Study of Sunitinib in Patients With Advanced/Inoperable Fibrolamellar Carcinoma

Hepatocellular Carcinoma Clinical Trial

— Fibrolam  

Official title:

A Multicenter National Phase II Open Study Coupled With Translational Assessment of Biomarkers Predictive of Response to Sunitinib in Patients With Advanced/Inoperable Fibrolamellar Hepatocellular Carcinoma.

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT01215565
• Other study ID #: P070134
• Secondary ID: 2008-003423-23
• Status: Terminated
• Phase: Phase 2
• First received: September 24, 2010
• Last updated: March 12, 2014
• Start date: October 2009
• Est. completion date: May 2012

Study information

• Verified date: March 2014
• Source: Assistance Publique - Hôpitaux de Paris
• Contact: n/a
• Is FDA regulated: No
• Health authority: France: Ministry of Health
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the antitumor activity of sunitinib in patients with advanced/inoperable fibrolamellar hepatocellular carcinoma.

Rationale: Sunitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor

Description:

Fibrolamellar hepatocellular carcinoma is variant rare of hepatocellular carcinoma witch distinct clinical, histological and prognostic features from conventional hepatocellular carcinoma. This entity typically occurs in young adults with no underlying hepatitis or cirrhosis. Surgical resections could be proposed in some referral centers and this in cases of localized tumors. However, in cases of postoperative recurrence, "salvage" resection is not often possible. Overall prognosis remains poor, because of its primary chemoresistance and early recurrence of metastasis.

Sunitinib (SUTENT) is a potent tyrosine kinase inhibitor, with double antiangiogenic and antitumor activity, targeting multiple receptors as VEGF-R, PDGF-R, KIT and FLT3.

Since 2006, Sunitinib has been approved to treat advanced kidney cancer also called advanced renal cell carcinoma (a typically chemoresistant disease for which there no active treatment was available).

Several targets of sunitinib are overexpressed hepatocellular carcinoma lines as shown in the Literature review and pathological studies.

Otherwise, the overexpression of PDGFR and VEGFR correlates with recurrence and invasion in HCC. Finally, sunitinib showed an interesting antitumor activity in patients with conventional advanced HCC.

Thereby, it seems important to study how well the sunitinib, a potent antitumor and antiangiogenic agent, works in treating patients with advanced or inoperable fibrolamellar hepatocellular carcinoma especially, this setting lacks effective therapies. Furthermore, it seems urgent to conduct translational research and assessment to identify predictive biomarkers of response.

In this study, orally sunitinib at dosed of 50 mg daily will be administrated to patients for 4 weeks, followed by 2 weeks of wash out. This administration schedule is based on the phase I study of sunitinib.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 4
• Est. completion date: May 2012
• Est. primary completion date: May 2011
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Fibrolamellar hepatocellular carcinoma histopathologically proven

• Inoperable/advanced (Tumor recurrence inoperable or metastatic with no surgical indication).

• Available Tumor tissue for analysis(biopsy or surgical specimen)

• Performance status WHO = 2.

• Adequate organ function :

• Hematology (absolute neutrophil count equal or superior to 1,5 x 10*9/l , platelet equal or superior to 100 x 10*9/l),

• clearance of creatinine > 60 ml/min),

• AST/ALT = 5 N, PAL = 5 N, total bilirubin = 2N.

Exclusion Criteria:

• Hypersensitivity to sunitinib.

• Contraindication to sunitinib, including uncontrolled hypertension, medical history of cerebrovascular accident, unstable cardiac pathology despite optimal medical therapy (myocardial infarction within the 6 months prior to study drug administration, severe/unstable angina ), active hemorrhagic syndrome or concomitant treatment with anticoagulants.

• Any severe acute or chronic co-morbid that may compromise to comply with study participation : uncontrolled infection, symptomatic congestive heart failure, liver disturbance, chronic renal failure, active gastro-duodenal ulcer (nonexhaustive list)

• Known brain metastases.

• Diagnosis of any second malignancy within the last 3 years, except for basal cell or squamous cell skin cancer, or in situ carcinoma of the cervix uteri

• Current treatment on another clinical trial.

• Prior treatment with an investigational agent within 4 weeks

• Patient on i.v bisphosphonate therapy

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Carcinoma
• Carcinoma, Hepatocellular
• Fibrolamellar Hepatocellular Carcinoma
• Hepatocellular Carcinoma

Intervention

Drug:
• Sutent
Sunitinib 50mg/day (per os) for 6 cycles duration of one cycle = 6 weeks (4 weeks of treatment over 6 weeks)

Locations

Country	Name	City	State
France	Hôpital Beaujon	Clichy	Hauts de Seine

Sponsors (1)

Lead Sponsor	Collaborator
Assistance Publique - Hôpitaux de Paris

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Objective response	to evaluate the objective response according to RECIST Criteria 1.1	1 year	No
Secondary	Objective response	to evaluate objective response to sunitinib according to secondary radiological criteria (evaluation on CT scan of: tumor density, % of tumor necrosis and tumor vascularisation)	1 year	No
Secondary	Overall survival		6 months and 1 year	No
Secondary	Progression-Free survival		6 months and 1 year	No
Secondary	Biomarkers of response	to evaluate the correlation between biomarkers expression and objective response so sunitinib	1 year	No
Secondary	Biomarkers of radiological response	to evaluate the correlation between biomarkers expression and secondary radiological criteria (significant decrease of tumor density on CT scan, formation of significant intratumor necrosis, significant decrease of tumoral vascularisation using of perfusion software	1 year	No