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CS1008- in Combination With Sorafenib Compared to Sorafenib Alone in Subjects With Advanced Liver Cancer

6 aprile 2021 aggiornato da: Daiichi Sankyo, Inc.

Clinical Study Protocol Phase 2, Randomized Study of CS-1008 in Combination With Sorafenib Compared to Sorafenib Alone as First-Line Systemic Therapy in Subjects With Advanced Hepatocellular Carcinoma

The purpose of this study is to determine the safety and efficacy of CS-1008 in combination with sorafenib to sorafenib alone for treating liver cancer. Approximately 160 participants will take part in this study at approximately 22 sites (4 in the US, 8 in Japan, and 10 in Asia).

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Effettivo)

172

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Corea, Repubblica di
      • Daegu, Corea, Repubblica di, 700-712
        • Keimyung University Dongsan Hospital
      • Seoul, Corea, Repubblica di, 135-710
        • Samsung Medical Center
      • Seoul, Corea, Repubblica di, 138-736
        • Asan Medical Center
      • Seoul, Corea, Repubblica di, 110-744
        • Seoul National University Hospital
      • Seoul, Corea, Repubblica di, 120-752
        • Severance Hospital
      • Seoul, Corea, Repubblica di, 136-705
        • Korea University Anam Hospital
      • Seoul, Corea, Repubblica di, 137-701
        • Catholic Univ. of Korea, Seoul St. Mary's Hospital
  • Giappone
      • Chiba, Giappone, 260-8677
        • Chiba University Hospital
      • Okayama, Giappone, 700-8558
        • Okayama University Hospital
      • Osaka, Giappone, 537-8511
        • Osaka Med Center Cancer and Cardiovascular Disease
      • Tokyo, Giappone, 180-8610
        • Musashino Red-Cross Hospital
    • Fukuoka
      • Kurume-shi, Fukuoka, Giappone, 830-0011
        • Kurume University Hospital
    • Hiroshima
      • Hiroshima-city, Hiroshima, Giappone
        • Hiroshima University
    • Ishikawa
      • Kanazawa, Ishikawa, Giappone
        • Kanazawa University
    • Osaka-sayama
      • Osaka, Osaka-sayama, Giappone, 589-8511
        • Kinki University Hospital
    • Yamaguchi
      • Ube, Yamaguchi, Giappone
        • Yamaguchi University Hospital
  • Stati Uniti
    • California
      • Los Angeles, California, Stati Uniti, 90057
        • Kenmar Research Group
    • District of Columbia
      • Washington, District of Columbia, Stati Uniti, 20007
        • Georgetown-Lombardi Cancer Center
    • New York
      • New York, New York, Stati Uniti, 10029
        • The Mount Sinai Medical Center
    • Tennessee
      • Nashville, Tennessee, Stati Uniti, 37232
        • Vanderbilt-Ingram Cancer Center
  • Taiwan
      • Changhua, Taiwan, 500
        • Changhua Christian Hospital
      • Chiayi City, Taiwan
        • Chang Gung Memorial Hospital
      • Kaohsiung, Taiwan, 807
        • Kaohslung Medical University Hospital
      • Tainan, Taiwan, 73657
        • Chi-Mei Medical Center
      • Tainan city, Taiwan, 704
        • National Cheng-Kung University Hospital
      • Taipei, Taiwan
        • National Taiwan University Hospital
      • Taoyuan, Taiwan, 33305
        • Chang Gung Medical Foundation-Linkuo
    • Niaosung Hsiang
      • Kaohsiung, Niaosung Hsiang, Taiwan
        • Kaohiung Chang Gung Hospital

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • Histologically or cytologically confirmed hepatocellular carcinoma (HCC) or clinical diagnosis of HCC when the following criteria are all met:

    • History of chronic hepatitis and/or cirrhosis of liver;
    • Typical features of HCC demonstrated in dynamic imaging studies, such as three-phase computed tomography (CT); AND
    • Alpha-fetoprotein (AFP) level > 200 ng/mL

