- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04264260
Evaluation the Palliative Effects of Colchicine on Primary Hepatic Malignant Tumors Unable to Receive Curative Treatment
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study procedures
- Written informed consent before study specific procedures are undertaken. The investigators will explain the contents of the trial especially the information about the possible side effects, other alternative treatment and the right to withdraw based on the participant own willing to the candidates. Patient can choose to sign or not to sign the inform consent based on his/her own decision after completely understanding the investigators explanation.
- The process of the experiment
Start to receive colchicine:
Participant will start to receive colchicine starting from 2 tablets after meal twice per day (total 2 mg).
Adjustment the dosage of colchicine during study: based on the following steps:
2 tablets-2 tablets-2 tablets (three times per day, after meal, total 3 mg, maximum dose)<-> 2 tablets -1 tablet -2 tablets (three times per day, after meal, total 2.5 mg)<->2 tablets -2 tablets (twice per day, after meal, 2 mg, starting dose)<->1 tablet -1 tablet -1 tablet (three times per day, after meal, 1.5 mg, minimum dose)
The colchicine dosage will be changed when the hepatic reserved function of the participant changes to Child score 8-9 points according to the following rules.
- 1 tablet after meal three times per day with total dose of 1.5 mg; continue 4 days and stop for 3 days (1 cycle)
- If the hepatic reserved function of the participant returns to Child score < 8 points, the dosage changes to starting dose.
- If the hepatic reserved function of the participant changes to Child score > 9 points, colchicine will be stopped and participant receives regular follow-up only.
- If participant suffers from severe diarrhea, colchicine will be temporarily stopped. When the symptom of diarrhea subsides, colchicine will be given again according to the above steps of dose adjustment.
If the participant has one of the following conditions, colchicine will be temporarily stopped. When the condition of the participant improves, colchicine will be given again after the judgment from the doctor of the research team. For participants unable to receive colchicine again, they will receive regular follow-up only.
- . There are life-threatening hemorrhage including gastrointestinal hemorrhage and hemorrhage from other vital organs such as lungs or brain.
- . There are life-threatening bacterial, fungal or viral infection (not included hepatitis B and C virus).
- . Patient has serum creatinine level > 1.5 mg/dL.
- . Patient has white blood cell count < 1500/µL, platelet count < 30000/µL or hemoglobin < 9.0 gm/dL after medication.
- . The research team decides that the participant is not suitable to continue the study caused by abnormality of any vital organ or severe side effects caused by the study.
- Colchicine will be temporarily stopped before non-curative operative resection of tumor or transcatheter arterial chemoembolization until participant has body temperature < 38 ℃, same hepatic reserved function as before, and serum creatinine level < 1.5 mg/dL.
- no need to stop colchicine during irradiation therapy, pure ethanol injection or local radiofrequency abrasion
- Colchicine needs to be temporarily reduced to half of the original dose when the participant will temporarily take P-Glycoprotein inhibitor or strong Cytochrome P450 3A4 inhibitor.
The conditions for the participant to withdraw or terminate the trial:
- Participant suffers from systemic itching, nausea, vomiting, abdominal pain, fever, or skin rash after colchicine administration.
- Participant is unable to tolerate 1.5 mg total daily dose of colchicine for at least 4 cycles. This does not include temporarily reduce dose to total 1 mg during temporarily application of P-Glycoprotein inhibitor or strong Cytochrome P450 3A4 inhibitor.
Follow-up procedures and items for the participants to co-operate:
All participants will be followed according to the guide line of the National Health Council and the clinical practice in the treatment of hepatic malignancy. Ultrasonography, contrasted-enhanced computed tomography or magnetic resonance imaging will be performed within every 3 to 4 months. Chest x-ray and whole body bone scan will be followed based on the condition of the participants. Serum alpha-fetoprotein or CA19-9 will be determined within 3 months in participants with abnormal original levels. The complete blood count, hepatic and renal function will be determined at least one session every month. The participants are asked to visit investigators' outpatient clinic at least one session every month.
