Hepatocellular Carcinoma
Conditions
Brief summary
The purpose of this study is to compare the overall survival (OS) for Orantinib in combination with transcatheter arterial chemoembolization (TACE) versus placebo in combination with TACE in patients with unresectable hepatocellular carcinoma (HCC).
Detailed description
This is a randomized, multi-center, double-blind, placebo-controlled phase III trial of Orantinib administered in combination with TACE in patients with unresectable HCC. Patients will be randomly assigned (1:1) to receive TACE given in combination with either Orantinib (200 mg orally, twice per day) or placebo. ORIENTAL:ORantinib InvEstigatioN on TAce combination triaL.
Interventions
200 mg (1 tablet) of Orantinib was administered orally twice per day after meals, morning and evening.
1 tablet was administered orally twice per day after meals, morning and evening.
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients must be diagnosed as HCC. * Patients has no indications for treatment with curative hepatic resection or curative percutaneous local therapy. * Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1. * Patients are able to receive oral medication.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Overall Survival(OS) | The time from the date of enrollment to the date of death from any cause, assessed up to three years after randomizationof the last patient |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Transcatheter Arterial Chemoembolization (TACE) Failure | The time from the date of enrollment to the date of event for TACE discontinuation, assessed up to three years after randomizationof the last patient | Patients should not receive additional TACE therapy in this study after meeting any of the following conditions, at the Investigator's discretion. 1. The patient develops an intra-hepatic lesion that is uncontrolled by serial TACE 2. Deterioration in arterial pathways to treat HCC that makes additional TACE impossible 3. Severe vascular invasion occurs that makes additional TACE impossible 4. Extra hepatic spread considered relevant to life expectancy that requires another treatment modality for HCC 5. Liver function at grade Child-Pugh class C lasting for 28 days |
Countries
Japan, South Korea, Taiwan
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Orantinib Orantinib (TSU-68): 200 mg (1 tablet) of Orantinib was administered orally twice per day after meals, morning and evening. | 444 |
| Placebo Placebo: 1 tablet was administered orally twice per day after meals, morning and evening. | 444 |
| Total | 888 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 96 | 49 |
| Overall Study | Lack of Efficacy | 139 | 190 |
| Overall Study | Ongoing treatment at cutoff date | 140 | 166 |
| Overall Study | Other | 9 | 3 |
| Overall Study | Physician Decision | 13 | 5 |
| Overall Study | Protocol Violation | 1 | 1 |
| Overall Study | Withdrawal by Subject | 46 | 30 |
Baseline characteristics
| Characteristic | Placebo | Orantinib | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 242 Participants | 255 Participants | 497 Participants |
| Age, Categorical Between 18 and 65 years | 202 Participants | 189 Participants | 391 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 444 Participants | 444 Participants | 888 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 0 Participants | 0 Participants | 0 Participants |
| Region of Enrollment Japan | 213 participants | 219 participants | 432 participants |
| Region of Enrollment South Korea | 170 participants | 170 participants | 340 participants |
| Region of Enrollment Taiwan | 61 participants | 55 participants | 116 participants |
| Sex: Female, Male Female | 80 Participants | 81 Participants | 161 Participants |
| Sex: Female, Male Male | 364 Participants | 363 Participants | 727 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 33 / 444 | 24 / 444 |
| other Total, other adverse events | 443 / 444 | 436 / 444 |
| serious Total, serious adverse events | 200 / 444 | 134 / 444 |
Outcome results
Overall Survival(OS)
Time frame: The time from the date of enrollment to the date of death from any cause, assessed up to three years after randomizationof the last patient
Population: When approximately 50% of the targeted number of time to TACE discontinuation events were confirmed, interim analysis was performed by IDMC.~Because the Committee considered that significant results would no longer be obtained, the IDMC recommended to the Sponsor that the clinical trial would be discontinued, and the Sponsor stopped this trial.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Orantinib | Overall Survival(OS) | 946.0 days |
| Placebo | Overall Survival(OS) | 984.0 days |
Time to Transcatheter Arterial Chemoembolization (TACE) Failure
Patients should not receive additional TACE therapy in this study after meeting any of the following conditions, at the Investigator's discretion. 1. The patient develops an intra-hepatic lesion that is uncontrolled by serial TACE 2. Deterioration in arterial pathways to treat HCC that makes additional TACE impossible 3. Severe vascular invasion occurs that makes additional TACE impossible 4. Extra hepatic spread considered relevant to life expectancy that requires another treatment modality for HCC 5. Liver function at grade Child-Pugh class C lasting for 28 days
Time frame: The time from the date of enrollment to the date of event for TACE discontinuation, assessed up to three years after randomizationof the last patient
Population: When approximately 50% of the targeted number of time to TACE discontinuation events were confirmed, interim analysis was performed by IDMC.~Because the Committee considered that significant results would no longer be obtained, the IDMC recommended to the Sponsor that the clinical trial would be discontinued, and the Sponsor stopped this trial.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Orantinib | Time to Transcatheter Arterial Chemoembolization (TACE) Failure | 728.0 days |
| Placebo | Time to Transcatheter Arterial Chemoembolization (TACE) Failure | 602.0 days |