- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03535259
Phase II Study of Concurrent Sorafenib and Intensity-modulated Radiotherapy (IMRT) for Advanced Hepatocellular Carcinoma (SIRAHCC)
January 8, 2024 updated by: BO CHEN, Cancer Institute and Hospital, Chinese Academy of Medical Sciences
This is a single-arm phase II clinical trial to investigate the efficacy and toxicity of concurrent sorafenib and intensity-modulated radiotherapy (IMRT) for advanced hepatocellular carcinoma with portal vein or hepatic vein tumor thrombosis or lymph node involved.
Eligibility patients will receive IMRT to hepatic primary tumor, vein tumor thrombosis, and metastasis lymph node with concurrently sorafenib with a dose of 400mg twice daily.
Prescription of IMRT will be a conventional fraction dose of 2Gy to a total dose of 40 to 60Gy.
Sorafenib will be maintained with a dose of 400mg twice daily after IMRT until disease progression, or unacceptable adverse events.
Six months of sorafenib maintenance is recommended.
Study Overview
Status
Completed
Intervention / Treatment
Detailed Description
With the clinical application of three-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT), radiotherapy (RT) has shown important role in the treatment of hepatocellular carcinoma (HCC).
Meta-analysis has demonstrated that transcatheter arterial chemoembolization (TACE) combined RT was more therapeutically beneficial than TACE alone.
Especially for advanced disease with portal vein tumor thrombosis (PVTT), or hepatic vein tumor thrombosis, or lymph node involved, RT was more effective than other treatment methods.
Previous studies had showed that RT could receive response rate of 50% to 60% for HCC with PVTT.
But for those patients, high accidence of out RT field failure of liver and distance metastasis was found.
Effective systemic therapy was necessary to advanced HCC.
Based on two phase III trials, sorafenib was recommended as systemic therapy to advanced HCC.
But tumor response rate of sorafenib alone was only 2.3-3% by RICIST criteria.
More than half of patients was received survival benefit by maintaining in stable disease.
It is feasible to improve survival by combining IMRT and sorafenib for advanced HCC with portal vein tumor thrombosis (PVTT), or hepatic vein tumor thrombosis, or lymph node involved.
In addition, it was demonstrated that sorafenib could potentiate irradiation in HCC cell lines through inhibiting radiation-induced proliferation and DNA repair and promoting radiation-induced apoptosis.
Study Type
Interventional
Enrollment (Actual)
86
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Beijing
-
Beijing, Beijing, China, 100021
- Bo Chen
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Clinical or histologic diagnosis of Hepatocellular carcinoma (HCC)
- Aged between 18 and 80 years
- ECOG 0-1
- Liver-GTV>700ml
- BCLC stage C, HCC with portal vein or hepatic vein tumor thrombosis or lymph node involved (LN involved can be included one treatment planning)
- Estimated life expectancy > 3 months
- Child-Pugh Score: A5-B8
- Hepatic function: alanine transaminase (ALT) and aspartate transaminase (AST)≤ 1.5 times ULN; or ALT ≤ ULN and AST≤ 6 times ULN exclude possibility of heart disease
- Renal function: creatinine (CRE) and blood urea nitrogen (BUN)≤ 1.5 times ULN
- Blood routine examination: Hb≥80g/L, ANC≥1.0×109 /L, PLT≥40×109 /L
- Voluntary to participate and sign informed consent
Exclusion Criteria:
- Had prior abdominal irradiation
- Had prior liver transplantation
- Had serious myocardial disease or renal failure
- Pregnant, breast feeding, or unwilling to use adequate contraception
- Known hypersensitivity to sorafenib
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Sorafenib and IMRT
Concurrent sorafenib and IMRT, followed sorafenib maintenance for advanced hepatocellular carcinoma with portal vein or hepatic vein tumor thrombosis or lymph node involved
|
IMRT 40-60Gy/20-30f; concurrent sorafenib 400mg bid po (it can be given to patients in four weeks before IMRT is applied, so that it can control disease during waiting for IMRT); maintenance sorafenib 400mg bid po until disease progress or unacceptable adverse events; six months is recommended but not mandatory.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
MST
Time Frame: 24 months
|
Median Survival Time (MST) was defined as the duration from the date of patient recruited to the date of death from any cause
|
24 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
TTP
Time Frame: 24 months
|
Time to Progression (TTP) was defined as the duration from the date of patient recruited to the first progress at any site or the date of death
|
24 months
|
Rate of III-IV grade adverse events
Time Frame: up to 24 months
|
Adverse events was evaluated during received protocol therapy according to CTCAE 4.03
|
up to 24 months
|
ORR
Time Frame: Assessment in 1 to 3 months after IMRT
|
Overall Response Rate (ORR) was defined as the total of CR (Complete Response) and PR (Partial Response).
