Hepatocellular Carcinoma
Conditions
Keywords
Hepatocellular Carcinoma, HCC, Liver cancer, Child Pugh A, HCC Stage C
Brief summary
The purpose of this open-label, randomized, phase II study is to compare the safety and efficacy of dovitinib versus sorafenib as first-line treatment in adult patients with advanced Hepatocellular Carcinoma (HCC). This trial will be opened in countries of the Asia-Pacific region.
Interventions
500 mg p.o. o.d. 5 days on/2 days off
400 mg p.o. b.i.d.
Sponsors
Study design
Eligibility
Inclusion criteria
Diagnosis of advanced Hepatocellular Carcinoma (HCC) according to the AASLD Guidelines * Advance HCC Stage B and C according to BCLC staging classification * Child Pugh A * At least one measurable lesion as assessed by CT or MRI * ECOG PS of 0 or 1 * Adequate bone marrow, liver, and renal function
Exclusion criteria
* Prior systemic therapy for HCC * Brain metastases * Active bleeding (including variceal bleeding as the result of esophageal varices) Patients who have received a liver transplant or are awaiting an immediate transplant Other protocol-defined inclusion/
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival - Overall Survival | Every 6 weeks from date of randomization until the patient has progressed, or the patient can no longer be followed, or at least 130 deaths have been observed in the study, whichever came first. | The overall survival (OS), defined as the time from date of randomization to the date of death from any cause. If a patient was not known to have died at the date of analysis cut-off, OS was censored at the last date of contact. Survival information was collected every 6 wks until at least 130 deaths have been observed |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disease Control Rate (Tumor Assessment) | Every 6 weeks from date of randomization until the patient has progressed, or the patient can no longer be followed, or at least 130 deaths have been observed in the study, whichever came first. | Disease Control Rate (DCR) is defined as the proportion of patients whose best overall response is either complete response \[CR\], partial response \[PR\] or stable disease \[SD\] according to RECIST 1.1. |
| Time to Definitive Deterioration in ECOG Performance Status (PS) | Every 6 weeks from date of randomization until the patient has progressed, or the patient can no longer be followed, or at least 130 deaths have been observed in the study, whichever came first | Time to definitive deterioration on ECOG PS scale (by at least one point) was defined as the time from the date of randomization to the date of definitive deterioration of the ECOG PS by at least one category of the score from baseline or to the date of death whichever occurred earlier. 0 is Fully active, able to carry on all pre-disease performance without restriction, 1 is Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g. light housework, office work and 2 is ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours. |
| Time to Tumor Progression (Tumor Assessment) | Every 6 weeks from date of randomization until the patient has progressed, or the patient can no longer be followed, or at least 130 deaths have been observed in the study, whichever came first. | Disease progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1). For target lesions, disease progression mean at least a 20% increase in the sum of diameter of all measured target lesions, taking as reference the smallest sum of diameter of all target lesions recorded at or after baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. For non-target lesions, disease progression refers to unequivocal progression of existing non-target lesions. In addition, the appearance of new lesions is always considered as disease progression. |
| Pharmacokinetic (PK) Parameter of Tmax Following a Single Dose of TKI258 | Week 1 day 1, week 4 day 5 | Tmax will be evaluated after a single dose of TKI258 following a 5 days on/2 days off dosing schedule. Tmax is the time to to reach maximum (peak) plasma, blood, serum, or other body fluid drug concentration after a single dose administration (time) |
| Pharmacokinetic (PK) Parameter of AUCtau Following a Single Dose of TKI258 | Week 1 day 1, week 4 day 5 | The mean AUC from time zero to the last measurable concentration sampling time (t last) (mass x time x volume-1) |
| Pharmacokinetic (PK) Parameter of Cmax Following a Single Dose of TKI258 | Week 1 day 1, week 4 day 5 | Cmax will be evaluated after a single dose of TKI258 following a 5 days on/2 days off dosing schedule. Cmax is the maximum (peak) observed plasma, blood, serum, or other body fluid drug concentration after a single dose administration (mass x volume - 1). |
Countries
China, Hong Kong, Japan, Singapore, South Korea, Taiwan, Thailand
Participant flow
Pre-assignment details
165 Participants were screened and randomized. However 3 participants discontinued prior to recieving study drug. The number enrolled in the protocol section reflects the randomized participants who received study drug.