  • Advanced diseases

    • Extrahepatic metastasis, OR
    • Locally advanced diseases which are not amenable for surgical resection or other loco-regional therapies including transhepatic arterial (chemo) embolization (TACE or TAE) and local ablative therapy
  • Measurable disease based on Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 of at least 1 untreated target lesion that can be measured in 1 dimension
  • At least 18 years of age
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Child-Pugh class A
  • Life expectancy of at least 12 weeks

  • Adequate organ and bone marrow function as assessed by clinical laboratory evaluations:

    • Hemoglobin ≥ 8.5 g/dL (transfusion and/or growth factor support allowed)
    • Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L
    • Platelet count ≥ 75 x 10^9/L
    • Serum creatinine ≤ 1.5 x upper limit of normal (ULN) or creatinine clearance > 40 mL/min
    • Aspartate Aminotransferase (AST) and alkaline phosphatase ≤ 5.0 x ULN
    • Total bilirubin ≤ 1.5 x ULN
  • Serum amylase and lipase ≤ 1.5 x ULN
  • Women of childbearing potential must be willing to consent to using effective contraception (eg, abstinence, hormonal contraceptives, bilateral tubal ligation, barrier with spermicide, intrauterine device) while on treatment and for 3 months thereafter. Men who are the partner of a woman of childbearing potential must be willing to consent to using effective contraception (eg, vasectomy or barrier with spermicide) while on treatment and for 3 months thereafter
  • All female participants of childbearing potential must have a negative pregnancy test (serum or urine) result
  • Participants must be fully informed about their illness and the investigational nature of the study protocol (including foreseeable risks and possible side effects) and must sign and date an International Review Board (IRB)/ Independent Ethics Committee (IEC) approved Informed Consent Form (ICF) before the performance of any study specific procedures or tests
  • Participants must be willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures

Exclusion Criteria:

  • Any prior systemic therapy for HCC, including systemic chemotherapy (prior exposure to chemotherapy by TACE is allowed), immunotherapy, sorafenib or other Raf kinase inhibitors, Vascular Endothelial Growth Factor (VEGF)/Vascular Endothelial Growth Factor Receptor (VEGFR)-inhibitors, epidermal growth factor receptor inhibitors or mechanistic target of rapamycin (mTOR) inhibitors
  • Radiotherapy or major surgical procedure within 4 weeks of the screening/baseline visit or minor surgical procedures (eg, core biopsy or fine needle aspiration) within 2 weeks of the screening/baseline visit
  • Anticipation of need for radiotherapy (RT) or a major surgical procedure during the study
  • Any investigational agent within 4 weeks before the screening/baseline visit

  • History of any of the following conditions within 6 months before the screening/baseline visit:

    • Myocardial infarction with significant impairment of cardiac function (eg, ejection fraction ≤ 30%)
    • Severe/unstable angina pectoris
    • New York Heart Association (NYHA) class III or intravenous (IV) congestive heart failure
    • Clinically significant pulmonary disease (eg, severe chronic obstructive pulmonary disease or asthma)
  • Clinically active brain metastases (defined as untreated, symptomatic or requiring steroids or anticonvulsants medications to control associated symptoms), uncontrolled seizure disorder; spinal cord compression; or carcinomatous meningitis. Participants with treated brain metastasis will be included in the study if they have recovered from the acute, toxic effects of radiotherapy. A minimum of 15 days must have elapsed between the end of RT and the screening/baseline visit
  • History of organ transplantation
  • Clinically significant, severe, active infection requiring IV antibiotics
  • Known history of human immunodeficiency virus (HIV) infection
  • History of prior sensitivity reaction to any components of CS-1008 or sorafenib formulations
  • History of a second malignancy, with the exception of in situ cervical cancer or adequately treated basal cell or squamous cell carcinoma of the skin
  • Pregnant or breast feeding
  • Serious intercurrent medical illnesses that, in the opinion of the Investigator, would impair the participant's ability to provide informed consent or unacceptably reduce the safety of the proposed treatment
  • Clinically significant (National Cancer Institute Common Terminology Criteria for Adverse Events [NCI CTCAE] grade ≥ 3) gastrointestinal bleeding in the past 12 months or current active gastrointestinal bleeding
  • Presence of esophageal varices at risk of bleeding, such as large esophageal/gastric varices or those with red sign, or active peptic ulcer with or without exposed vessels at risk of bleeding (as documented by endoscopy)
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within past 6 months