Concomitant treatment:
Permitted:
non-curative operative resection of the tumor, local abrasion therapy, local irradiation therapy, transcatheter arterial chemoembolization, target therapy, immunotherapy
- Prohibited:
systemic chemotherapy, other clinical trial testing drugs, Chinese traditional medicine, herb drugs
Statistical analysis
1.Statistical Method for Efficacy / Safety measurements: (A) Survival analysis for efficacy: (log-rank test and median survival)
- colchicine combined with other therapy is better than other therapy without target drug or immunotherapy
- colchicine combined with other therapy is not inferior than target drug or immunotherapy combined with other therapy (B) Safety measurements The safety assessment is presented in a narrative statistical manner for the collection of participants' severe adverse events and adverse events.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Zu Y Lin, MD
- Phone Number: 7475 88673121101
- Email: linzuyau@yahoo.com.tw
Study Locations
-
-
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Kaohsiung, Taiwan, 807
- Recruiting
- Kaohsiung Medical University Hospital
-
Contact:
- Zu Y Lin, MD
- Phone Number: 7475 88673121101
- Email: linzuyau@yahoo.com.tw
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Principal Investigator:
- Zu Y Lin, MD
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Sub-Investigator:
- Wan L Chuang, PhD
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Sub-Investigator:
- Ming L Yu, PhD
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Sub-Investigator:
- Chia Y Dai, PhD
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Sub-Investigator:
- Shinn C Chen, PhD
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Sub-Investigator:
- Jee F Huang, PhD
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Sub-Investigator:
- Chung F Huang, PhD
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Sub-Investigator:
- Ching I Huang, MD
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Sub-Investigator:
- Po C Liang, MD
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Sub-Investigator:
- Cheng T Hsu, MD
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Sub-Investigator:
- Po Y Hsu, MD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
(A). Primary hepatic malignancy including hepatocellular carcinoma, intrahepatic cholangiocarcinoma, hepatocellular-cholangiocarcinoma, poorly differentiated or undifferentiated primary hepatic malignancy.
- Diagnosis of hepatocellular carcinoma: Patient has at least one of the following criteria: (1) positive for hepatocellular carcinoma evidenced by cytology or pathology, (2) serum alpha-fetoprotein level > 400 ng/mL and has evidence of hepatocellular carcinoma on contrast-enhanced computed tomography or magnetic resonance imaging.
- Diagnosis of intrahepatic cholangiocarcinoma: Patient has at least one of the following criteria: (1) evidenced by cytology or pathology, (2) serum CA19-9 level > 10 times of normal upper limit and has evidence on contrast-enhanced computed tomography or magnetic resonance imaging, and no evidence of extrahepatic original malignancy.
- Diagnosis of hepatocellular-cholangiocarcinoma: concomitantly fit at least one of the items described in (a) and (b)
- Diagnosis of poorly differentiated or undifferentiated primary hepatic malignancy: Patient fits all of the following criteria: (1) evidenced of malignancy other than hepatocellular carcinoma, intrahepatic cholangiocarcinoma or hepatocellular-cholangiocarcinoma by cytology or pathology, (2) no evidence of extrahepatic original malignancy
(B). Primary hepatic malignant tumors unable to receive curative treatment indicate that the malignancy can not be completely eliminated by operative resection, liver transplantation or local abrasion therapy. Patient also needs to fit at least one of the following criteria: (1) evidence of distant metastasis or large vessels (intrahepatic first branch portal vein, portal main trunk, major hepatic vein or inferior vena cava) invasion, (2) unable to be controlled by transcatheter arterial chemoembolization including appearance of new rather than incompletely treated nodules within 3 months of chemoembolization, or chemoembolization fails
(C). The performance status of the patient based on the Eastern Cooperative Oncology Group (ECOG) belongs to 0 or 1 and the calculated Child score is below 8 points.
Exclusion Criteria:
- . life-threatening hemorrhage at the present time
- . life-threatening bacterial, fungal or viral infection (not included hepatitis B and C virus) at the present time
- . extrahepatic original malignancy unable to be controlled
- . serum creatinine level > 1.5 mg/dL.
- . Patient must receive long-term statin or fibrates drugs. The doses of these medications can not be altered.
- . Patient has white blood cell count < 1500/µL, platelet count < 30000/µL or hemoglobin < 9.0 gm/dL after medication.
- . Pregnant woman or plan to be a pregnant woman
- . allergy to colchicine or has history of severe side effects caused by colchicine
- . Patient has received systemic chemotherapy within 2 months before enrollment or plans to receive systemic chemotherapy in the future.
- . Patient is under or plans to receive other clinical trial testing drug.
- . Patient has severe malfunction of vital organs and can not participate in this study justified by the member of the research team.
- . Patient is under or plans to receive Chinese traditional medicine or herb drugs.
- . Patient is under or plans to receive hospice care.
- . Patient took other clinical trial testing drug within 3 months before enrollment.
- . Patient can not quit drug abuse or heavy alcohol drinking.
Study Plan
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: colchicine group
The participants will receive colchicine starting from 2 tablets after meal twice per day (total 2 mg).
The dose will be adjusted ranging from total minimum 1.5 mg to maximum 3 mg per day based on the condition and tolerance of the participant.
One cycle of treatment is defined as 4 days treatment and 3 days off.
The participants will receive repeated cycles till the participants quit the trial.
