- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05669339
AD HOC Trial: Artificial Intelligence-Based Drug Dosing In Hepatocellular Carcinoma
March 28, 2024 updated by: University of Florida
This study will test the hypothesis that a novel combination of three drugs (sorafenib, sonidegib, and irinotecan), in conjunction with individually optimized doses, can be safely administered and lead to improved clinical outcomes in patients with hepatocellular carcinoma compared to standard of care.
The main objective of this study is to establish safe dose ranges for the coadministration of sorafenib, sonidegib, and irinotecan in patients with hepatocellular carcinoma.
Furthermore, we will collect data to inform the application of an artificial intelligence/computational approach to individual dosing of combination chemotherapy.
Individualization of dosing will be achieved by using Phenotypic Personalized Medicine (PPM) to maximize treatment efficacy in patients with hepatocellular carcinoma, while minimizing toxicity.
Drug efficacy will be assessed by measuring plasma circulating tumor DNA (ctDNA).
Toxicity will be assessed by quantitating organ injury and patient tolerability.
Recommended dosing for future studies will be based on the totality of the data.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
12
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Teresa Ware, MPH
- Phone Number: 352-273-5739
- Email: PMO@cancer.ufl.edu
Study Locations
-
-
Florida
-
Gainesville, Florida, United States, 32610
- Recruiting
- University of Florida
-
Contact:
- Allison Springer
- Phone Number: 352-265-0702
- Email: sheehanallison@ufl.edu
-
-
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 99 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Adults ≥ eighteen years of age
- Biopsy proven advanced-stage hepatocellular carcinoma (HCC), as confirmed by pathological analysis.
- Not eligible for, or had disease progression after, surgical or locoregional therapies.
- Subjects must not have more than one active malignancy at the time of enrollment (Subjects with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen [as determined by the treating physician and approved by the PI] may be included).
- Eastern Cooperative Oncology Group (ECOG) performance status score of 2 or less.
- Child-Pugh liver function class A or B7
- Life expectancy of 12 weeks or more
- At least one untreated target lesion that could be measured in one dimension, according to the Response Evaluation Criteria in Solid Tumors (mRECIST).
Must have lab values consistent with the following:
- Platelet count ≥ 60,000
- Hemoglobin, ≥8.0 g/dL
- INR ≤2.5
- Albumin ≥2.5 g/dL
- Total bilirubin, ≤5 mg/dL
- ALT & AST ≤5 times the upper limit of normal
- Creatinine ≤ 2 times the upper limit of normal
- Written informed consent obtained from the subject and the subject agrees to comply with all the study-related procedures.
- Subjects of childbearing potential (SOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study and for at least 20 months after the last dose of study drug to minimize the risk of pregnancy.
- Subjects with partners of child-bearing potential must agree to use physician-approved contraceptive methods (e.g., abstinence, condoms, vasectomy) throughout the study and should avoid conceiving children for 8 months following the last dose of study drug.
Exclusion Criteria:
- Subjects of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for at least 20 months after the last dose of study drug.
- Subjects who are pregnant or breastfeeding.
- History of any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of protocol therapy or that might affect the interpretation of the results of the study or that puts the subject at high risk for treatment complications or protocol noncompliance, in the opinion of the treating physician.
- Prisoners or subjects who are involuntarily incarcerated, or subjects who are compulsorily detained for treatment of either a psychiatric or physical illness.
- Inability to follow up with treatment center for up to 12 weeks after enrollment
- Anticipated major surgery during the time of planned study
- Homozygosity for UGT1A1*28 via genotyping
- History of liver transplant
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: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Irinotecan, Sonidegib, and Sorafenib
Subjects will be assigned to a dose of each drug following a 3 + 3 design
|
All subjects will be given either 25 mg/m2 (dose level -1), 50 mg/m2 (dose level 0), or 75 mg/m2 (dose level +1) irinotecan intravenously every 7 days.
All subjects will take 200 mg sonidegib orally either every 96 hours (dose level -1), every 48 hours (dose level 0), or every 24 hours (dose level +1).
All subjects will take 200 mg sorafenib orally either every 48 hours (dose level -1), every 24 hours (dose level 0), or every 12 hours (dose level +1).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Maximally tolerated dose
Time Frame: 32 days
|
Determine the maximum tolerated dose of irinotecan, sonidegib, and sorafenib
|
32 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Objective response rate
Time Frame: 32 days
|
Determine the objective response rate, as measured by mRECIST 1.1 criteria
|
32 days
|
Change in the biomarker AFP
Time Frame: 32 days
|
Measure the change in the blood level of the biomarker AFP
|
32 days
|
Change in the biomarker AFP-L3
Time Frame: 32 days
|
Measure the change in the blood level of the biomarker AFP-L3
|
32 days
|
Change in the biomarker DGC
Time Frame: 32 days
|
Measure the change in the blood level of the biomarker DGC
|
32 days
|
Change in the biomarker TGF-B
Time Frame: 32 days
|
Measure the change in the blood level of the biomarker TGF-B
|
32 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Ali Zarrinpar, MD, PhD, University of Florida
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 (Estimated)
April 1, 2024
Primary Completion (Estimated)
April 1, 2026
Study Completion (Estimated)
April 1, 2026
Study Registration Dates
First Submitted
December 20, 2022
First Submitted That Met QC Criteria
December 20, 2022
First Posted (Actual)
December 30, 2022
Study Record Updates
Last Update Posted (Actual)
April 1, 2024
Last Update Submitted That Met QC Criteria
March 28, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
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
- Topoisomerase Inhibitors
- Protein Kinase Inhibitors
- Topoisomerase I Inhibitors
- Sorafenib
- Irinotecan
Other Study ID Numbers
- UF-GI-015
- OCR43006 (Other Identifier: University of Florida)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
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.
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