Trial Outcomes & Findings for Bevacizumab and Chemoembolization in Treating Patients With Liver Cancer That Cannot Be Removed By Surgery (NCT NCT00335829)

NCT ID: NCT00335829

Last Updated: 2021-08-13

Results Overview

This outcome was not assessed. Instead, the primary outcome of time to tumor progression (TTP) of the targeted lesions and secondary outcomes of TTP of nontargeted lesions and overall TTP were assessed and reported.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

26 participants

Primary outcome timeframe

Time through study completion, an average of 1 year

Results posted on

2021-08-13

Participant Flow

Patients with a diagnosis of unresectable hepatocellular carcinoma (HCC) were enrolled on this protocol to receive a combination of intravenous bevacizumab and transarterial chemoembolization (TACE) therapy. A total of 26 patients were enrolled on protocol; 10 patients at Northwestern University and 16 at Johns Hopkins University.

Participant milestones

Participant milestones
Measure
Single Arm, Received Bevacizumab and TACE
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Overall Study
STARTED
26
Overall Study
Received Bevacizumab
26
Overall Study
Received First TACE
25
Overall Study
COMPLETED
23
Overall Study
NOT COMPLETED
3

Reasons for withdrawal

Reasons for withdrawal
Measure
Single Arm, Received Bevacizumab and TACE
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Overall Study
Withdrawal by Subject
1
Overall Study
Lost to Follow-up
1
Overall Study
Adverse Event
1

Baseline Characteristics

Bevacizumab and Chemoembolization in Treating Patients With Liver Cancer That Cannot Be Removed By Surgery

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Single Arm, Received Bevacizumab and TACE
n=26 Participants
bevacizumab chemotherapy embolization therapy hepatic artery infusion
Age, Continuous
64 years
n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
Sex: Female, Male
Male
21 Participants
n=5 Participants
Region of Enrollment
United States
26 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Time through study completion, an average of 1 year

Population: PFS analysis was not conducted. No data were collected for this Outcome Measure

This outcome was not assessed. Instead, the primary outcome of time to tumor progression (TTP) of the targeted lesions and secondary outcomes of TTP of nontargeted lesions and overall TTP were assessed and reported.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: 6 months and 1 year

Time to tumor progression was estimated via Kaplan-Meier methodology using the 23 patients who underwent treatment.

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=23 Participants
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Time to Tumor Progression (TTP) of Targeted Lesions
NA months
Among the targeted lesions, the majority had no evidence of progression at 6 months (86%) or at 1 year (53%). The median TTP of the targeted lesions from the start of therapy was not reached at last follow-up of 1 year.

SECONDARY outcome

Timeframe: 1 year

TTP of nontargeted lesions assessed via Kaplan-Meier methodology.

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=23 Participants
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
TTP of Nontargeted Lesions Within the Liver
9.1 months
Interval 6.5 to 9.1

SECONDARY outcome

Timeframe: 1 year

Overall TTP assessed via Kaplan-Meier methodology.

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=23 Participants
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Overall TTP
7.2 months
Interval 5.8 to 9.1

SECONDARY outcome

Timeframe: 6 months and 1 year

Overall TTP assessed via Kaplan-Meier methodology at 6 months and 1 year

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=23 Participants
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
TTP Rate at 6 Months and 1 Year
TTP rate at 1 year
23 percentage of participants
Interval 9.0 to 60.0
TTP Rate at 6 Months and 1 Year
TTP rate at 6 months
65 percentage of participants
Interval 47.0 to 90.0

SECONDARY outcome

Timeframe: 1 year

OS assessed via Kaplan-Meier methodology both from initiation of therapy and from the date of diagnosis until death.

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=23 Participants
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Overall Survival (OS)
OS from start of therapy
10.8 months
Interval 4.8 to 24.7
Overall Survival (OS)
OS from date of diagnosis
23.6 months
Interval 12.8 to 31.5

SECONDARY outcome

Timeframe: 6 months

Efficacy as assessed by radiographic tumor response using RECIST criteria at baseline, 3 weeks after TACE, and 4 weeks after completion of final cycle. Complete Response (CR): Disappearance of all lesions targeted by therapy Partial Response (PR): At least 30% decrease in the sum of longest diameter (LD) of lesions targeted by therapy Progressive Disease (PD): At least 20% increase in sum of LD of lesions targeted by therapy Stable Disease (SD): Neither sufficient shrinkage for PR nor sufficient increase for PD.

