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Telaprevir Plus Standard of Care (SOC) in HCV Associated Hepatocellular Carcinoma (HCC)

2020年9月1日 更新者:M.D. Anderson Cancer Center

Telaprevir in Combination With Standard of Care in Hepatitis C Genotype 1 Infection in Patients With Hepatocellular Carcinoma Awaiting Liver Transplantation

The goal of this clinical research study is to learn if the antiviral combination of telaprevir, pegylated Interferon Alfa 2a (PegIFN alfa-2a) and ribavirin (RBV) can prevent the virus from coming back after the liver transplant.

Telaprevir, PegIFN alfa-2a, and RBV are different antiviral drugs that work in combination at different stages of the HCV infection to stop the virus.

調査の概要

詳細な説明

Study Drug Administration:

If you are found to be eligible to take part in this study, you will take telaprevir 3 times a day. You will take RVB by mouth 2 times a day. You will receive PEGIFN alfa-2a by an injection under the skin 1 time a week.

Study Visits:

On the first day you take the study drug:

  • You will have an eye exam performed by the study doctor.
  • You will have a physical exam, including measurement of your vital signs (blood pressure, heart rate, temperature, and breathing rate).
  • Blood (about 2 teaspoons) will be drawn for routine tests and to check for the hepatitis virus.
  • You will be asked about any drugs you are taking or side effects you may be having.

Every Week while you are on study:

  • You will have a physical exam, including measurement of your vital signs.
  • Blood (about 2 teaspoons) will be drawn for routine tests and to check for the hepatitis C virus. If part of the blood sample is left over after the Hepatitis C testing, it will be stored in the laboratory as a back-up sample, in case the original samples get lost. This sample may also be used to check if the Hepatitis C virus has become resistant to the study drug. No extra blood will be drawn for this storage.
  • You will be asked about any drugs you are taking or side effects you may be having.
  • At Weeks 12, 24, 36, and 42, urine will be collected to check for infection and any other side effects to the drugs.

If you can become pregnant, you will have a urine pregnancy test every 4 weeks

Length of Treatment:

You may continue receiving the antiviral therapy for up to 48 weeks, as long as the doctor thinks it is in your best interest. You will no longer be able to take the study drug if the disease gets worse, if intolerable side effects occur, or if you are unable to follow study directions.

Your participation on the study will be over after the follow-up visits.

Follow-Up Visits:

Beginning the day after you stop taking antiviral therapy (or the day of transplantation, whichever comes first), you will have up to 24 weeks of follow-up testing performed. About 4 and 20 weeks after your last dose:

  • You will have a physical exam, including measurement of your vital signs.
  • Blood (about 2 teaspoons) will be drawn for routine tests and to check for the hepatitis C virus.
  • You will be asked about any side effects you may be having.
  • At week 4 only, urine will be collected to check for infection and any other side effects to the drugs.

This is an investigational study. Telaprevir, PegIFN alfa-2a, and RBV are all FDA approved and commercially available for the treatment of HCV infection. The use of these drugs in preventing the HCV infection is investigational.

Up to 40 patients will take part in this study. All will be enrolled at MD Anderson.

研究の種類

介入

入学 (実際)

1

段階

  • フェーズ 3

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • Texas
      • Houston、Texas、アメリカ、77030
        • University of Texas MD Anderson Cancer Center

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~69年 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  1. Males or females aged ≥ 18 and ≤ 70 years
  2. Detectable Hepatitis C Virus ribonucleic acid (HCV-RNA) in serum
  3. HCV genotype 1 infection
  4. Child-Pugh-Turcotte (CPT) score < 7 and Model for End-Stage Liver Disease (MELD) score < 18
  5. PegIFN alfa-2a/RBV-naïve or previously treated patients (partial responders, null responders and relapsers)
  6. Hepatocellular carcinoma within transplant criteria in the United Network for Organ Sharing (UNOS) Region IV:

