Different Regimens of Transarterial Chemoembolization for Hepatocellular Carcinoma

NCT ID: NCT00493402

Last Updated: 2012-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

365 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-07-31

Study Completion Date

2010-12-31

Brief Summary

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The purpose of this study is to evaluate efficacy, safety, and patient reported outcomes (PRO) of different regimens of transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).

Detailed Description

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Transarterial chemoembolization (TACE) has been recommended as first line non-curative therapy for non-surgical patients with large/multifocal HCC who do not have vascular invasion or extrahepatic spread. There has not been any standardized protocol in the choice of chemotherapeutic agents, dosage, dilution, rate of injection, and time interval between treatments. Similarly, there is no agreement on the choice of embolizing agents, degree of embolization, and whether the chemotherapeutic agent should be given together, or before the embolizing agent.

Comparison(s): In patients with HCC who underwent TACE therapy, stratified by whether they have vascular invasion and tumor size, we compare efficacy, safety, and patient reported outcomes (PRO) of different regimens of TACE.

Regimen 1: lipiodol combined chemotherapy with embolization

Regimen 2: lipiodol combined chemotherapy without embolization

Regimen 3: lipiodol single agent chemotherapy with embolization

Conditions

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Hepatocellular Carcinoma

Keywords

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Antineoplastic Agents administration & dosage Carcinoma, Hepatocellular Chemoembolization, Therapeutic Humans Liver Neoplasms therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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combined chemotherapy with embolization

chemotherapy with lipiodol mixed with EADM 50mg, lobaplatin 50mg, and MMC 6mg, with particle embolization.

Group Type EXPERIMENTAL

Transarterial chemoembolization (TACE)

Intervention Type PROCEDURE

drugs and dosage: chemotherapy with lipiodol mixed with EADM 50mg, lobaplatin 50mg, and MMC 6mg, plus particle embolization.

combined chemotherapy without embolization

chemotherapy with lipiodol mixed with EADM 50mg, lobaplatin 50mg, and MMC 6mg, without particle embolization.

Group Type EXPERIMENTAL

Transarterial chemoembolization (TACE)

Intervention Type PROCEDURE

drugs and dosage: chemotherapy with lipiodol mixed with EADM 50mg, lobaplatin 50mg, and MMC 6mg.

single agent chemotherapy with embolization

chemotherapy with lipiodol mixed with EADM 50mg, plus particle embolization.

Group Type EXPERIMENTAL

Transarterial chemoembolization (TACE)

Intervention Type PROCEDURE

Drugs and dosage:chemotherapy with lipiodol mixed with EADM 50mg, plus particle embolization.

Interventions

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Transarterial chemoembolization (TACE)

drugs and dosage: chemotherapy with lipiodol mixed with EADM 50mg, lobaplatin 50mg, and MMC 6mg, plus particle embolization.

Intervention Type PROCEDURE

Transarterial chemoembolization (TACE)

drugs and dosage: chemotherapy with lipiodol mixed with EADM 50mg, lobaplatin 50mg, and MMC 6mg.

Intervention Type PROCEDURE

Transarterial chemoembolization (TACE)

Drugs and dosage:chemotherapy with lipiodol mixed with EADM 50mg, plus particle embolization.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Adult patients with minimal height of 150cm and minimal weight of 50 KG
* Histological confirmed HCC
* with no previous treatment
* With unresectable tumor
* With solitary or multiple intrahepatic tumor, the diameter of the largest one must larger than 7cm.
* No significant baseline liver dysfunction. Cirrhotic status of Child-Pugh class A only
* No significant renal impairment (creatinine clearance \< 30 mL/minute)
* The following laboratory parameters:

