Hepatocellular carcinoma (HCC) MedDRA version: 19.0 Level: LLT Classification code 10019829 Term: Hepatocellular carcinoma recurrent System Organ Class: 100000004864
Conditions
Sponsors
Bayer AG
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: • Signed informed consent (IC) obtained before any study specific procedure. Patients must be able to understand and willing to sign the written informed consent. • Male or female patients =18 years of age. • Histological or cytological confirmation of HCC or non-invasive diagnosis of HCC as per American Association for the Study of Liver Diseases (AASLD) criteria in patients with a confirmed diagnosis of cirrhosis. • Barcelona Clinic Liver Cancer (BCLC) stage Category B or C that cannot benefit from treatments of established efficacy with higher priority such as resection, local ablation, chemoembolization or systemic sorafenib. • Failure to prior treatment with sorafenib (defined as documented radiological progression according to the radiology charter). Randomization needs to be performed within 10 weeks after the last treatment with sorafenib. • Tolerability of prior treatment with sorafenib defined as not less than 20 days at a minimum daily dose of 400 mg QD within the last 28 days prior to withdrawal. • Liver function status Child-Pugh Class A. Child Pugh status should be calculated based on clinical findings and laboratory results during the screening period. • Local or loco-regional therapy of intrahepatic tumor lesions (e.g. surgery, radiation therapy, hepatic arterial embolization, chemoembolization, radiofrequency ablation, percutaneous ethanol injection, or cryoablation) must have been completed = 4 weeks before first dose of study medication. Note: patients who received sole intrahepatic intraarterial chemotherapy, without lipiodol or embolizing agents are not eligible • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1. • Adequate bone marrow, liver and renal function as assessed by the following laboratory tests conducted within 7 days before randomization: o Hemoglobin > 8.5 g/dl o Absolute neutrophil count (ANC) = 1500/mm3 o Platelet count = 60,000/mm3 o Total bilirubin = 2 mg/dl. Mildly elevated total bilirubin (<6 mg/dL) is allowed if Gilbert's syndrome is documented. o Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) = 5 x upper limit of normal (ULN) o Prothrombin time-international normalized ratio (PT-INR) < 2.3 x (ULN) and PTT < 1.5 X (ULN). Patients who are therapeutically anticoagulated with an agent such as warfarin or heparin will be allowed to participate provided that no prior evidence of underlying abnormality in this parameter exists. Close monitoring of at least weekly evaluations will be performed until INR/PTT is stable based on a measurement that is pre-dose as defined by the local standard of care. o Serum creatinine = 1.5 x ULN o Lipase = 2 x ULN • Glomerular filtration rate (GFR) = 30 ml/min/1.73 m2 according to the Modification of diet in renal disease (MDRD) study equation • At least one uni-dimensional measurable lesion by computed tomography (CT) scan or magnetic resonance imaging (MRI) according to RECIST (RECIST version 1.1), and modified RECIST for HCC. Tumor lesions situated in a previously irradiated area, or in an area subjected to other loco-regional therapy, may be considered measurable if there has been demonstrated progression in the lesion. • Life expectancy of at least 3 months. • Women of childbearing potential and men must agree to use adequate contraception since signing of the informed consent form until at least 2 months after the last study drug administration. The investigator or a designated associate is requested to advise the subje
Exclusion criteria
Exclusion criteria: • Prior liver transplantation or candidates for liver transplantation • Prior treatment with regorafenib. Patients permanently withdrawn from study participation will not be allowed to re-enter the study. • Prior and/or concomitant treatment within a clinical study other than with sorafenib during or within 4 weeks of randomization. • Sorafenib treatment within 2 weeks of randomization. • Patients with large esophageal varices at risk of bleeding that are not being treated with conventional medical intervention: beta blockers or endoscopic treatment. Assessment of esophageal varices for patients in whom conventional medical intervention for known esophageal varices is already in place should be performed by endoscopy as per local standard of care. • Prior systemic treatment for HCC, except sorafenib. • Permanent discontinuation of prior sorafenib therapy due to sorafenib related toxicity. • Permanent discontinuation of prior sorafenib therapy due to any cause more than 10 weeks prior to randomization. • Past or concurrent history of neoplasm other than HCC, except for in situ carcinoma of the cervix uteri and/or non-melanoma skin cancer and superficial bladder tumors (Ta [Noninvasive tumor], Tis [Carcinoma in situ] and T1 [Tumor invades lamina propria]). Any cancer curatively treated > 3 years prior to study entry is permitted. • Known history or symptomatic metastatic brain or meningeal tumors (head CT or MRI at screening to confirm the absence of central nervous system [CNS] disease if patient has symptoms suggestive or consistent with CNS disease). • Major surgical procedure or significant traumatic injury within 28 days before randomization. • Congestive heart failure New York Heart Association (NYHA) = class 2 • Unstable angina (angina symptoms at rest, new-onset angina i.e., within the last 3 months) or myocardial infarction (MI) within the past 6 months before randomization. • Cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted). • Uncontrolled hypertension (systolic blood pressure [BP] > 150 mmHg or diastolic pressure > 90 mmHg despite optimal medical management). • Patients with phaeochromocytoma. • Uncontrolled ascites (defined as not easily controlled with diuretic or paracentesis treatment). • Pleural effusion or ascites that causes respiratory compromise (NCI-CTCAE version 4.0 Grade =2 dyspnea). • Persistent proteinuria of NCI-CTCAE version 4.0 Grade 3 or higher. Urine dipstick result of 3+ is allowed if protein excretion (estimated by urine protein/creatinine ratio on a random urine sample) is Grade 2 according to NCI-CTCAE version 4.0. Hepatitis B is allowed if no active replication is present. Hepatitis C is allowed if no antiviral treatment is required. • Clinically significant bleeding NCI-CTCAE version 4.0 Grade 3 or higher within 30 days before randomization. • Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism within 6 months before the start of study medication. • Unresolved toxicity higher than NCI-CTCAE version 4.0 Grade 1 (excluding alopecia or anemia) attributed to any prior therapy/procedure. • Any illness or medical condition that is unstable or could jeopardize the safety of the patient and his/her compliance in the study. • Known history of human immunodeficiency virus (HIV) infection. • Seizure disorder requiring
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: The objective of this study is to evaluate efficacy and safety of regorafenib in patients with HCC who have progressed after sorafenib;Secondary Objective: None;Primary end point(s): Overall survival (OS) ;Timepoint(s) of evaluation of this end point: The time (days) from randomisation to death due to any cause | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): • Time to progression (TTP) • Progression free survival (PFS) • Objective tumor response rate (ORR) • Disease control rate (DCR = CR + PR + SD) ;Timepoint(s) of evaluation of this end point: Approximately 33 months | — |
Countries
Argentina, Australia, Austria, Belgium, Brazil, China, Czech Republic, France, Germany, Hungary, Italy, Japan, Korea, Republic of, Netherlands, Russian Federation, Singapore, Spain, Switzerland, Taiwan, United Kingdom, United States
Contacts
Public ContactClinical Trials Contact
Bayer AG
Outcome results
None listed