    1. Single lesion up to 6 cm, or
    2. Two or three lesions with largest no greater than 5 cm and the total tumor diameter no greater than 9 cm
  7. Listed for liver transplantation
  8. Willingness to give written consent and agree to double contraception

Exclusion Criteria:

  1. Decompensated cirrhosis
  2. Baseline platelet count less than 35,000/µL
  3. Baseline hemoglobin level less than 10 g/dL
  4. Baseline absolute neutrophil count less than 750/mm3
  5. Baseline creatinine clearance < 50 mL per min.
  6. Women with a positive pregnancy test at baseline or men whose female partners are pregnant or are contemplating pregnancy
  7. Intolerance or contraindications to PegIFN alfa-2a/RBV use per standard treatment guidelines

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:なし
  • 介入モデル:単一グループの割り当て
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
実験的:Pegylated Interferon Alfa 2a + Ribavirin + Telaprevir
Triple combination with Telaprevir, PegIFN alfa-2a and Ribavirin administered for 12 weeks, followed by dual therapy with PegIFN alfa-2a and Ribavirin. Dual therapy continued for 48 weeks of total duration of therapy, as standard of care treatment for cirrhotic patients, or until day of transplantation, whichever comes first. Starting doses for standard of care pegylated interferon (PegIFN) alfa-2a 180 mcg subcutaneously once weekly, for ribavirin (RBV) 1,000 mg orally daily (< 75 kg) and 1,200 mg orally daily (≥ 75 kg), and for telaprevir 750 mg taken orally 3 times a day.
Starting dose: 180 mcg subcutaneously once weekly.
他の名前:
  • ペグIFN
Starting dose: 1,000 mg by mouth daily.
Starting dose: 750 mg by mouth 3 times a day.
他の名前:
  • インシベク

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Number of Participants With Undetectable Viral Load 12 Weeks Post-transplant
時間枠:12 weeks post-transplant, up to 48 weeks for overall monitoring

The primary endpoint is number of participants with undetectable viral load at 12 weeks post-transplant (Post-transplant virological response, (PTVR)) which is defined as undetectable Hepatitis C Virus ribonucleic acid (HCV-RNA) 12 weeks after liver transplantation). In order to have undetectable HCV RNA viral load after transplant, participants need to have undetectable viral load before the liver transplant.

Response rate based on the modified intent-to-treat (ITT) population where ITT population is defined as those patients who have achieved an undetectable HCV-RNA level before the transplant. If patients drop out the study early due to severe toxicity or treatment failure including treatment-related death, they will be counted as non-responders when evaluating the response rate.

12 weeks post-transplant, up to 48 weeks for overall monitoring

二次結果の測定

結果測定
メジャーの説明
時間枠
Sustained Virological Response (SVR)
時間枠:60 weeks
Sustained virological response (SVR) defined as a single undetectable HCV-RNA measurement 12 weeks after the 48-week treatment period for those still waiting for transplantation. The treatment duration will be summarized with descriptive statistics. Additional analyses based on evaluable patients also conducted regarding the PTVR response rate. The evaluable patients are defined as those patients who complete at least 16 weeks of treatment and have the 12 weeks post-transplant response measurement. The rate will also be computed stratified by the HCV treatment time (i.e., the 48-week HCV treatment versus less than 48 week HCV treatment) considering the different times under HCV. The SVR rate will be estimated, along with the exact 95% confident interval.
60 weeks

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2013年4月1日

一次修了 (実際)

2014年2月1日

研究の完了 (実際)

2014年2月1日

試験登録日

最初に提出

2013年3月27日

QC基準を満たした最初の提出物

2013年3月27日

最初の投稿 (見積もり)

2013年4月1日

学習記録の更新

投稿された最後の更新 (実際)

2020年9月24日

QC基準を満たした最後の更新が送信されました

2020年9月1日

最終確認日

2020年9月1日

詳しくは

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

Pegylated Interferon Alfa 2aの臨床試験

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