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=23 Participants
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Response Rate - Based on Response Evaluation Criteria in Solid Tumors (RECIST)
Stable Disease (SD)
15 Participants
Response Rate - Based on Response Evaluation Criteria in Solid Tumors (RECIST)
Complete Response (CR)
0 Participants
Response Rate - Based on Response Evaluation Criteria in Solid Tumors (RECIST)
Partial Response (PR)
8 Participants
Response Rate - Based on Response Evaluation Criteria in Solid Tumors (RECIST)
Progressive Disease (PD)
0 Participants
Response Rate - Based on Response Evaluation Criteria in Solid Tumors (RECIST)
Overall response rate (CR + PR)
8 Participants
Response Rate - Based on Response Evaluation Criteria in Solid Tumors (RECIST)
Disease control rate (CR + PR + SD)
23 Participants

SECONDARY outcome

Timeframe: 6 months

Efficacy as assessed by radiographic tumor response utilizing the following tumor enhancement criteria: Complete Response (CR): 100% tumor necrosis of the target lesion(s) upon completion of any of the 3 cycles of TACE therapy Partial Response (PR): Greater than 50% tumor necrosis of target lesion(s) Progressive Disease (PD): Reappearance or increased tumor enhancement greater than 25% in target lesion(s) Stable Disease (SD): Cases that do not meet CR or PR and did not demonstrate evidence of tumor progression.

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=23 Participants
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Response Rate - Based on Tumor Enhancement
Complete Response (CR)
4 Participants
Response Rate - Based on Tumor Enhancement
Partial Response (PR)
10 Participants
Response Rate - Based on Tumor Enhancement
Overall response rate (CR + PR)
14 Participants
Response Rate - Based on Tumor Enhancement
Disease control rate (CR + PR + SD)
23 Participants
Response Rate - Based on Tumor Enhancement
Stable Disease (SD)
9 Participants
Response Rate - Based on Tumor Enhancement
Progressive Disease (PD)
0 Participants

SECONDARY outcome

Timeframe: Cycle 1 pre-TACE - 2 weeks

Safety and toxicity assessed by National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE v3.0) for all patients (n=26) who received bevacizumab prior to TACE therapy.

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=24 Adverse events
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Coagulation
3 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Weight loss
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Esophageal varices
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Elevated ALT
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Fatigue
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Ascites
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Anorexia
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Nausea
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Vomiting
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Elevated AST
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Hyperbilirubinemia
3 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Hyponatremia
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Encephalopathy
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Right upper quadrant pain
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Proteinuria
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Pre-TACE
Respiratory
1 adverse events

SECONDARY outcome

Timeframe: Cycle 1 post-TACE - 5 weeks

Population: 1 out of the initial 26 patients did not complete the first TACE on protocol and was not included in this assessment.

Safety and toxicity assessed by National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE v3.0) for 25 who completed the first cycle of TACE and bevacizumab therapy

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=151 Adverse events
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Ischemia
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Coagulation
10 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Night sweats
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Weight loss
6 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Ascites
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Hyperglycemia
8 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Hypocalcemia
3 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Hypokalemia
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Hyponatremia
7 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Psychosis
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Abdominal pain, not otherwise specified (NOS)
6 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Epigastric pain
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Right upper quadrant pain
3 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Anemia
10 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Leukocytopenia
7 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Lymphopenia
8 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Edema
3 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Fatigue
12 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Anorexia
11 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Nausea
4 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Vomiting
6 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
HEENT
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Elevated ALT
7 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Elevated AST
7 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Hyperbilirubinemia
6 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Liver failure
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Cellulitis
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Colangitis
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Delirium
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Chest pain
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Pain - other
3 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Dyspnea
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Acute renal failure
1 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Proteinuria
2 adverse events
Safety and Treatment Toxicity - Cycle 1 Post-TACE
Respiratory
3 adverse events

SECONDARY outcome

Timeframe: 6 months

Population: 14 out of the original 26 study participants completed 2 or 3 cycles of TACE and bevacizumab therapy - adverse events associated with these patients for cycles 2 and 3 assessed.

Safety and toxicity assessed by National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE v3.0) for patients (n=14) who completed 2 or 3 cycles of TACE and bevacizumab therapy

Outcome measures

Outcome measures
Measure
Single Arm, Received Bevacizumab and TACE
n=103 Adverse events
Patients received intravenous bevacizumab (10mg/kg) and chemoembolization for up to 3 cycles over 6 months. After completion of last treatment cycle, follow-up including clinic visits and imaging was performed every 8 to 12 weeks.
Safety and Treatment Toxicity - Cycles 2 and 3
Right upper quadrant pain
4 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Pain - other
3 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Dyspnea
1 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Leukocytopenia
7 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Lymphopenia
12 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Heart failure
1 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Edema
2 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Coagulation
5 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Fatigue
11 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Weight loss
2 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Dermatologic
3 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Endocrine
2 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Ascites
3 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Anorexia
2 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Duodenal perforation
1 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Nausea
1 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Vomiting
2 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Elevated ALT
2 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Elevated AST
6 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Hyperbilirubinemia
4 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Clostridium difficile
1 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Hyperglycemia
11 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Hypocalcemia
2 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Hypokalemia
1 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Hyponatremia
4 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Fracture
1 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Cord compression
1 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Stroke
1 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Proteinuria
2 adverse events
Safety and Treatment Toxicity - Cycles 2 and 3
Respiratory
5 adverse events

