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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT01869088
Other study ID # HCC-120402
Secondary ID
Status Active, not recruiting
Phase Phase 3
First received February 16, 2013
Last updated March 14, 2017
Start date January 2013
Est. completion date January 2018

Study information

Verified date March 2017
Source Sun Yat-sen University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to determine if TACE plus Recombinant Human Adenovirus Type 5 Injection will improve outcome in patients with advanced hepatocellular carcinoma (HCC) not amenable to surgery or local ablative therapy.


Description:

Transarterial chemoembolization (TACE) is currently one of the mainstays of palliative treatments worldwide for patients with unresectable Hepatocellular Carcinoma(HCC).However, the long term outcomes were generally poor for HCC patients treated with TACE. Recombinant Human Adenovirus Type 5, an E1B gene deleted adenovirus, is known to have a significant antitumor activity. In addition, local injection of recombinant human adenovirus type 5 can enhance the effect of antitumor therapies (chemotherapy and radiotherapy). The hypothesis is that patients with unresectable HCC may benefit from recombinant human adenovirus type 5 in combination with TACE.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 266
Est. completion date January 2018
Est. primary completion date January 2018
Accepts healthy volunteers No
Gender All
Age group 18 Years to 70 Years
Eligibility Inclusion Criteria:

- Patients newly diagnosed as HCC according to European Association for Study of the Liver criteria.

- BCLC stage A or B

- Child-Pugh class A or B (Child-Pugh score 7)

- ECOG performance status of 0

- Patients must have at least one tumor lesion that meets both of the following criteria:

- The lesion can be accurately measured in at least one dimension according to RECIST criteria

- The lesion has not been previously treated with surgery, radiation therapy, radiofrequency ablation, percutaneous ethanol or acetic acid injection, or cryoablation.

- Patients who have received previous local therapy treatments (RFA, PEI, cryoablation, surgery, resection) to non-target lesions are eligible

- Local therapy must have been completed at least 4 weeks prior to baseline scan.

- Haematology:Absolute neutrophil count (ANC) > 1 x 109/L, Platelet count > 40 x 109/L, Haemoglobin > 9 g/dL (may be transfused to maintain or exceed this level) Prothrombin time international normalized ratio < 1.5

- Biochemistry:Total bilirubin < 2 mg/dL Serum creatinine < 1.5 x the upper limit of normal

- Ability to understand the protocol and to agree to and sign a written informed consent document

Exclusion Criteria:

- Tumor factors

- Presence of extrahepatic metastasis

- Predominantly infiltrative lesion

- Diffuse tumor morphology with extensive lesions involving both lobes.

- Vascular complications

- Hepatic artery thrombosis, or

- Partial or complete thrombosis of the main portal vein, or

- Tumor invasion of portal branch of contralateral lobe, or

- Hepatic vein tumor thrombus, or

- Significant arterioportal shunt not amenable to shunt blockage

- Liver function

- Advanced liver disease: ascites, hepatic encephalopathy

- Patients with clinically significant gastrointestinal bleeding within the 30 days prior to study entry.

- Others

- Renal failure requiring hemo- or peritoneal dialysis

- Pregnant or lactating women.

- Active sepsis or bleeding.

- Hypersensitivity to intravenous contrast agents.

- The patient has received prior treatment for HCC target lesion.

- History of cardiac disease

- Congestive heart failure > NYHA class 2; active coronary artery disease

- Cardiac arrhythmias requiring anti-arrhythmic therapy other than beta blockers or digoxin.

- Hypertension defined as systolic blood pressure > 150 mmHg or diastolic pressure > 90 mmHg despite optimal medical management.

- Serious non-healing wounds (including wounds healing by secondary intention), acute or non-healing ulcers, or bone fractures within 3 months.

- The patient is, in the opinion of the investigator, unable and / or unwilling to comply with treatment and study instructions.

- Substance abuse (current), psychological, or social conditions that may interfere with the patient's participation in the study or evaluation of the study results.

- Any active clinically serious infections (> grade 2 NCI-CTCAE ver 3.0)

- HIV infection or AIDS-related illness or serious acute or chronic illness (based on medical history)

Study Design


Intervention

Drug:
Recombinant Human Adenovirus Type 5 Injection
After identifying the target artery of HCC, Recombinant Human Adenovirus Type 5 Injection(15.0*1011vp:0.5ml*3) will be first infused through the target artery
Procedure:
Transartery Chemoembolization
Transartery chemoembolization with chemothrapy drugs (E-ADM 50mg, Lobaplatin 50 mg, MMC 6mg)and followed with embolization with lipiodol or/and polyvinyl alcohol particles.