Participants by arm
| Arm | Count |
|---|---|
| TKI258 500 mg capsules p.o. o.d. 5 days on/2 days off | 82 |
| Sorafenib 400 mg tablet p.o. b.i.d. | 83 |
| Total | 165 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 24 | 12 |
| Overall Study | Death | 1 | 6 |
| Overall Study | Physician Decision | 1 | 1 |
| Overall Study | Progressive disease | 43 | 61 |
| Overall Study | Study terminated by sponsor | 0 | 1 |
| Overall Study | Subject/guardian decision | 10 | 2 |
| Overall Study | Technical problems | 3 | 0 |
Baseline characteristics
| Characteristic | TKI258 | Sorafenib | Total |
|---|---|---|---|
| Age, Continuous | 55.5 Years STANDARD_DEVIATION 12.16 | 56.2 Years STANDARD_DEVIATION 11.72 | 55.8 Years STANDARD_DEVIATION 11.91 |
| Sex: Female, Male Female | 9 Participants | 16 Participants | 25 Participants |
| Sex: Female, Male Male | 73 Participants | 67 Participants | 140 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 77 / 79 | 80 / 83 |
| serious Total, serious adverse events | 40 / 79 | 34 / 83 |
Outcome results
Overall Survival - Overall Survival
The overall survival (OS), defined as the time from date of randomization to the date of death from any cause. If a patient was not known to have died at the date of analysis cut-off, OS was censored at the last date of contact. Survival information was collected every 6 wks until at least 130 deaths have been observed
Time frame: Every 6 weeks from date of randomization until the patient has progressed, or the patient can no longer be followed, or at least 130 deaths have been observed in the study, whichever came first.
Population: The Full Analysis Set (FAS) comprises of all patients to whom study treatment had been assigned by randomization. According to the intent to treat principle, patients were analyzed according to the treatment (and strata) they were assigned to during the randomization procedure.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| TKI258 | Overall Survival - Overall Survival | 33 Weeks |
| Sorafenib | Overall Survival - Overall Survival | 39.4 Weeks |
Disease Control Rate (Tumor Assessment)
Disease Control Rate (DCR) is defined as the proportion of patients whose best overall response is either complete response \[CR\], partial response \[PR\] or stable disease \[SD\] according to RECIST 1.1.
Time frame: Every 6 weeks from date of randomization until the patient has progressed, or the patient can no longer be followed, or at least 130 deaths have been observed in the study, whichever came first.
Population: The Full Analysis Set (FAS) comprises of all patients to whom study treatment had been assigned by randomization. According to the intent to treat principle, patients were analyzed according to the treatment (and strata) they were assigned to during the randomization procedure.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| TKI258 | Disease Control Rate (Tumor Assessment) | Partial response (PR) | 5 Participants |
| TKI258 | Disease Control Rate (Tumor Assessment) | Progressive disease | 17 Participants |
| TKI258 | Disease Control Rate (Tumor Assessment) | Stable disease (SD) | 42 Participants |
| TKI258 | Disease Control Rate (Tumor Assessment) | Unknown (UNK) | 18 Participants |
| TKI258 | Disease Control Rate (Tumor Assessment) | Complete response (CR) | 0 Participants |
| Sorafenib | Disease Control Rate (Tumor Assessment) | Unknown (UNK) | 8 Participants |
| Sorafenib | Disease Control Rate (Tumor Assessment) | Complete response (CR) | 1 Participants |
| Sorafenib | Disease Control Rate (Tumor Assessment) | Partial response (PR) | 8 Participants |
| Sorafenib | Disease Control Rate (Tumor Assessment) | Stable disease (SD) | 44 Participants |
| Sorafenib | Disease Control Rate (Tumor Assessment) | Progressive disease | 22 Participants |
Pharmacokinetic (PK) Parameter of AUCtau Following a Single Dose of TKI258
The mean AUC from time zero to the last measurable concentration sampling time (t last) (mass x time x volume-1)
Time frame: Week 1 day 1, week 4 day 5
Population: The Full-PK analysis set: all patients who were selected for full PK sampling and provided at least one evaluable PK concentration profile
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| TKI258 | Pharmacokinetic (PK) Parameter of AUCtau Following a Single Dose of TKI258 | Week 1 Day 1 | 5774.69 (ng.h/mL) | Standard Deviation 1616.159 |
| TKI258 | Pharmacokinetic (PK) Parameter of AUCtau Following a Single Dose of TKI258 | Week 4 Day 5 (n=23) | 6493.99 (ng.h/mL) | Standard Deviation 2409.119 |
Pharmacokinetic (PK) Parameter of Cmax Following a Single Dose of TKI258
Cmax will be evaluated after a single dose of TKI258 following a 5 days on/2 days off dosing schedule. Cmax is the maximum (peak) observed plasma, blood, serum, or other body fluid drug concentration after a single dose administration (mass x volume - 1).