* Platelet count ≥ 60,000/µL
* Hemoglobin ≥ 8.5 g/dL
* Total bilirubin ≤ 1.5 mg/dL
* ASL and AST ≤ 5 x upper limit of normal
* Serum albumin ≥ 35 g/L
* Serum creatinine ≤ 1.5 x upper limit of normal
* INR ≤ 1.5 or a Pt/PTT within normal limits
* Absolute neutrophil count (ANC) \> 1,500/mm3
* Ability to understand the protocol and to agree to and sign a written informed consent document

Exclusion Criteria

* Avascular tumor
* Main portal vein obstruction without cavernous transformation
* Evidence of hepatic decompensation including esophageal or gastric variceal bleeding or hepatic encephalopathy
* Obstructive jaundice
* Severe underlying cardiac or renal diseases
* Known or suspected allergy to the investigational agent or any agent given in association with this trial
* Pregnant or breast-feeding patients.
* History of organ allograft
* Active clinically serious infections
* Any condition that is unstable or which could jeopardize the safety of the patient and his/her compliance in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Health, China

OTHER_GOV

Sponsor Role collaborator

Guangdong Provincial People's Hospital

OTHER

Sponsor Role collaborator

The 458 Hospital of Chinese PLA

OTHER

Sponsor Role collaborator

Kaiping Central Hospital

OTHER

Sponsor Role collaborator

Sun Yat-sen University

OTHER

Sponsor Role lead

Responsible Party

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Shi Ming

Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jin-Qing Li, M.D.

Role: PRINCIPAL_INVESTIGATOR

Cancer Center, Sun Yat-set University

Locations

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Cancer Center Sun Yat-sen University

Guangzhou, Guangdong, China

Site Status

Countries

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China

References

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Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 2005 Nov;42(5):1208-36. doi: 10.1002/hep.20933. No abstract available.

Reference Type BACKGROUND
PMID: 16250051 (View on PubMed)

BREEDIS C, YOUNG G. The blood supply of neoplasms in the liver. Am J Pathol. 1954 Sep-Oct;30(5):969-77. No abstract available.

Reference Type BACKGROUND
PMID: 13197542 (View on PubMed)

Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology. 2003 Feb;37(2):429-42. doi: 10.1053/jhep.2003.50047.

Reference Type BACKGROUND
PMID: 12540794 (View on PubMed)

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):564-8. doi: 10.1097/00000421-200012000-00006.

Reference Type BACKGROUND
PMID: 11202797 (View on PubMed)

Lau WY, Yu SC, Lai EC, Leung TW. Transarterial chemoembolization for hepatocellular carcinoma. J Am Coll Surg. 2006 Jan;202(1):155-68. doi: 10.1016/j.jamcollsurg.2005.06.263. Epub 2005 Oct 19. No abstract available.

Reference Type BACKGROUND
PMID: 16377509 (View on PubMed)

Lopez PM, Villanueva A, Llovet JM. Systematic review: evidence-based management of hepatocellular carcinoma--an updated analysis of randomized controlled trials. Aliment Pharmacol Ther. 2006 Jun 1;23(11):1535-47. doi: 10.1111/j.1365-2036.2006.02932.x.

Reference Type BACKGROUND
PMID: 16696801 (View on PubMed)

Lai CL, Wu PC, Chan GC, Lok AS, Lin HJ. Doxorubicin versus no antitumor therapy in inoperable hepatocellular carcinoma. A prospective randomized trial. Cancer. 1988 Aug 1;62(3):479-83. doi: 10.1002/1097-0142(19880801)62:33.0.co;2-l.

Reference Type BACKGROUND
PMID: 2839280 (View on PubMed)

Hong K, Georgiades CS, Geschwind JF. Technology insight: Image-guided therapies for hepatocellular carcinoma--intra-arterial and ablative techniques. Nat Clin Pract Oncol. 2006 Jun;3(6):315-24. doi: 10.1038/ncponc0512.

