이 페이지는 자동 번역되었으며 번역의 정확성을 보장하지 않습니다. 참조하십시오 영문판 원본 텍스트의 경우.

간암 환자 치료에서 간 이식 후 소라페닙 토실레이트

2026년 10월 9일 업데이트: Jonsson Comprehensive Cancer Center

간세포 암종(HCC)이 있는 고위험 동소 간 이식(OLT) 수용자에서 소라페닙 보조제 요법에 대한 II상 무작위 다기관 위약 대조 맹검 연구

The purpose of this study is to determine if sorafenib (sorafenib tosylate) is a safe and effective treatment option for preventing liver cancer in high risk patients following liver transplantation. Liver transplantation is a treatment option for liver cancer patients, but despite transplantation, the liver cancer can recur in the new, transplanted liver. It is not known whether sorafenib is effective in preventing cancer recurrence in high risk patients following liver transplantation

연구 개요

상태

완전한

정황

개입 / 치료

상세 설명

PRIMARY OBJECTIVES:

I. Two-year recurrence free survival (RFS).

SECONDARY OBJECTIVES:

I. One-year recurrence free survival. II. Overall survival (OS). III. Safety. IV. Impact of drug-drug interactions (i.e. immunosuppression agents). V. Impact of biomarkers (alpha-fetoprotein [AFP], protein-induced by vitamin K absence or antagonist II [PIVKA II]).

VI. Effects of therapy on wound healing. VII. Impact of hepatitis C viral recurrence.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive sorafenib tosylate orally (PO) twice daily (BID).

ARM II: Patients receive placebo PO BID.

In both arms treatment continues for 24 months in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 6 months for 2 years.

연구 유형

중재적

등록 (실제)

73

단계

  • 2 단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Alabama
      • Birmingham, Alabama, 미국, 35294-0007
        • University of Alabama
    • California
      • Los Angeles, California, 미국, 90095
        • Jonsson Comprehensive Cancer Center
    • Colorado
      • Denver, Colorado, 미국, 80217-3364
        • University of Colorado
    • Connecticut
      • Hartford, Connecticut, 미국, 06112
        • Mount Sinai Hospital
    • District of Columbia
      • Washington D.C., District of Columbia, 미국, 20057
        • Lombardi Comprehensive Cancer Center at Georgetown University
    • Georgia
      • Atlanta, Georgia, 미국, 30322
        • Emory University
    • Illinois
      • Chicago, Illinois, 미국, 60611
        • Northwestern University
    • Louisiana
      • New Orleans, Louisiana, 미국, 70121
        • Ochsner Clinic Foundation
    • Maryland
      • Baltimore, Maryland, 미국, 21287-8936
        • Johns Hopkins University
    • Massachusetts
      • Burlington, Massachusetts, 미국, 01805
        • Lahey Clinic Medical Center
    • Michigan
      • Ann Arbor, Michigan, 미국, 48109
        • University of Michigan University Hospital
    • Nebraska
      • Omaha, Nebraska, 미국, 68198-7830
        • University of Nebraska Medical Center
    • New Jersey
      • Cherry Hill, New Jersey, 미국, 08034
        • University of Pennsylvania Health System
    • New York
      • New York, New York, 미국, 10016
        • New York University Langone Medical Center
      • New York, New York, 미국, 10065
        • New York Presbyterian-The University Hospital of Columbia and Cornell
    • Ohio
      • Cleveland, Ohio, 미국, 44195
        • Cleveland Clinic Foundation
    • Oklahoma
      • Oklahoma City, Oklahoma, 미국, 73112
        • Integris-Baptist Medical
    • Pennsylvania
      • Pittsburgh, Pennsylvania, 미국, 15213
        • University of Pittsburgh
    • Tennessee
      • Nashville, Tennessee, 미국, 37232
        • Vanderbilt University
    • Texas
      • Houston, Texas, 미국, 77030
        • Baylor College of Medicine
      • Houston, Texas, 미국, 77030
        • The Methodist Hospital Research Institute

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

19년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

  • Patients must have hepatocellular carcinoma (HCC) with one of the following on explant: microvascular/macrovascular invasion, tumor outside of Milan criteria, poor tumor differentiation; patients with macrovascular invasion on explant pathology will be stratified

    * Additionally, the following will be included

    ** Patients with elevated surrogate markers (AFP > 500 or PIVKA > 400) pre transplant and with biopsy proven HCC prior to orthotopic liver transplantation (OLT) or on explant

  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2

  • Patients with a life expectancy > 12 weeks

  • Patients must have completed prednisone taper within 6 weeks post OLT

  • Patients must be enrolled between 6 to 12 weeks post OLT

  • Cadaveric donors only (no living donor liver transplantation [LDLT] or donor after cardiac death transplantation [DCDT])

  • No sorafenib prior to inclusion in the study

  • Platelet count > 50 x 10^9/L

  • Hemoglobin >= 8.5 g/dL

  • Total bilirubin =< 5 mg/dL

  • Alanine transaminase (ALT) and aspartate aminotransferase (AST) =< 5 x upper limit of normal

