- Phone Number: 571-472-3173
- Email: keary.janet@inova.org
-
Principal Investigator:
- Arthur Winer
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18 or older.
- Patients have newly diagnosed and previously untreated, histologically or radiologically confirmed hepatocellular carcinoma with at least one lesion that is measurable by RECIST 1.1 criteria. A prior HCC lesion that was treated surgically or by radiation is allowed as long as it was at least 2 years or more from the current HCC diagnosis.
- Patient's cancer must be deemed locally advanced and unresectable
- Patients must have a Childs-Pugh cirrhosis score of A5 or A6.
- Eastern Cooperative Oncology Group Performance Status of 0-1.
Patients must have bone marrow and organ function as defined below:
- Absolute Neutrophil Count ≥ 1,500/μL
- Platelets ≥ 100,000/μL
- Hemoglobin ≥ 90 g/L (9g/dL)
- Total Bilirubin ≤ 3 x ULN
- AST(SGOT)/ALT(SGPT)/Alkaline Phosphatase ≤ 3 x ULN Or ≤5x ULN if due to liver involvement by tumor
- Creatinine ≤ 2.0 mg/dL
- eGFR (using Cockcroft Gault equation) > 40ml/min
- Chemotherapy is harmful to the human fetus. For this reason, sexually active males and females with partners of childbearing potential must agree to use an accepted and effective method of contraception prior to study entry and for the duration of the study.
- Patients must demonstrate the ability to understand and the willingness to sign a written informed consent document.
- Men and women, regardless of race, ethnic group, or sexual orientation are eligible for this study.
- Patient must be able to swallow oral medication.
Exclusion Criteria:
- Patients with Childs-Pugh B or C cirrhosis.
- Female patients who are pregnant or breast-feeding.
- Concomitant illness that would prevent adequate patient assessment or in the investigators' opinion pose an added risk for study participants.
- Any history or evidence of severe illness or any other condition that would make the patient, in the opinion of the investigator unsuitable for the study. This would include any uncontrolled or untreated viral infection such as HIV, HBV, HCV etc.
- Subject is enrolled in a separate interventional clinical trial.
- Active tuberculosis.
- Significant cardiovascular disease (such as New York Heart Association Class II or greater cardiac disease, myocardial infarction, or cerebrovascular accident) within 3 months prior to initiation of study treatment, unstable arrhythmia, or unstable angina.
- History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins.
- Known hypersensitivity to Chinese hamster ovary cell products or to any component of the atezolizumab or bevacizumab formulation.
- Known fibrolamellar HCC, sarcomatoid HCC, or mixed cholangiocarcinoma and HCC.
- Uncontrolled tumor-related pain. Patients requiring pain medication must be on a stable regimen at study entry.
- Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to initiation of study treatment.
- Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases.
18. Active, untreated grade 2 or 3 varices. Patients with treated varices to the point that they are grade 1 or less will be allowed.
19. Patients already on memantine for any reason prior to enrollment will be excluded.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Addition of Memantine to Atezolizumab and Bevacizumab (the current systemic standard of care)
The study intervention consists of the use of the triplet therapy (atezolizumab, bevacizumab, and memantine) given in 21-day cycles over six months.
|
Memantine (5mg) is an N-methyl-D-aspartate (NMDA) receptor antagonist given in 21-day cycles over six months in combination with Bevacizumab and Atezolizumab.
Each week memantine will be escalated by 5mg as tolerated
Other Names:
Bevacizumab (15mg/kg) is a vascular endothelial growth factor inhibitor given in 21-day cycles over six months in combination with Memantine and Atezolizumab.
Other Names:
Atezolizumab (1200mg) is a programmed death-ligand 1 (PD-L1) blocking antibody given in 21-day cycles over six months in combination with Memantine and Bevacizumab
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Objective response rate (ORR) of patients who are treated with the combination of atezolizumab, bevacizumab, and memantine.
Time Frame: Up to 2 years
|
The effectiveness of the combination therapy using Azozolizumab, Bevacizumab,and Memantine in relation to the Objective Response Rate (ORR), defined as the proportion of complete or partial responses to the treatment by the response evaluation criteria for solid tumors(RECIST) 1.1.
|
Up to 2 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Arthur Winer, MD, Principal Investigator
Publications and helpful links
General Publications
- Cabrera R, Nelson DR. Review article: the management of hepatocellular carcinoma. Aliment Pharmacol Ther. 2010 Feb 15;31(4):461-76. doi: 10.1111/j.1365-2036.2009.04200.x. Epub 2009 Nov 19.
- Rawla P, Sunkara T, Muralidharan P, Raj JP. Update in global trends and aetiology of hepatocellular carcinoma. Contemp Oncol (Pozn). 2018;22(3):141-150. doi: 10.5114/wo.2018.78941. Epub 2018 Sep 30.
- El-Serag HB, Kanwal F. Epidemiology of hepatocellular carcinoma in the United States: where are we? Where do we go? Hepatology. 2014 Nov;60(5):1767-75. doi: 10.1002/hep.27222. Epub 2014 Aug 25. No abstract available.
- Liu P, Xie SH, Hu S, Cheng X, Gao T, Zhang C, Song Z. Age-specific sex difference in the incidence of hepatocellular carcinoma in the United States. Oncotarget. 2017 Jul 12;8(40):68131-68137. doi: 10.18632/oncotarget.19245. eCollection 2017 Sep 15.
- Kim E, Viatour P. Hepatocellular carcinoma: old friends and new tricks. Exp Mol Med. 2020 Dec;52(12):1898-1907. doi: 10.1038/s12276-020-00527-1. Epub 2020 Dec 2.
- Amit S, Jorge A M. Screening for hepatocellular carcinoma. Gastroenterol Hepatol (N Y). 2008 Mar;4(3):201-8.
- Singal AG, Lampertico P, Nahon P. Epidemiology and surveillance for hepatocellular carcinoma: New trends. J Hepatol. 2020 Feb;72(2):250-261. doi: 10.1016/j.jhep.2019.08.025.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Digestive System Neoplasms
- Digestive System Diseases
- Liver Diseases
- Neoplasms, Glandular and Epithelial
- Adenocarcinoma
- Liver Neoplasms
- Carcinoma
- Carcinoma, Hepatocellular
- Amino Acids, Peptides, and Proteins
- Proteins
- Organic Chemicals
- Hydrocarbons
- Hydrocarbons, Cyclic
- Antibodies, Monoclonal, Humanized
- Antibodies, Monoclonal
- Antibodies
- Immunoglobulins
- Immunoproteins
- Blood Proteins
- Serum Globulins
- Globulins
- Adamantane
- Bridged-Ring Compounds
- Amantadine
- Bevacizumab
- Memantine
- atezolizumab
Other Study ID Numbers
Other Study ID Numbers
- INOVA-2023-74
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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