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Safety Cohort 1 CS-1008 and Sorafenib
Combination of CS-1008 and sorafenib; CS-1008 (2 mg/kg per week) in combination with sorafenib (400 mg self-administered by mouth twice daily) over 4 weeks observation, and may continue treatment until progression.
Droga: CS-1008 2 mg/kg
On a once a week basis CS-1008 will be administered intravenously starting at 2 mg/kg.
Droga: Sorafenib
On a daily basis, one sorafenib tablet, 400 mg, is taken orally twice a day. The total daily dose of sorafenib is 800 mg. The sorafenib tablets are taken at least 1 hour before or 2 hours after a meal.
Altri nomi:
  • Nexavar
Sperimentale: Safety Cohort 2 CS-1008 and Sorafenib
Combination of CS-1008 and sorafenib; CS-1008 (4 mg/kg per week) in combination with sorafenib (400 mg self-administered by mouth twice daily) over 4 weeks observation, and may continue treatment until progression.
Droga: Sorafenib
On a daily basis, one sorafenib tablet, 400 mg, is taken orally twice a day. The total daily dose of sorafenib is 800 mg. The sorafenib tablets are taken at least 1 hour before or 2 hours after a meal.
Altri nomi:
  • Nexavar
Droga: CS-1008 4 mg/kg
On a once a week basis CS-1008 will be administered intravenously at 4 mg/kg if tolerated.
Comparatore attivo: Safety Cohort 3 CS-1008 and Sorafenib
Combination of CS-1008 and sorafenib; CS-1008 (6 mg/kg per week) in combination with sorafenib (400 mg self-administered by mouth twice daily) over 4 weeks observation, and may continue treatment until progression.
Droga: Sorafenib
On a daily basis, one sorafenib tablet, 400 mg, is taken orally twice a day. The total daily dose of sorafenib is 800 mg. The sorafenib tablets are taken at least 1 hour before or 2 hours after a meal.
Altri nomi:
  • Nexavar
Droga: CS-1008 6 mg/kg
On a once a week basis CS-1008 will be administered intravenously at 6 mg/kg if tolerated.
Sperimentale: Treatment Group 1 CS-1008 and Sorafenib
Combination of CS-1008 and sorafenib. Treatment Group 1: CS-1008 (6 mg/kg [or as determined] loading, 2 mg/kg/week maintenance) + sorafenib twice daily (N=50)
Droga: Sorafenib
On a daily basis, one sorafenib tablet, 400 mg, is taken orally twice a day. The total daily dose of sorafenib is 800 mg. The sorafenib tablets are taken at least 1 hour before or 2 hours after a meal.
Altri nomi:
  • Nexavar
Droga: CS-1008 6/2 mg/kg
A 6 mg/kg loading dose of CS-1008 will be administered intravenously, followed by a 2 mg/kg/week maintenance dose on a once-a-week basis.
Sperimentale: Treatment Group 2 with CS-1008 and Sorafenib
Combination of CS-1008 and sorafenib. Treatment Group 2: CS-1008 (6 mg/kg [or as determined] loading, 6 mg/kg/week [or maximum tolerated dose {MTD}] maintenance) + sorafenib twice daily (N=50)
Droga: Sorafenib
On a daily basis, one sorafenib tablet, 400 mg, is taken orally twice a day. The total daily dose of sorafenib is 800 mg. The sorafenib tablets are taken at least 1 hour before or 2 hours after a meal.
Altri nomi:
  • Nexavar
Droga: CS-1008 6/6 mg/kg
A 6 mg/kg loading dose of CS-1008 will be administered intravenously, followed by a 6 mg/kg/week maintenance dose on a once-a-week basis.
Sperimentale: Treatment Group 3 with Sorafenib Alone
Sorafenib. Treatment Group 3: sorafenib twice daily (N=50)
Droga: Sorafenib
On a daily basis, one sorafenib tablet, 400 mg, is taken orally twice a day. The total daily dose of sorafenib is 800 mg. The sorafenib tablets are taken at least 1 hour before or 2 hours after a meal.
Altri nomi:
  • Nexavar