  • Amylase and lipase =< 1.5 x the upper limit of normal

  • Serum creatinine < 2 x the upper limit of normal

  • Prothrombin time (PT) =< 6 seconds or international normalized ratio (INR) =< 2.3

  • AFP > 500 (pre-transplant)

  • PIVKA > 400 (pre-transplant)

  • Patient has not received prior anti-angiogenic therapy, systemic targeted agents or systemic chemotherapy

    * Prior surgical resection, chemoembolization or other local therapy prior to transplant is permitted

  • Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of study drug; post-menopausal women (defined as no menses for at least 1 year) and surgically sterilized women are not required to undergo a pregnancy test

  • Patients (men and women) of childbearing potential must agree to use adequate contraception beginning at the signing of the informed consent form (ICF) until at least 30 days after the last dose of study drug; the definition of adequate contraception will be based on the judgment of the principal investigator or a designated associate

  • Patient must be able to swallow and retain oral medication

  • Patient must exhibit the ability to understand and willingness to sign a written informed consent regarding the study and alternative treatments

Exclusion Criteria:

  • Significant ongoing immunologic rejection based on pathology and clinical diagnosis (from time of transplant until randomization)

  • Use of T cell depleting agents for prevention or treatment of rejection at any point prior to or after enrollment in the study

  • Patient with documented evidence of metastatic disease

  • 100% tumor necrosis on explant pathology

  • Use of mammalian target of rapamycin (mTOR) inhibitors prior to transplant and as post-transplant immunosuppression

  • Use of alemtuzumab

  • Living donor liver transplant (LDLT) or donation after cardiac death transplant (DCDT)

  • Human immunodeficiency virus (HIV) positive patients

  • Hepatitis C virus (HCV) recurrence at the time of randomization

  • Use of direct acting antivirals for HCV recurrence

  • Requirement of re-transplantation for primary non function

  • Uncontrolled hypertension, defined as systolic blood pressure > 140 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management

  • Active or clinically significant cardiac disease including:

    • Congestive heart failure - New York Heart Association (NYHA) > class II
    • Coronary artery disease
    • Cardiac arrhythmias requiring anti-arrhythmic therapy other than beta blockers or digoxin
    • Unstable angina or new-onset angina within 3 months before randomization, or myocardial infarction (MI) within 6 months before randomization
  • Clinically active serious infection documented by positive cultures or an incomplete course of treatment for bacteremia or fungemia

  • Evidence or history of bleeding diathesis or coagulopathy

  • Patients with any pulmonary hemorrhage/bleeding event grade 2 or higher within 4 weeks before randomization

  • Patients with thrombotic, embolic, venous, or arterial events, such as cerebrovascular accident (including transient ischemic attacks [TIAs]) within 6 months before randomization

  • Prior use of raf-kinase inhibitors (sorafenib), vascular endothelial growth factor (VEGF) inhibitors, mitogen-activated protein kinase (MAPK)/extracellular-signal-related kinase (ERK) kinase (MEK) inhibitors, or farnesyl transferase inhibitors

  • Patients using cytochrome P450 3A4 (CYP3A4) inducers (eg, phenytoin, carbamazepine, phenobarbital, St. John's Wort dexamethasone) at a dose of greater than 16 mg daily, or rifampin and/or rifabutin within 28 days before randomization

  • Patients with non-HCC malignancy except those with DCIS (ductal carcinoma in situ), cervical cancer in-situ, basal cell or superficial bladder tumor; patients surviving a cancer that was curatively treated and without evidence of recurrence for more than 3 years before randomization are allowed

  • Presence of a non-healing wound, non-healing ulcer, or bone fracture

  • Known or suspected allergy or hypersensitivity to any of the study drugs, study drug classes, or excipients of the formulations given during the course of this trial

  • Any malabsorption condition

  • Women who are pregnant or breast-feeding

  • Inability to comply with the protocol and/or not willing or not available for follow-up assessments

  • Patients with fibrolamellar HCC, cholangiocarcinoma, and combined HCC-cholangiocarcinoma

  • Any condition which, in the investigator's opinion, makes the patient unsuitable for trial participation

  • Prior use of any systemic chemotherapy for HCC

  • Prior use of systemic investigational agents for HCC

  • Prior use of raf-kinase inhibitors (sorafenib), VEGF inhibitors, MEK inhibitors or farnesyl transferase inhibitors

  • Use of biologic response modifiers, such as granulocyte colony-stimulating factor (G-CSF), will not be permitted within 3 weeks prior to study entry; G-CSF and other hematopoietic growth factors may be used in the management of acute toxicity, such as febrile neutropenia, when clinically indicated or at the discretion of the investigator; however, they may not be administered to prevent a dose reduction; patients taking chronic erythropoietin are permitted, provided no dose adjustment is undertaken within 1 month prior to randomization or during the study

  • Autologous bone marrow transplant or stem cell rescue within four months of start of study drug

  • Concomitant treatment with rifampin and St. John's wort

  • Concomitant oral mTOR inhibitor treatment

  • Use of direct acting antivirals for HCV recurrence

  • Use of T-cell depleting agents

  • Use of alemtuzumab

  • Anticoagulation, as described below, is allowed:

    • Vitamin-K antagonists (e.g., warfarin)

      ** Low dose warfarin (1 mg orally, once daily) with PT-INR =< 1.5 x ULN is permitted; patients taking concomitant warfarin should be monitored regularly for changes in PT, PT-INR or clinical bleeding episodes

    • Low dose aspirin (=< 100 mg daily).

