Transcatheter Arterial Chemoembolization (TACE) in Combination With Arsenic Trioxide Versus TACE in the Treatment of Middle-advanced Primary Hepatocellular Carcinoma (HCC) Patients
2017년 2월 21일 업데이트: Xiang Hua, Hunan Provincial People's Hospital
A Prospective Multicenter Randomized Controlled Open-label Trial of Transcatheter Arterial Chemoembolization (TACE) in Combination With Arsenic Trioxide Versus TACE in the Treatment of Middle-advanced Primary Hepatocellular Carcinoma (HCC) Patients
A multicentre, randomized, open-label, parallel-group, active controlled study.
연구 개요
상세 설명
Primary hepatocellular carcinoma (HCC) is one of the most common types of cancer and accounts for significant morbidity and mortality worldwide. Notably, more than half of the new HCC cases and deaths develop in China. Transarterial chemoembolization (TACE) has been proposed as the first-line therapeutic strategy for the treatment of patients with unresectable HCC. However, TACE has several limitations itself which might be potentially associated with tumor metastasis and relapse.
Recent studies have demonstrated that arsenic trioxide (As2O3) can act as the first-line therapeutic option in the treatment of acute promyelocytic leukemia. Thereafter, several small studies in China showed promising clinical benefits when As2O3 is administrated among the HCC patients. With these preliminary results, the investigators are planning to carry out a multicenter randomized controlled trial through which to explore the potential efficacy and safety of adjuvant As2O3 treatment for HCC patients.
연구 유형
중재적
등록 (예상)
190
단계
- 2 단계
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 장소
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Guizhou
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Guiyang, Guizhou, 중국
- Guizhou Cancer Hospital
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Guiyang, Guizhou, 중국
- Guizhou Province Tumor Hospital
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Hunan
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Changsha, Hunan, 중국
- Hunan Cancer Hospital
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Changsha, Hunan, 중국
- Xiangya Hospital Central South University
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Changsha, Hunan, 중국, 410001
- Hunan Provincial People's Hospital
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Hengyang, Hunan, 중국
- The First Affiliated Hospital of University of South China
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Jiangsu
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Nanjing, Jiangsu, 중국
- Jiangsu Province Hospital
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Xinjiang
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Urumqi, Xinjiang, 중국
- Xinjiang Medical University Cancer Hospital
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Yunnan
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Kunming, Yunnan, 중국
- The Tumor Hospital of Yunnan Province
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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
18년 (성인, 고령자)
건강한 자원 봉사자를 받아들입니다
아니
연구 대상 성별
모두
설명
- Subject is 18-80 years old.
- Subject has no portal stem vein tumor thrombus.
- Subject has primary middle-advanced liver cancer of Barcelona Clinic Liver Cancer stages B/C inappropriate for surgical resection or other locoregional therapy and still presents with tumor lesions in the liver.
- Subject has evaluable tumor lesion(s) (using Magnetic Resonance Imaging /Computed Tomography) according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) Version 1.1: single lesion size ≥5cm or at least one lesion of >3cm in size when 2-3 lesions exist or there are 4 or more lesions.
- Subject has an Eastern Cooperative Oncology Group (ECOG) performance status ≤1, Fibrosis index based on 4 factors (FIB-4)≤6 and an expected survival time of 12 weeks or more.
- Haematology: white blood cell count ≥3.0×10^9/L; hemoglobin≥10 g/dL; blood platelet count≥80×10^9/L
- Blood biochemistry: serum albumin ≥2.8 g/dL, total bilirubin ≤2 mg/dL or ≤34.2 umol/L, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2 times of upper limit of normal (ULN); amylase and lipase ≤ 1.5 times of ULN; serum creatinine ≤2.0 mg/dL or < 1.5 times of ULN; estimated creatinine clearance ≥60 mL/min.
- International normalized ratio (INR) is ≤ 2.3 or prothrombin time (PT) is ≤3 seconds than upper limit of normal control.