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Time to Progression (TTP) Following CS1008 in Combination With Sorafenib Compared to Sorafenib Alone in Participants With Advanced Liver Cancer
Lasso di tempo: Baseline up to approximately 2 years post-dose.
Time to progression was defined as the time from randomization to the date of the first objective documentation of radiographic or symptomatic progression, whichever came first.
Baseline up to approximately 2 years post-dose.

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Overall Survival Following CS1008 in Combination With Sorafenib Compared to Sorafenib Alone in Participants With Advanced Liver Cancer
Lasso di tempo: Baseline up to approximately 3 years 2 months post-dose.
Overall survival (OS) was defined as the time from randomization to the date of death. The factors in the final model were treatment, Eastern Cooperative Oncology Group (ECOG) performance status, presence of extrahepatic metastasis and/or macrovessel invasion, and region.
Baseline up to approximately 3 years 2 months post-dose.
Best Overall Response and Objective Response Rate Following CS1008 in Combination With Sorafenib Compared to Sorafenib Alone in Participants With Advanced Liver Cancer
Lasso di tempo: Baseline up to disease progression, death, lost to follow up, or study discontinuation (whichever comes first), up to approximately 3 years 2 months post-dose.
The best overall response is the best response (in the order of confirmed complete response [CR], confirmed partial response [PR], unconfirmed CR, unconfirmed PR, stable disease [SD], and progressive disease [PD]) among all overall responses recorded from the start of treatment until the participant withdraws from the study based on Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. If there is no tumor assessment after the first dose of study drug, the best overall response is classified as Inevaluable. CR was defined as a disappearance of all target lesions, PR was defined as at least a 30% decrease in the sum of diameters of target lesions, and SD was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD defined as at least a 20% increase in the sum of diameters of target lesions. Objective response rate was defined as confirmed CR and confirmed PR.
Baseline up to disease progression, death, lost to follow up, or study discontinuation (whichever comes first), up to approximately 3 years 2 months post-dose.
Treatment-Emergent Adverse Events Following CS1008 in Combination With Sorafenib Compared to Sorafenib Alone in Participants With Advanced Liver Cancer
Lasso di tempo: Baseline up to 30 days after last dose, up to approximately 3 years 2 months post-dose.
Treatment-Emergent Adverse Events (TEAEs) were defined as those adverse events (AEs) that occurred, having been absent before the study, or worsened in severity after the initiation of study treatment administration. An AE that occurred more than 30 days after the last dose of study medication was not included as a TEAE unless it was considered related to treatment or the assessment of relatedness was missing.
Baseline up to 30 days after last dose, up to approximately 3 years 2 months post-dose.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Daiichi Sankyo, Inc.

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

9 luglio 2010

Completamento primario (Effettivo)

13 luglio 2012

Completamento dello studio (Effettivo)

9 settembre 2013

Date di iscrizione allo studio

Primo inviato

15 dicembre 2009

Primo inviato che soddisfa i criteri di controllo qualità

15 dicembre 2009

Primo Inserito (Stima)

16 dicembre 2009

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

8 aprile 2021

Ultimo aggiornamento inviato che soddisfa i criteri QC

6 aprile 2021

Ultimo verificato

1 aprile 2021

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • CS1008-A-U204

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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Prove cliniche su CS-1008 2 mg/kg

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Sponsor e collaboratori

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CROs by country

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Condizioni

Malattie rare

Interventi farmacologici

Supplementi dietetici

Sponsor / Collaboratori

Sedi

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