Locations

Country Name City State
China Cancer Center Sun Yat-sen University Guangzhou Guangdong

Sponsors (1)

Lead Sponsor Collaborator
Sun Yat-sen University

Country where clinical trial is conducted

China, 

References & Publications (32)

A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. Groupe d'Etude et de Traitement du Carcinome Hépatocellulaire. N Engl J Med. 1995 May 11;332(19):1256-61. — View Citation

Bauzon M, Castro D, Karr M, Hawkins LK, Hermiston TW. Multigene expression from a replicating adenovirus using native viral promoters. Mol Ther. 2003 Apr;7(4):526-34. — View Citation

Benedict CA, Norris PS, Prigozy TI, Bodmer JL, Mahr JA, Garnett CT, Martinon F, Tschopp J, Gooding LR, Ware CF. Three adenovirus E3 proteins cooperate to evade apoptosis by tumor necrosis factor-related apoptosis-inducing ligand receptor-1 and -2. J Biol — View Citation

Bruix J, Llovet JM, Castells A, Montañá X, Brú C, Ayuso MC, Vilana R, Rodés J. Transarterial embolization versus symptomatic treatment in patients with advanced hepatocellular carcinoma: results of a randomized, controlled trial in a single institution. H — View Citation

Cammà C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F, Andreone P, Craxì A, Cottone M. Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology. 2002 Jul;224(1):47-54. — View Citation

Caturelli E, Siena DA, Fusilli S, Villani MR, Schiavone G, Nardella M, Balzano S, Florio F. Transcatheter arterial chemoembolization for hepatocellular carcinoma in patients with cirrhosis: evaluation of damage to nontumorous liver tissue-long-term prospe — View Citation

Chen CA, Lo CK, Lin BL, Sibley E, Tang SC. Application of doxorubicin-induced rAAV2-p53 gene delivery in combined chemotherapy and gene therapy for hepatocellular carcinoma. Cancer Biol Ther. 2008 Feb;7(2):303-9. — View Citation

Choi JY, Park YM, Byun BH, Kim BS, Hong EG, Shin DY, Seong YR, Im DS. Adenovirus-mediated p53 tumor suppressor gene therapy against subcutaneous HuH7 hepatoma cell line nodule of nude mice. J Korean Med Sci. 1999 Jun;14(3):271-6. — View Citation

Geschwind JF, Ramsey DE, Cleffken B, van der Wal BC, Kobeiter H, Juluru K, Hartnell GG, Choti MA. Transcatheter arterial chemoembolization of liver tumors: effects of embolization protocol on injectable volume of chemotherapy and subsequent arterial paten — View Citation

Guo Y, Zeng Y, Wang K, Zhu X, Luo H, Zheng M, Li M, Chen J. [Therapeutic potential of recombinant adenovirus expressing p53 in hepatocellular carcinoma cell lines]. Zhonghua Gan Zang Bing Za Zhi. 2001 Jul;9 Suppl:43-5. Chinese. — View Citation

Hamid O, Varterasian ML, Wadler S, Hecht JR, Benson A 3rd, Galanis E, Uprichard M, Omer C, Bycott P, Hackman RC, Shields AF. Phase II trial of intravenous CI-1042 in patients with metastatic colorectal cancer. J Clin Oncol. 2003 Apr 15;21(8):1498-504. — View Citation

He Q, Liu Y, Zou Q, Guan YS. Transarterial injection of H101 in combination with chemoembolization overcomes recurrent hepatocellular carcinoma. World J Gastroenterol. 2011 May 14;17(18):2353-5. doi: 10.3748/wjg.v17.i18.2353. — View Citation

Hermiston TW, Kuhn I. Armed therapeutic viruses: strategies and challenges to arming oncolytic viruses with therapeutic genes. Cancer Gene Ther. 2002 Dec;9(12):1022-35. Review. — View Citation

Higashi S, Tabata N, Kondo KH, Maeda Y, Shimizu M, Nakashima T, Setoguchi T. Size of lipid microdroplets effects results of hepatic arterial chemotherapy with an anticancer agent in water-in-oil-in-water emulsion to hepatocellular carcinoma. J Pharmacol E — View Citation

Khuri FR, Nemunaitis J, Ganly I, Arseneau J, Tannock IF, Romel L, Gore M, Ironside J, MacDougall RH, Heise C, Randlev B, Gillenwater AM, Bruso P, Kaye SB, Hong WK, Kirn DH. a controlled trial of intratumoral ONYX-015, a selectively-replicating adenovirus, — View Citation