CR and PR were assessed by independent reviewers according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
ORR evaluated in 1 to 3 months after the completion of IMRT.
|
Assessment in 1 to 3 months after IMRT
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
May 8, 2018
Primary Completion (Actual)
January 31, 2020
Study Completion (Actual)
June 1, 2021
Study Registration Dates
First Submitted
May 12, 2018
First Submitted That Met QC Criteria
May 22, 2018
First Posted (Actual)
May 24, 2018
Study Record Updates
Last Update Posted (Actual)
January 10, 2024
Last Update Submitted That Met QC Criteria
January 8, 2024
Last Verified
January 1, 2024
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Adenocarcinoma
- Neoplasms, Glandular and Epithelial
- Digestive System Neoplasms
- Liver Diseases
- Liver Neoplasms
- Carcinoma
- Carcinoma, Hepatocellular
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Protein Kinase Inhibitors
- Sorafenib
Other Study ID Numbers
- NCC201803020
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Hepatocellular Carcinoma, Radiotherapy, Sorafenib
-
Cancer Institute and Hospital, Chinese Academy...RecruitingAdvanced Hepatocellular Carcinoma | Radiotherapy | Sorafenib | ToripalimabChina
-
University Hospital TuebingenGerman Federal Ministry of Education and ResearchTerminatedHepatocellular Carcinoma | SorafenibGermany
-
Sun Yat-sen UniversityCompletedHepatocellular Carcinoma | Hepatectomy | SorafenibChina
-
Sun Yat-sen UniversityCompletedHepatocellular Carcinoma | Sorafenib | Transarterial ChemoembolizationChina
-
Shandong Cancer Hospital and InstituteUnknownCarcinoma, Hepatocellular | PHENYTOIN/SORAFENIB [VA Drug Interaction]China
-
Second Affiliated Hospital, School of Medicine,...RecruitingHepatectomy | Stereotactic Body Radiotherapy | Centrally Located Hepatocellular CarcinomaChina
-
Sun Yat-sen UniversitySouthern Medical University, China; Shantou University Medical College; Guangzhou...RecruitingHepatocellular Carcinoma | Hepatectomy | RadiotherapyChina
-
Sichuan Cancer Hospital and Research InstituteRecruitingLiver Diseases | Digestive System Neoplasms | Liver Neoplasms | Hepatocellular Carcinoma | Antineoplastic Agents | Molecular Mechanisms of Pharmacological Action | Protein Kinase Inhibitors | SorafenibChina
-
Cancer Institute and Hospital, Chinese Academy...RecruitingHepatocellular Carcinoma | Radiotherapy | Narrow MarginChina
-
Second Affiliated Hospital, School of Medicine,...UnknownHepatocellular Carcinoma | Hepatectomy | Stereotactic Body RadiotherapyChina
Clinical Trials on concurrent sorafenib and IMRT, followed sorafenib maintenance
-
Yonsei UniversityCompletedHepatocellular CarcinomaKorea, Republic of
-
Jennerex BiotherapeuticsCompletedCarcinoma, HepatocellularKorea, Republic of
-
BayerAmgenCompleted
-
Eastern Hepatobiliary Surgery HospitalUnknownAdvanced Hepatocellular CarcinomaChina
-
Ohio State University Comprehensive Cancer CenterBayerTerminated
-
Technical University of MunichCompleted
-
Ottawa Hospital Research InstituteBayerCompletedMetastatic Colorectal CancerCanada
-
British Columbia Cancer AgencyWithdrawnLocally Advanced Squamous Cell Carcinomas of the Head and Neck (SCCHN)Canada
-
Duke UniversityBayerTerminated
-
Yiviva Inc.RecruitingAdvanced Hepatocellular CarcinomaUnited States, Taiwan, China, Hong Kong