- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT02406508
Sequential Melphalan for Use With Hepatic Delivery System Treatment Followed by Sorafenib in Patients With Unresectable HCC
An International Multi-center Phase 2 Study to Evaluate the Safety and Efficacy of Sequential Melphalan Hydrochloride for Injection for Use With the Hepatic Delivery System Treatment Followed by Sorafenib in Patients With Unresectable Hepatocellular Carcinoma
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
This is a single arm, open label, multi-center, phase 2 study to evaluate the safety and efficacy of sequential treatment with Melphalan/HDS followed by sorafenib in patients with unresectable hepatocellular carcinoma (HCC) confined to the liver.
Eligible patients will receive up to 3 Melphalan/HDS treatments. Each treatment cycle consists of 6 weeks with an acceptable delay for another 2 weeks before next planned treatment. The Melphalan/HDS treatment will be terminated in patients with progressive disease (PD), complete response (CR), and > 8 weeks delay of recovery from toxicity after last PHP treatment.
With the exception of patients with PD, all patients will be treated with sorafenib after completing the Melphalan/HDS treatment. Patients with PD will be managed with standard of care off-study by their treating physician.
Tipo di studio
Fase
- Fase 2
Contatti e Sedi
Luoghi di studio
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Florida
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Tampa, Florida, Stati Uniti, 33612
- H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
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New York
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New York, New York, Stati Uniti, 10467
- Montefiore Medical Center
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- HCC diagnosed by tissue or imaging study
- Unresectable HCC without extrahepatic disease based on CT
- At least one target lesion. In patients with prior loco-regional therapy, the target lesion(s) must be located in area(s) outside previous treatment
- Child-Pugh Class A in the absence of hepatoencephalopathy or clinically evident ascites
- Barcelona Clinic Liver Cancer (BCLC) stage B
- MELD Score < 15
- Eastern Cooperative Oncology Group Performance Status 0-1
- No prior systemic therapy for HCC
- No prior radiation therapy to the liver including Y90-, I131-based loco-regional therapy. Prior loco-regional therapy based on other technology for HCC, if any, must have been completed at least 4 weeks prior to baseline imaging
- Age ≥ 18 years
- Signed informed consent
Exclusion Criteria:
- Metastatic disease outside of liver
- Greater than 50% tumor burden in the liver by imaging
- History of orthotopic liver transplantation, clinical symptoms of portal hypertension, Whipple's procedure, hepatic artery anatomy incompatible with perfusion or known unresolved venous shunting
- Evidence of ascites on imaging study, or the use of diuretics for ascites
- Clinically significant encephalopathy
- History of allergies or known hypersensitivity to any components of melphalan or the components of the Melphalan/HDS system
- Known hypersensitivity to heparin or the presence of heparin-induced thrombocytopenia
- Received an investigational agent for any indication within 30 days prior to first treatment
- Not recovered from side effects of prior therapy to ≤ grade 1 (according to National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 [NCI CTCAE v. 4.03]). Certain side effects that are unlikely to develop into serious or life-threatening events (e.g. alopecia) are allowed at > grade 1
- Those with New York Heart Association functional classification II, III or IV; active cardiac conditions including unstable coronary syndromes (unstable or severe angina, recent myocardial infarction), worsening or new-onset congestive heart failure, significant arrhythmias and severe valvular disease must be evaluated for risks of undergoing general anesthesia
- History or evidence of clinically significant pulmonary disease that precludes the use of general anesthesia
- Uncontrolled diabetes mellitus, hypothyroidism, or hyperthyroidism
- Active uncontrolled infection, including Hepatitis B, Hepatitis C infection. Patients with anti-HBc positive, or HBsAg but DNA negative are exception(s)
- History of bleeding disorders
- Brain lesions with a propensity to bleed
- Known esophageal varices at risk of bleeding, including medium or large esophageal or gastric varices, or active peptic ulcer
- Previous malignancy within 3 years prior to enrollment, except for curatively-treated basal cell or squamous cell carcinoma of the skin, cervical carcinoma in situ, bladder carcinoma in situ or breast cancer in situ