Kirn D. Oncolytic virotherapy for cancer with the adenovirus dl1520 (Onyx-015): results of phase I and II trials. Expert Opin Biol Ther. 2001 May;1(3):525-38. Review. — View Citation

Lau WY, Yu SC, Lai EC, Leung TW. Transarterial chemoembolization for hepatocellular carcinoma. J Am Coll Surg. 2006 Jan;202(1):155-68. Review. — View Citation

Lee KH, Liapi E, Ventura VP, Buijs M, Vossen JA, Vali M, Geschwind JF. Evaluation of different calibrated spherical polyvinyl alcohol microspheres in transcatheter arterial chemoembolization: VX2 tumor model in rabbit liver. J Vasc Interv Radiol. 2008 Jul — View Citation

Lee KH, Liapi E, Vossen JA, Buijs M, Ventura VP, Georgiades C, Hong K, Kamel I, Torbenson MS, Geschwind JF. Distribution of iron oxide-containing Embosphere particles after transcatheter arterial embolization in an animal model of liver cancer: evaluation — View Citation

Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology. 2003 Feb;37(2):429-42. Review. — View Citation

Llovet JM, Bustamante J, Castells A, Vilana R, Ayuso Mdel C, Sala M, Brú C, Rodés J, Bruix J. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials. Hepatology. 1999 Jan;29(1):62-7 — View Citation

Llovet JM, Real MI, Montaña X, Planas R, Coll S, Aponte J, Ayuso C, Sala M, Muchart J, Solà R, Rodés J, Bruix J; Barcelona Liver Cancer Group.. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocel — View Citation

Lo CM, Ngan H, Tso WK, Liu CL, Lam CM, Poon RT, Fan ST, Wong J. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology. 2002 May;35(5):1164-71. — View Citation

Mullen JT, Tanabe KK. Viral oncolysis. Oncologist. 2002;7(2):106-19. Review. — View Citation

Nemunaitis J, Khuri F, Ganly I, Arseneau J, Posner M, Vokes E, Kuhn J, McCarty T, Landers S, Blackburn A, Romel L, Randlev B, Kaye S, Kirn D. Phase II trial of intratumoral administration of ONYX-015, a replication-selective adenovirus, in patients with r — View Citation

Ono Y, Yoshimasu T, Ashikaga R, Inoue M, Shindou H, Fuji K, Araki Y, Nishimura Y. Long-term results of lipiodol-transcatheter arterial embolization with cisplatin or doxorubicin for unresectable hepatocellular carcinoma. Am J Clin Oncol. 2000 Dec;23(6):56 — View Citation

Rieger R, Whitacre D, Cantwell MJ, Prussak C, Kipps TJ. Chimeric form of tumor necrosis factor-alpha has enhanced surface expression and antitumor activity. Cancer Gene Ther. 2009 Jan;16(1):53-64. doi: 10.1038/cgt.2008.57. — View Citation

Shi M, Wang F, Liu M, Zhang B, Qiu Z, Lei Z, Masayoshi N, Gao L, Wu Z. [Adenovirus-mediated transfer of human wild-type p53, GM-CSF, and B7-1 genes efficiently produces growth suppression and apoptosis of hepatocellular cells in vitro]. Zhonghua Gan Zang — View Citation

Shi M, Wang FS, Wu ZZ. Synergetic anticancer effect of combined quercetin and recombinant adenoviral vector expressing human wild-type p53, GM-CSF and B7-1 genes on hepatocellular carcinoma cells in vitro. World J Gastroenterol. 2003 Jan;9(1):73-8. — View Citation

Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Tr — View Citation

Vogl TJ, Trapp M, Schroeder H, Mack M, Schuster A, Schmitt J, Neuhaus P, Felix R. Transarterial chemoembolization for hepatocellular carcinoma: volumetric and morphologic CT criteria for assessment of prognosis and therapeutic success-results from a liver — View Citation

Yoon JH, Kim HC, Chung JW, Yoon JH, Jae HJ, Park JH. CT findings of completely regressed hepatocellular carcinoma with main portal vein tumor thrombosis after transcatheter arterial chemoembolization. Korean J Radiol. 2010 Jan-Feb;11(1):69-74. doi: 10.334 — View Citation

* Note: There are 32 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Overall survival time 3 years
Secondary Number of adverse events Number of adverse events, and number of patients who developed adverse event. Postoperative adverse events were graded based on the Common Terminology Criteria for Adverse Events ( CTCAE ) 30 days
Secondary Tumor response Tumor response based on modified RECIST 12 weeks
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