Reference Type BACKGROUND
PMID: 16757969 (View on PubMed)

Trevisani F, De Notariis S, Rossi C, Bernardi M. Randomized control trials on chemoembolization for hepatocellular carcinoma: is there room for new studies? J Clin Gastroenterol. 2001 May-Jun;32(5):383-9. doi: 10.1097/00004836-200105000-00005.

Reference Type BACKGROUND
PMID: 11319307 (View on PubMed)

Kajanti M, Pyrhonen S, Mantyla M, Rissanen P. Intra-arterial and intravenous use of 4' epidoxorubicin combined with 5-fluorouracil in primary hepatocellular carcinoma. A randomized comparison. Am J Clin Oncol. 1992 Feb;15(1):37-40. doi: 10.1097/00000421-199202000-00008.

Reference Type BACKGROUND
PMID: 1312770 (View on PubMed)

Heresbach D, Raoul JL, Bentue-Ferrer D, Bretagne JF, Van den Driessche J, Gastard J. [Chemotherapy combined with Lipiodol. In vitro study of the kinetics of release of adriamycin]. Gastroenterol Clin Biol. 1989 Oct;13(10):775-8. French.

Reference Type BACKGROUND
PMID: 2556315 (View on PubMed)

Higashi S, Shimizu M, Nakashima T, Iwata K, Uchiyama F, Tateno S, Tamura S, Setoguchi T. Arterial-injection chemotherapy for hepatocellular carcinoma using monodispersed poppy-seed oil microdroplets containing fine aqueous vesicles of epirubicin. Initial medical application of a membrane-emulsification technique. Cancer. 1995 Mar 15;75(6):1245-54. doi: 10.1002/1097-0142(19950315)75:63.0.co;2-u.

Reference Type BACKGROUND
PMID: 7882276 (View on PubMed)

Raoul JL, Heresbach D, Bretagne JF, Ferrer DB, Duvauferrier R, Bourguet P, Messner M, Gosselin M. Chemoembolization of hepatocellular carcinomas. A study of the biodistribution and pharmacokinetics of doxorubicin. Cancer. 1992 Aug 1;70(3):585-90. doi: 10.1002/1097-0142(19920801)70:33.0.co;2-#.

Reference Type BACKGROUND
PMID: 1320447 (View on PubMed)

Kasugai H, Kojima J, Tatsuta M, Okuda S, Sasaki Y, Imaoka S, Fujita M, Ishiguro S. Treatment of hepatocellular carcinoma by transcatheter arterial embolization combined with intraarterial infusion of a mixture of cisplatin and ethiodized oil. Gastroenterology. 1989 Oct;97(4):965-71. doi: 10.1016/0016-5085(89)91505-9.

Reference Type BACKGROUND
PMID: 2550311 (View on PubMed)

Nakao N, Uchida H, Kamino K, Nishimura Y, Ohishi H, Takayasu Y, Miura K. Determination of the optimum dose level of lipiodol in transcatheter arterial embolization of primary hepatocellular carcinoma based on retrospective multivariate analysis. Cardiovasc Intervent Radiol. 1994 Mar-Apr;17(2):76-80. doi: 10.1007/BF00193921.

Reference Type BACKGROUND
PMID: 8013027 (View on PubMed)

Nakao N, Uchida H, Kamino K, Nishimura Y, Ohishi H, Takayasu Y, Nakamura H, Kuroda C, Fujita M, Yoshioka H, et al. Effectiveness of Lipiodol in transcatheter arterial embolization of hepatocellular carcinoma. Cancer Chemother Pharmacol. 1992;31 Suppl:S72-6. doi: 10.1007/BF00687110.

Reference Type BACKGROUND
PMID: 1333913 (View on PubMed)

Takayasu K, Shima Y, Muramatsu Y, Moriyama N, Yamada T, Makuuchi M, Hasegawa H, Hirohashi S. Hepatocellular carcinoma: treatment with intraarterial iodized oil with and without chemotherapeutic agents. Radiology. 1987 May;163(2):345-51. doi: 10.1148/radiology.163.2.3031724.

