Hepatocellular Carcinoma Clinical Trial
Official title:
A Phase I Dose Escalation Study of TH-302 Plus Doxorubicin Delivered by Trans-Arterial Chemoembolization (TACE) in Patients With Hepatocellular Carcinoma
The primary objective of this phase I dose escalation study is to determine the maximum tolerated dose of TH-302 when administered with doxorubicin via trans-arterial chemo-embolization (TACE) in patients with hepatocellular carcinoma (HCC) who are not transplant candidates and have unresectable disease. HCC is the second leading cause of worldwide cancer death and is generally incurable without liver transplant. TACE can convert about 40% of these patients to transplant candidates. Additionally, in non-transplant HCC patients, TACE confers statistical improvements in overall survival. Selective HCC arterial catheterization during TACE allows for the delivery of concentrated drugs to the liver tumor but the optimal TACE chemotherapy regimen has not yet been determined. TH-302 is a hypoxia inducible agent that can be activated in the hypoxic environment induced by TACE.
Transarterial chemoembolization (TACE) is the major modality utilized for tumor downstaging
for transplant and for local therapy in non-transplant patients. This procedure allows
delivery of concentrated drugs to the tumor, followed by embolization that eliminates its
blood supply creating an environment of hypoxia. The process induces tumor ischemia, while
achieving a drug concentration in the tumor 10 to 25 times greater than can be achieved by
infusion.
A hypoxic microenvironment is a characteristic of many solid tumors including hepatocellular
cancer, further induced by TACE. The hypoxia-activated prodrug, TH-302, is designed to
selectively physiologically target the hypoxic microenvironment. While doxorubicin and
cisplatin have been used as the drugs in TACE among other agents, none have stood out as the
optimal agent in targeting HCC. Because of the action of TH-302 in hypoxia, this agent has a
mechanistic advantage as a agent in TACE.
The current study is designed to assess the potential therapeutic benefit of adding TH-302
to the standard doxorubicin based TACE regimen in patients with advanced hepatocellular
carcinomas.
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Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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