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three times or two times per day after meal with the daily total dose ranging from 1.5 to 3 mg
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
survival
Time Frame: through study completion, an average of 31 months
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The overall survival of the participants
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through study completion, an average of 31 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
serious adverse effect
Time Frame: through study completion, an average of 31 months
|
The events of serious adverse effect occurred during the study
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through study completion, an average of 31 months
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Zu Y Lin, MD, Kaohsiung Medical University
Publications and helpful links
General Publications
- Ferron GM, Rochdi M, Jusko WJ, Scherrmann JM. Oral absorption characteristics and pharmacokinetics of colchicine in healthy volunteers after single and multiple doses. J Clin Pharmacol. 1996 Oct;36(10):874-83. doi: 10.1002/j.1552-4604.1996.tb04753.x.
- Arrieta O, Rodriguez-Diaz JL, Rosas-Camargo V, Morales-Espinosa D, Ponce de Leon S, Kershenobich D, Leon-Rodriguez E. Colchicine delays the development of hepatocellular carcinoma in patients with hepatitis virus-related liver cirrhosis. Cancer. 2006 Oct 15;107(8):1852-8. doi: 10.1002/cncr.22198.
- Finkelstein Y, Aks SE, Hutson JR, Juurlink DN, Nguyen P, Dubnov-Raz G, Pollak U, Koren G, Bentur Y. Colchicine poisoning: the dark side of an ancient drug. Clin Toxicol (Phila). 2010 Jun;48(5):407-14. doi: 10.3109/15563650.2010.495348.
- Imazio M, Bobbio M, Cecchi E, Demarie D, Demichelis B, Pomari F, Moratti M, Gaschino G, Giammaria M, Ghisio A, Belli R, Trinchero R. Colchicine in addition to conventional therapy for acute pericarditis: results of the COlchicine for acute PEricarditis (COPE) trial. Circulation. 2005 Sep 27;112(13):2012-6. doi: 10.1161/CIRCULATIONAHA.105.542738.
- Kallinich T, Haffner D, Niehues T, Huss K, Lainka E, Neudorf U, Schaefer C, Stojanov S, Timmann C, Keitzer R, Ozdogan H, Ozen S. Colchicine use in children and adolescents with familial Mediterranean fever: literature review and consensus statement. Pediatrics. 2007 Feb;119(2):e474-83. doi: 10.1542/peds.2006-1434. Epub 2007 Jan 22.
- Leighton JA, Bay MK, Maldonado AL, Schenker S, Speeg KV. Colchicine clearance is impaired in alcoholic cirrhosis. Hepatology. 1991 Dec;14(6):1013-5.
- Rochdi M, Sabouraud A, Girre C, Venet R, Scherrmann JM. Pharmacokinetics and absolute bioavailability of colchicine after i.v. and oral administration in healthy human volunteers and elderly subjects. Eur J Clin Pharmacol. 1994;46(4):351-4. doi: 10.1007/BF00194404.
- Terkeltaub RA, Furst DE, Bennett K, Kook KA, Crockett RS, Davis MW. High versus low dosing of oral colchicine for early acute gout flare: Twenty-four-hour outcome of the first multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison colchicine study. Arthritis Rheum. 2010 Apr;62(4):1060-8. doi: 10.1002/art.27327.
- Lin ZY, Wu CC, Chuang YH, Chuang WL. Anti-cancer mechanisms of clinically acceptable colchicine concentrations on hepatocellular carcinoma. Life Sci. 2013 Sep 3;93(8):323-8. doi: 10.1016/j.lfs.2013.07.002. Epub 2013 Jul 16.
- Wu CC, Lin ZY, Kuoc CH, Chuang WL. Clinically acceptable colchicine concentrations have potential for the palliative treatment of human cholangiocarcinoma. Kaohsiung J Med Sci. 2015 May;31(5):229-34. doi: 10.1016/j.kjms.2015.01.008. Epub 2015 Mar 10.
- Lin ZY, Kuo CH, Wu DC, Chuang WL. Anticancer effects of clinically acceptable colchicine concentrations on human gastric cancer cell lines. Kaohsiung J Med Sci. 2016 Feb;32(2):68-73. doi: 10.1016/j.kjms.2015.12.006. Epub 2016 Feb 2.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms by Histologic Type
- Neoplasms by Site
- Adenocarcinoma
- Neoplasms, Glandular and Epithelial
- Digestive System Neoplasms
- Liver Diseases
- Liver Neoplasms
- Neoplasms
- Carcinoma
- Carcinoma, Hepatocellular
- Cholangiocarcinoma
- Molecular Mechanisms of Pharmacological Action
- Antirheumatic Agents
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Gout Suppressants
- Colchicine
Other Study ID Numbers
- KMUHIRB-F(II)-20190152
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.
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.
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