Inadequate hematologic function as evidenced by any of the following:
- Platelets < 125,000/µL
- Hemoglobin ≤ 10 g/dL, independent of transfusion or growth factor support
- Neutrophils < 1,500/µL
- Serum creatinine > 1.5 mg/dL
Inadequate liver function as evidenced by any of the following:
- Total serum bilirubin ≥ 2.0 mg/dL
- Prothrombin time International Normalized Ratio (INR) > 1.5
- Aspartate aminotransferase (AST) or alanine transaminase (ALT) > 5 times ULN
- Serum albumin < 3.0 g/dL
- Alcohol consumption within 30 days of first study treatment, or refusing to abstain from alcohol for the duration of study treatment
- For female subjects of childbearing potential (i.e., have had a menstrual period within the past 12 months): a positive serum pregnancy test (β-human chorionic gonadotropin) within 7 days prior to enrollment; or unwilling or unable to undergo hormonal suppression to avoid menstruation during treatment
- Sexually active females of childbearing potential and sexually active males with partners of reproductive potential: unwilling or unable to use appropriate contraception from screening until at least 30 days after last administration of study treatment
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
---|---|
Sperimentale: Hepatic Delivery System Treatment followed by Sorafenib
Percutaneous hepatic perfusion with melphalan hydrochloride for injection using the Hepatic Delivery System. Melphalan hydrochloride is administered at a dose of 3mg/kg ideal body weight once every 6 weeks for a maximum of 3 cycles of treatment. After the Melphalan/HDS treatment patients will be treated with sorafenib according to the package prescribing information. |
Altri nomi:
Altri nomi:
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Lasso di tempo |
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Numero di pazienti con eventi avversi dopo il trattamento con Melfalan/HDS.
Lasso di tempo: 2 anni
|
2 anni
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Number of patients with adverse events after treatment with Sorafenib following treatment with Melphalan/HDS.
Lasso di tempo: 2 years
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2 years
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Tasso di risposta obiettiva in percentuale del trattamento con Melfalan/HDS
Lasso di tempo: 2 anni
|
2 anni
|
Progression free survival in months of patients receiving Melphalan/HDS treatment followed by Sorafenib
Lasso di tempo: 2 years
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2 years
|
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
---|---|---|
AUC of melphalan after Melphalan/HDS treatment
Lasso di tempo: Baseline - prior to infusion. Infusion period - 10 min, 20 min, End of infusion. Washout period - 10 min, 20 min, 30 min. Post-procedure period - 5 min, 10 min, 15 min, 30 min, 1 hour, 2 hours, 3.5 hours, 5 hours.
|
Pharmacokinetic study
|
Baseline - prior to infusion. Infusion period - 10 min, 20 min, End of infusion. Washout period - 10 min, 20 min, 30 min. Post-procedure period - 5 min, 10 min, 15 min, 30 min, 1 hour, 2 hours, 3.5 hours, 5 hours.
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Quality of life questionnaires
Lasso di tempo: Baseline, Week 6 of each PHP cycle, Day 1 of every Sorafenib cycle, End of treatment, every 12 weeks in follow-up.
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Baseline, Week 6 of each PHP cycle, Day 1 of every Sorafenib cycle, End of treatment, every 12 weeks in follow-up.
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Collaboratori e investigatori
Sponsor
Investigatori
- Direttore dello studio: Leslie Callahan, RN, Delcath Systems
Studiare le date dei record
Studia le date principali
Inizio studio
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Malattie dell'apparato digerente
- Neoplasie per tipo istologico
- Neoplasie
- Neoplasie per sede
- Adenocarcinoma
- Neoplasie, ghiandolari ed epiteliali
- Neoplasie dell'apparato digerente
- Malattie del fegato
- Neoplasie del fegato
- Carcinoma
- Carcinoma, epatocellulare
- Effetti fisiologici delle droghe
- Meccanismi molecolari dell'azione farmacologica
- Inibitori enzimatici
- Agenti antineoplastici
- Agenti immunosoppressivi
- Fattori immunologici
- Agenti Antineoplastici, Alchilanti
- Agenti Alchilanti
- Agonisti mieloablativi
- Inibitori della chinasi proteica
- Sorafenib
- Melfalan
Altri numeri di identificazione dello studio
- PHP-HCC-201
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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