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
研究概览
详细说明
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.
研究类型
阶段
- 阶段2
联系人和位置
学习地点
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Florida
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Tampa、Florida、美国、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、美国、10467
- Montefiore Medical Center
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的: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. |
其他名称:
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
用美法仑/HDS 治疗后出现不良事件的患者人数。
大体时间:2年
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2年
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Number of patients with adverse events after treatment with Sorafenib following treatment with Melphalan/HDS.
大体时间:2 years
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2 years
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马法兰/HDS 治疗的客观反应率百分比
大体时间:2年
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2年
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Progression free survival in months of patients receiving Melphalan/HDS treatment followed by Sorafenib
大体时间:2 years
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2 years
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
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AUC of melphalan after Melphalan/HDS treatment
大体时间: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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Pharmacokinetic study
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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
大体时间: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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合作者和调查者
调查人员
- 研究主任:Leslie Callahan, RN、Delcath Systems
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
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