Reference Type BACKGROUND
PMID: 3031724 (View on PubMed)

Nakamura H, Hashimoto T, Oi H, Sawada S. Transcatheter oily chemoembolization of hepatocellular carcinoma. Radiology. 1989 Mar;170(3 Pt 1):783-6. doi: 10.1148/radiology.170.3.2536946.

Reference Type BACKGROUND
PMID: 2536946 (View on PubMed)

Konno T. Targeting cancer chemotherapeutic agents by use of lipiodol contrast medium. Cancer. 1990 Nov 1;66(9):1897-903. doi: 10.1002/1097-0142(19901101)66:93.0.co;2-j.

Reference Type BACKGROUND
PMID: 2171752 (View on PubMed)

Egawa H, Maki A, Mori K, Yamamoto Y, Mitsuhashi S, Bannai K, Asano K, Ozawa K. Effects of intra-arterial chemotherapy with a new lipophilic anticancer agent, estradiol-chlorambucil (KM2210), dissolved in lipiodol on experimental liver tumor in rats. J Surg Oncol. 1990 Jun;44(2):109-14. doi: 10.1002/jso.2930440210.

Reference Type BACKGROUND
PMID: 2162452 (View on PubMed)

Mathupala SP, Rempel A, Pedersen PL. Glucose catabolism in cancer cells: identification and characterization of a marked activation response of the type II hexokinase gene to hypoxic conditions. J Biol Chem. 2001 Nov 16;276(46):43407-12. doi: 10.1074/jbc.M108181200. Epub 2001 Sep 13.

Reference Type BACKGROUND
PMID: 11557773 (View on PubMed)

Ramsey DE, Kernagis LY, Soulen MC, Geschwind JF. Chemoembolization of hepatocellular carcinoma. J Vasc Interv Radiol. 2002 Sep;13(9 Pt 2):S211-21. doi: 10.1016/s1051-0443(07)61789-8.

Reference Type BACKGROUND
PMID: 12354839 (View on PubMed)

Camma C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F, Andreone P, Craxi A, Cottone M. Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology. 2002 Jul;224(1):47-54. doi: 10.1148/radiol.2241011262.

Reference Type BACKGROUND
PMID: 12091661 (View on PubMed)

Llovet JM, Real MI, Montana X, Planas R, Coll S, Aponte J, Ayuso C, Sala M, Muchart J, Sola R, Rodes J, Bruix J; Barcelona Liver Cancer Group. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet. 2002 May 18;359(9319):1734-9. doi: 10.1016/S0140-6736(02)08649-X.

Reference Type BACKGROUND
PMID: 12049862 (View on PubMed)

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. doi: 10.1053/jhep.2002.33156.

Reference Type BACKGROUND
PMID: 11981766 (View on PubMed)

Homma H, Mezawa S, Doi T, Miyanishi K, Takada K, Kukitsu T, Oku T, Masuko E, Nojiri S, Niitsu Y. A comparative randomized trial of intermittent intrahepatic arterial carboplatin- versus doxorubicin-lipiodol emulsion in advanced hepatocellular carcinoma (stage IV). Hepatogastroenterology. 2004 Jul-Aug;51(58):1135-9.

Reference Type BACKGROUND
PMID: 15239261 (View on PubMed)

Stuart K. Chemoembolization in the management of liver tumors. Oncologist. 2003;8(5):425-37. doi: 10.1634/theoncologist.8-5-425.

Reference Type BACKGROUND
PMID: 14530495 (View on PubMed)

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 patency. Cardiovasc Intervent Radiol. 2003 Mar-Apr;26(2):111-7. doi: 10.1007/s00270-002-2524-6. Epub 2003 Mar 6.

Reference Type BACKGROUND
PMID: 12616414 (View on PubMed)

Other Identifiers

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hcc-001

Identifier Type: -

Identifier Source: org_study_id