- Echocardiogram indicated a left ventricular ejection fraction (LVEF) of >50%.
- Subject has a liver function Child-Pugh class A or B.
- Subject is not pregnant or lactating.
- Female subjects must be infertile or agree to take effective contraceptives; male subjects and their partners of reproductive potential must also agree to use appropriate contraceptives.
- Subject had no second tumor in the last 5 years, excluding skin basal cell carcinoma or skin squamous carcinoma or any other carcinoma in situ.
- Subject had no history of systemic chemotherapy.
- Subject has no any other concomitant anticancer therapies, such as local radiotherapy, systemic chemotherapy and molecular targeted therapy.
- Subject and (or) guardian is able to understand this study and willing to provide written, informed consent to participate in this clinical study.
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: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
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실험적: TACE plus Arsenic Trioxide
Patients in this group are to receive a single dose of TACE treatment on day 1, followed by arsenic trioxide at 10 mg/day for 14 days (day 8-21).
TACE treatment is repeated every 9 weeks while arsenic trioxide every 3 weeks for treatment duration of 27 weeks.
At least 3 cycles of arsenic trioxide are administrated.
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After the puncture of femoral artery via Seldinger method, a catheter was inserted and digital celiac axis or hepatic arteriography performed.
Then a microcatheter was used to infuse chemotherapeutic agent (30 to 60 mg of pirarubicin) mixed with 5 to 20 mL of Lipiodol Ultra-Fluid.
Embosphere microspheres (size of 100 to 300 um) were inserted for embolization.
Arsenic trioxide 10 mg is put into 500 ml saline solution and then administrated by continuous intravenous drip for 5 hours during a treatment day.
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활성 비교기: TACE
Patients in this group are to receive a single dose of TACE treatment on day 1.
TACE treatment is repeated every 9 weeks for 27 weeks.
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After the puncture of femoral artery via Seldinger method, a catheter was inserted and digital celiac axis or hepatic arteriography performed.
Then a microcatheter was used to infuse chemotherapeutic agent (30 to 60 mg of pirarubicin) mixed with 5 to 20 mL of Lipiodol Ultra-Fluid.
Embosphere microspheres (size of 100 to 300 um) were inserted for embolization.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Progression free survival
기간: 2-year
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Progression free survival (PFS) is defined as the time interval from the day of the random assignment to the first evidence of progression or death.
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2-year
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Objective response rate
기간: 2-year
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Tumor response is defined as complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) according to RECIST and will be assessed by the investigators.
The tumor objective response rate (ORR) is calculated per treatment arm as the proportion of randomized patients having a confirmed best response of CR or PR.
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2-year
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Overall Survival
기간: 2-year
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Overall survival will be measured from the date of randomization up to the date of death of any cause
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2-year
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Incidence of adverse events
기간: Up to 2 years through study completion
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Toxicities will be evaluated and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v 4.0.
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Up to 2 years through study completion
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기타 결과 측정
결과 측정 |
기간 |
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Quality of life using EuroQol five dimensions five levels questionnaire
기간: Baseline and week 6, 12, 18, 24 and 30 using EuroQol five dimensions five levels questionnaire
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Baseline and week 6, 12, 18, 24 and 30 using EuroQol five dimensions five levels questionnaire
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공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: Hua Xiang, Dr., Hunan Provincial People's Hospital
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
2016년 11월 1일
기본 완료 (예상)
2019년 11월 1일
연구 완료 (예상)
2020년 11월 1일
연구 등록 날짜
최초 제출
2016년 11월 2일
QC 기준을 충족하는 최초 제출
2016년 11월 4일
처음 게시됨 (추정)
2016년 11월 6일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2017년 2월 23일
QC 기준을 충족하는 마지막 업데이트 제출
2017년 2월 21일
마지막으로 확인됨
2017년 2월 1일
추가 정보
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