Adverse Events

Single Arm, Received Bevacizumab and TACE

Serious events: 6 serious events
Other events: 26 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Single Arm, Received Bevacizumab and TACE
n=26 participants at risk
bevacizumab chemotherapy embolization therapy hepatic artery infusion
Infections and infestations
Clostridium difficile infection
3.8%
1/26 • Number of events 1 • 6 months
Nervous system disorders
Cerebral infarct
3.8%
1/26 • Number of events 1 • 6 months
Gastrointestinal disorders
Duodenal perforation
3.8%
1/26 • Number of events 1 • 6 months
Hepatobiliary disorders
Liver failure
3.8%
1/26 • Number of events 1 • 6 months
Cardiac disorders
Heart failure
3.8%
1/26 • Number of events 1 • 6 months
Gastrointestinal disorders
Esophageal varices
3.8%
1/26 • Number of events 1 • 6 months

Other adverse events

Other adverse events
Measure
Single Arm, Received Bevacizumab and TACE
n=26 participants at risk
bevacizumab chemotherapy embolization therapy hepatic artery infusion
Blood and lymphatic system disorders
Anemia
38.5%
10/26 • Number of events 10 • 6 months
Investigations
Leukocytopenia
26.9%
7/26 • Number of events 14 • 6 months
Investigations
Lymphopenia
46.2%
12/26 • Number of events 20 • 6 months
General disorders
Edema
11.5%
3/26 • Number of events 5 • 6 months
Investigations
Coagulation/Elevated INR
38.5%
10/26 • Number of events 15 • 6 months
General disorders
Fatigue
46.2%
12/26 • Number of events 25 • 6 months
Skin and subcutaneous tissue disorders
Night sweats
7.7%
2/26 • Number of events 2 • 6 months
General disorders
Weight loss
23.1%
6/26 • Number of events 8 • 6 months
Skin and subcutaneous tissue disorders
Dermatologic
11.5%
3/26 • Number of events 3 • 6 months
Endocrine disorders
Endocrine
7.7%
2/26 • Number of events 2 • 6 months
Gastrointestinal disorders
Ascites
11.5%
3/26 • Number of events 5 • 6 months
Metabolism and nutrition disorders
Anorexia
42.3%
11/26 • Number of events 14 • 6 months
Gastrointestinal disorders
Nausea
19.2%
5/26 • Number of events 7 • 6 months
Gastrointestinal disorders
Vomiting
23.1%
6/26 • Number of events 9 • 6 months
Investigations
Elevated ALT
26.9%
7/26 • Number of events 10 • 6 months
Investigations
Elevated AST
26.9%
7/26 • Number of events 15 • 6 months
Investigations
Hyperbilirubinemia
23.1%
6/26 • Number of events 13 • 6 months
Skin and subcutaneous tissue disorders
Cellulitis
3.8%
1/26 • Number of events 1 • 6 months
Hepatobiliary disorders
Cholangitis
3.8%
1/26 • Number of events 1 • 6 months
Metabolism and nutrition disorders
Hyperglycemia
42.3%
11/26 • Number of events 19 • 6 months
Metabolism and nutrition disorders
Hypocalcemia
11.5%
3/26 • Number of events 5 • 6 months
Metabolism and nutrition disorders
Hypokalemia
7.7%
2/26 • Number of events 3 • 6 months
Metabolism and nutrition disorders
Hyponatremia
26.9%
7/26 • Number of events 11 • 6 months
Injury, poisoning and procedural complications
Fracture
3.8%
1/26 • Number of events 1 • 6 months
Nervous system disorders
Spinal cord compression
3.8%
1/26 • Number of events 1 • 6 months
Psychiatric disorders
Delirium
3.8%
1/26 • Number of events 1 • 6 months
Nervous system disorders
Encephalopathy
3.8%
1/26 • Number of events 1 • 6 months
Psychiatric disorders
Psychosis
3.8%
1/26 • Number of events 1 • 6 months
Gastrointestinal disorders
Abdominal pain
23.1%
6/26 • Number of events 6 • 6 months
Gastrointestinal disorders
Epigastric pain
3.8%
1/26 • Number of events 1 • 6 months
Gastrointestinal disorders
Right upper quadrant pain
15.4%
4/26 • Number of events 8 • 6 months
General disorders
Chest pain
7.7%
2/26 • Number of events 2 • 6 months
General disorders
Pain - other
11.5%
3/26 • Number of events 6 • 6 months
Respiratory, thoracic and mediastinal disorders
Dyspnea
7.7%
2/26 • Number of events 3 • 6 months
Renal and urinary disorders
Proteinuria
7.7%
2/26 • Number of events 3 • 6 months
Renal and urinary disorders
Acute kidney injury
3.8%
1/26 • Number of events 1 • 6 months
Respiratory, thoracic and mediastinal disorders
Respiratory
19.2%
5/26 • Number of events 9 • 6 months

Additional Information

Jeff Geschwind, MD

Johns Hopkins, Interventional Radiology

Phone: 410-614-6597

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place