Time frame: Week 1 day 1, week 4 day 5
Population: The Full-PK analysis set: all patients who were selected for full PK sampling and provided at least one evaluable PK concentration profile
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| TKI258 | Pharmacokinetic (PK) Parameter of Cmax Following a Single Dose of TKI258 | Week 1 Day 1 (n=71) | 326.25 (ng/mL) | Standard Deviation 100.405 |
| TKI258 | Pharmacokinetic (PK) Parameter of Cmax Following a Single Dose of TKI258 | Week 4 Day 5 (n=23) | 364.04 (ng/mL) | Standard Deviation 131.973 |
Pharmacokinetic (PK) Parameter of Tmax Following a Single Dose of TKI258
Tmax will be evaluated after a single dose of TKI258 following a 5 days on/2 days off dosing schedule. Tmax is the time to to reach maximum (peak) plasma, blood, serum, or other body fluid drug concentration after a single dose administration (time)
Time frame: Week 1 day 1, week 4 day 5
Population: The Full-PK analysis set: all patients who were selected for full PK sampling and provided at least one evaluable PK concentration profile
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| TKI258 | Pharmacokinetic (PK) Parameter of Tmax Following a Single Dose of TKI258 | Week 4 Day 5 (n=23) | 5.9 hours |
| TKI258 | Pharmacokinetic (PK) Parameter of Tmax Following a Single Dose of TKI258 | Week 1 Day 1(71) | 6 hours |
Time to Definitive Deterioration in ECOG Performance Status (PS)
Time to definitive deterioration on ECOG PS scale (by at least one point) was defined as the time from the date of randomization to the date of definitive deterioration of the ECOG PS by at least one category of the score from baseline or to the date of death whichever occurred earlier. 0 is Fully active, able to carry on all pre-disease performance without restriction, 1 is Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g. light housework, office work and 2 is ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours.
Time frame: Every 6 weeks from date of randomization until the patient has progressed, or the patient can no longer be followed, or at least 130 deaths have been observed in the study, whichever came first
Population: The Full Analysis Set (FAS): all patients to whom study treatment had been assigned by randomization. According to the intent to treat principle, patients were analyzed according to the treatment (and strata) they were assigned to during the randomization procedure. Only Total number of definitive deterioration events included in the analysis
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| TKI258 | Time to Definitive Deterioration in ECOG Performance Status (PS) | 22.3 Weeks |
| Sorafenib | Time to Definitive Deterioration in ECOG Performance Status (PS) | 21.3 Weeks |
Time to Tumor Progression (Tumor Assessment)
Disease progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1). For target lesions, disease progression mean at least a 20% increase in the sum of diameter of all measured target lesions, taking as reference the smallest sum of diameter of all target lesions recorded at or after baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. For non-target lesions, disease progression refers to unequivocal progression of existing non-target lesions. In addition, the appearance of new lesions is always considered as disease progression.
Time frame: Every 6 weeks from date of randomization until the patient has progressed, or the patient can no longer be followed, or at least 130 deaths have been observed in the study, whichever came first.
Population: The Full Analysis Set (FAS) comprises of all patients to whom study treatment had been assigned by randomization. According to the intent to treat principle, patients were analyzed according to the treatment (and strata) they were assigned to during the randomization procedure.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| TKI258 | Time to Tumor Progression (Tumor Assessment) | 17.6 Weeks |
| Sorafenib | Time to Tumor Progression (Tumor Assessment) | 17.9 Weeks |