    • Heparins and heparinoids Use of any other investigational drug

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 하나의

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Arm I (sorafenib tosylate)

Patients receive sorafenib tosylate PO BID.

Correlative studies

Given PO

다른 이름들:
  • 베이 43-9006
  • BAY 43-9006 토실산염
  • 베이 54-9085
  • 넥사바
  • SFN
위약 비교기: Arm II (placebo)

Patients receive placebo PO BID.

Correlative studies

Given PO

다른 이름들:
  • PLCB

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Recurrence-free Survival at 2 Years
기간: Defined as the time from randomization to the first documented disease recurrence by radiological assessment or death due to any cause whichever occurs first, assessed at 2 years

Recurrence-free Survival at 2 Years: The number of participants who were alive without recurrence of hepatocellular carcinoma (HCC). Recurrence-free survival was defined as the time from randomization to the first documented HCC recurrence or death from any cause, whichever occurred first.

Defined as the time from randomization to the first documented disease recurrence by radiological assessment or death due to any cause whichever occurs first, assessed at 2 years

2차 결과 측정

결과 측정
측정값 설명
기간
Recurrence-free Survival at One Year
기간: Defined as the time from randomization to the first documented disease recurrence by radiological assessment or death due to any cause whichever occurs first, assessed at 1 year

Recurrence-free Survival at One Year: The number of participants who were alive without recurrence of hepatocellular carcinoma (HCC). Recurrence-free survival was defined as the time from randomization to the first documented HCC recurrence or death from any cause, whichever occurred first.

Defined as the time from randomization to the first documented disease recurrence by radiological assessment or death due to any cause whichever occurs first, assessed at 1 year
Overall Survival
기간: From randomization through the last available follow-up, approximately two years

The number of participants who were alive at the last available follow-up. Overall survival was defined as the time from randomization to death from any cause or the last date the participant was known to be alive.

From randomization through the last available follow-up, approximately two years
Graft Failure Free Survival
기간: From randomization through the end of study follow-up, approximately two years

Graft Failure Free Survival: The number of participants who remained alive without failure of the transplanted liver. Graft-failure-free survival was defined as the time from randomization to the first documented graft failure according to local clinical standards.

From randomization through the end of study follow-up, approximately two years
Serum Alpha-fetoprotein (AFP) Correlation to Recurrence
기간: From randomization through the end of study follow-up, approximately two years

Serum Alpha-fetoprotein (AFP) Correlation to Recurrence: Among participants who experienced hepatocellular carcinoma (HCC) recurrence, this outcome assessed whether serum alpha-fetoprotein (AFP), a blood biomarker used to monitor HCC, was associated with recurrence.

From randomization through the end of study follow-up, approximately two years
Serum Alpha-fetoprotein (AFP) 24 Months
기간: Assessed at two years

Serum Alpha-fetoprotein (AFP) 24 Months: Serum alpha-fetoprotein (AFP), a blood biomarker used to monitor hepatocellular carcinoma (HCC), was measured during follow-up. Results are reported as the median AFP level at 24 months.

Assessed at two years
Adverse Events Assessed in Terms of Seriousness, Severity, and Relationship to the Study Material According to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0
기간: Assessed from randomization through up to 30 days after last drug dose, approximately two years

See section four, Adverse events and serious adverse events

Assessed from randomization through up to 30 days after last drug dose, approximately two years
Impact of Sorafenib-Tacrolimus Interactions
기간: During the 24-month study treatment periodmeasured at 24 months

Median tacrolimus levels (ng/mL) measured at 24 months

During the 24-month study treatment periodmeasured at 24 months
Wound Complications
기간: During the 24-month study treatment period

Impact of therapy on wound healing

During the 24-month study treatment period
Hepatitis C Viral Recurrence
기간: During the 24-month study treatment period

data was insufficient to analyze the impact of Hepatitis C viral recurrence

During the 24-month study treatment period

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

협력자

수사관

  • 수석 연구원: Fady Kaldas, MD, Jonsson Comprehensive Cancer Center

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2012년 11월 8일

기본 완료 (실제)

2023년 2월 1일

연구 완료 (실제)

2023년 2월 1일

연구 등록 날짜

최초 제출

2012년 6월 18일

QC 기준을 충족하는 최초 제출

2012년 6월 19일

처음 게시됨 (추정된)

2012년 6월 20일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 11월 3일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 10월 9일

마지막으로 확인됨

2023년 2월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • 11-003311
  • NCI-2012-00911 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .