SHIELD: Sorafenib Hand-foot Syndrome Inhibition With Pre-Emptive Local Delivery of Topical Indomethacin
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
This is a single-center, open-label, single-arm prospective study evaluating the prophylactic use of topical indomethacin for prevention of sorafenib-associated hand-foot syndrome (HFS) in patients with advanced hepatocellular carcinoma (HCC). Sorafenib is an established systemic treatment option for advanced HCC, but HFS is a frequent toxicity that may reduce quality of life and interfere with treatment delivery. Historical studies have reported all-grade HFS rates of approximately 45% in patients treated with sorafenib.
Topical NSAIDs have shown preventive activity against chemotherapy-related HFS in prior studies. Based on this rationale, this study will investigate whether pre-emptive administration of 1% topical indomethacin gel can reduce the incidence of sorafenib-related HFS while avoiding the systemic adverse effects associated with oral NSAIDs.
Eligible adult patients with advanced HCC who are planned to start sorafenib will receive sorafenib at an initial dose of 400 mg orally twice daily, with subsequent dose modification according to routine clinical practice. Participants will also apply 1% topical indomethacin gel to the palmar and dorsal surfaces of both hands twice daily (total 4 g/day) for up to 12 weeks, or until development of HFS or discontinuation of sorafenib, whichever occurs first.
The primary endpoint is the incidence of all-grade HFS during the first 12 weeks of sorafenib treatment, defined according to NCI CTCAE version 5.0. Secondary endpoints include the incidence of grade 2 or higher HFS, incidence of grade 3 or higher HFS, mean sorafenib dose intensity during the first 12 weeks, adverse events of special interest, and sorafenib treatment duration. A total of 39 patients will be enrolled. Outcomes will be interpreted against historical control data.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
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Taipei, Taiwan, 10002
- Rekruttering
- National Taiwan University Hospital
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Kontakt:
- Yu-Yun Shao, M.D., Ph.D.
- Telefonnummer: 886-2-2312-3456
- E-mail: yuyunshao@gmail.com
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Kontakt:
- Tsung-Che Wu, M.D.
- Telefonnummer: 886-2-23123456
- E-mail: tsungchewu8825@gmail.com
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Female or male patients, 18 years of age or older, able to understand and give written informed consent.
- Hepatocellular carcinoma, diagnosed by clinical or pathological diagnosis.
- Patients with advanced HCC, defined as those with macrovascular invasion, extrahepatic spread, or who failed or are not feasible to locoregional therapy.
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
- Child-Pugh score A-B7.
- Sorafenib is deemed as an appropriate treatment option for the patient at the discretion of the investigator.
- Male subjects and female subjects of childbearing potential who engage in heterosexual intercourse must agree to use protocol-specified method(s) of contraception as described in Appendices.
- Willing and able to comply with the requirements and restrictions in this protocol.
Exclusion Criteria:
- Exposure to multikinase inhibitors or capecitabine within 1 week before starting the study treatment.
- Unresolved HFS.
- Exposure to oral NSAID, topical NSAID, or topical steroid within 1 week before starting the study treatment.
- Known allergy to NSAID.
- Any concurrent systemic chemotherapy, immunotherapy, or biologic for cancer treatment.
- Recent gastrointestinal bleeding within 12 weeks.
- Female patients who are pregnant, breast-feeding, or male or female patients of reproductive potential who are not employing an effective method of birth control.
- Have other concurrent medical or psychiatric conditions that, in the investigator's opinion, may be likely to confound study interpretation or prevent completion of study procedures and follow-up examinations.
- Any medical condition that, in the investigator's or sponsor's opinion, poses an undue risk to the patient's participation in the study.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Støttende pleje
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Experimental
Prophylactic topical indomethacin
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The participant will be provided with 2 tubes (20 gm each) per week in the first 4 weeks (D1, 8, 15, 22), 4 tubes per 2 weeks at the second 4 weeks (D29, 43), and 4 tubes per 4 weeks for the third 4 weeks (D57) suffice for topical application over 12 weeks.
The participant will apply 1 g (1 g = two fingertip units [FTU]: one FTU for one surface of one hand) of 1% topical indomethacin on the palmar and dorsal surface of each hand twice daily (= 4g/day) until discontinuation of sorafenib or 12 weeks or development of HFS, whichever is earlier.
If the patient has adequate residual indomethacin gel at the visit, the prescribing amount may be reduced accordingly.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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All-grade hand-foot skin reaction rate during the first 12 weeks of sorafenib treatment
Tidsramme: From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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The proportion of participants who experience any grade of hand-foot skin reaction during the first 12 weeks of sorafenib treatment.
Hand-foot skin reaction severity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0.
The grading scale ranges from Grade 1 to Grade 5, with higher grades indicating greater severity.
For participants who discontinue sorafenib before Week 12, hand-foot skin reaction events will be assessed during the actual sorafenib treatment period.
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From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Grade ≥2 hand-foot skin reaction rate during the first 12 weeks
Tidsramme: From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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The proportion of participants who experience Grade 2 or higher hand-foot skin reaction during the first 12 weeks of sorafenib treatment.
Hand-foot skin reaction severity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0.
The grading scale ranges from Grade 1 to Grade 5, with higher grades indicating greater severity.
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From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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Grade ≥3 hand-foot skin reaction rate during the first 12 weeks
Tidsramme: From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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The proportion of participants who experience Grade 3 or higher hand-foot skin reaction during the first 12 weeks of sorafenib treatment.
Hand-foot skin reaction severity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0.
The grading scale ranges from Grade 1 to Grade 5, with higher grades indicating greater severity.
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From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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Mean sorafenib dose intensity during the first 12 weeks of treatment
Tidsramme: From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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Adverse events of special interest in the first 12 weeks of sorafenib treatment
Tidsramme: From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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From initiation of sorafenib treatment through Week 12, assessed up to 12 weeks.
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Treatment duration of sorafenib
Tidsramme: From initiation of sorafenib treatment until permanent discontinuation of sorafenib, assessed up to 24 weeks.
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From initiation of sorafenib treatment until permanent discontinuation of sorafenib, assessed up to 24 weeks.
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Yu-Yun Shao, M.D., Ph.D., National Taiwan University Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Neoplasmer efter sted
- Neoplasmer
- Neoplasmer efter histologisk type
- Neoplasmer i fordøjelsessystemet
- Sygdomme i fordøjelsessystemet
- Leversygdomme
- Neoplasmer, kirtel og epitel
- Adenocarcinom
- Neoplasmer i leveren
- Karcinom
- Carcinom, hepatocellulært
- Heterocykliske forbindelser
- Heterocykliske forbindelser, 2-ring
- Heterocykliske forbindelser, smeltet ring
- Indoler
- Indomethacin
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 202508066MIPC
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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