Carcinoma, Hepatocellular, PHENYTOIN/SORAFENIB [VA Drug Interaction]
Conditions
Keywords
hepatocellular carcinoma, transarterial chemoembolization, sorafenib
Brief summary
TACE is widely used in patients with unresectable HCC. However, it is a non-curative approach; thus ,strategies to further improve the survival of these patients are needed. Sorafenib is regarded as standard treatment for advanced HCC. It is the first systemic therapy to demonstrate a significant survival benefit in HCC patients.The hypothesis is that the combination of TACE with sorafenib could improve the survival of patients with unresectable HCC.
Interventions
PROCEDURETACE
After obtaining arterial access,a diagnostic visceral arteriogram will be performed to demonstrate arterial supply to the tumor and the presence of variant arterial anatomy.After having positioned the catheter within the artery feeding tumor,the chemoembolization mixture will be infused into th e artery until stagnant flow is observed.
DRUGsorafenib combined with TACE
All patients will receive Sorafenib (800 mg/day) p.o. beginning four weeks after the first TACE and every day thereafter until patient death or premature withdrawal from study
Sponsors
Shandong Cancer Hospital and Institute
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patients newly diagnosed as HCC according to European Association for Study of the Liver criteria. * BCLC stage B or C * Child-Pugh class score≤8 * ECOG performance status ≤2 * Etiology: Hepatitis B virus(HBV) infection * Written informed consent (approved by the Institutional Review Board \[IRB\]obtained prior to any study specific screening procedures * Patient must be able to comply with the protocol * Age 18-75 years * Haematology:Absolute neutrophil count (ANC) \> 1.5 x 109/L, Platelet count \> 50 x 109/L, Haemoglobin \> 9 g/dL (may be transfused to maintain or exceed this level) Prothrombin time international normalized ratio \< 1.5 * Biochemistry:Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)\< 5 x the upper limit of normal,Total bilirubin \< 3 x the upper limit of normal,Serum creatinine \< 1.5 x the upper limit of normal,Cholinesterase\>0.5x the lower limit of normal，Prealbumin\>0.5x the lower limit of normal. * Life expectancy of \> 3 months
Exclusion criteria
* BCLC stage D * Child-Pugh Score≥9 * Clinically severe gastrointestinal bleeding within 4 weeks of the start of treatment * Preexisting or history of hepatic encephalopathy * uncontrolled hypertension * Pregnancy (positive serum pregnancy test) or lactation * Serious, non-healing wound, ulcer, or bone fracture * Currently or recent (within the 30 days prior to starting study treatment) treatment of another investigational drug or participation in another investigational study * Clinically significant (i.e. active) cardiovascular disease for example cerebrovascular accidents ( ≤ 6 months prior to study entry), myocardial infarction ( ≤ 6 months prior to study entry), unstable angina, New York Heart Association (NYHA) grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication * Evidence of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates use of Sorafenib/TACE or patient at high risk from treatment complications * Other severe concomitant disease that may reduce life expectancy * Risk of allergic reactions to the study drugs * Drug abuse or other physical, psychological , or social problems that may interfere with the participation in the study or evaluation of study results
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to Progression | 1 year | Time to progression is defined as time from randomization to radiological progression and will be evaluated every 8 week |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disease control rate | six months after TACE | CR+PR+SD |
| Safety | six months | Number of participants with adverse events as a measure of safety and tolerability(According to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0) |
| FACT-Hep | six months | FACT-Hep is a chart established to evaluate the life quality of patients with HCC every 4 weeks |
| Number of TACE sessions and the interval time between two TACE sessions | 2 years | — |
| AFP | six months | — |
| PFS and OS | two years | The overall survival is defined as time from randomization to death due to any cause, and will be evaluated every 8 weeks in the protocol treatment, and every one year in the follow-up period,respectively |
Countries
China
Contacts
Primary ContactJinlong Song, MD
Backup ContactWenbo Shao, MD,Ph D
Outcome results
None listed