Radiofrequency Ablation Accompanied With Spontaneous Sorafenib in Early to Intermediate Stage HCC

NCT ID: NCT02187081

Last Updated: 2017-03-28

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

380 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-15

Study Completion Date

2018-12-31

Brief Summary

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Radiofrequency ablation (RFA)can be curative with small localized HCCs up to 5 cm in diameter. However, the long-term prognosis is not satisfactory due to the high incidence of recurrence.Multimodality treatments are needed to prevent recurrences,but only useful with locoregional disease. Sorafenib is an oral multi-kinase inhibitor and the only systemic drug associated with improved overall survival (OS) in patients with advanced HCC. Retrospective and randomized studies have suggested that the combined use of Sorafenib may be useful in patients with unresectable HCC. Based on these information and the multiple actions of Sorafenib, we hypothesized that Sorafenib plus RFA may be useful in patients with early to Mid term HCC. In this investigation, we evaluated the safety and efficacy of a combination Sorafenib and RFA therapy in patients with Barcelona Clinic Liver Cancer (BCLC) Stage 0 -B1 HCC in a multicenter prospective cohort study.

Detailed Description

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Radiofrequency ablation (RFA) has been used as a minimally invasive option to eradicate tumors and preserve liver function in patients with impaired function or with a postoperative tumor recurrence. RFA can be curative with small localized HCCs up to 5 cm in diameter. However, the long-term prognosis for HCC patients treated with RFA is not satisfactory due to the high incidence of recurrence including local tumor recurrence and multicentric carcinogenesis.

Multimodality treatments are needed to prevent recurrences. Although there is a potential benefit with this strategy, it is only useful with locoregional disease. Sorafenib is an oral multi-kinase inhibitor and the only systemic drug associated with improved overall survival (OS) in patients with advanced HCC.

Retrospective and randomized studies have suggested that the combined use of Sorafenib, TACE, and RFA may be useful in patients with unresectable HCC. Based on these information and the multiple actions of Sorafenib, we hypothesized that Sorafenib plus RFA may be useful in patients with early HCC or recurrent HCC. Although no supportive data from clinical trials is available, this hypothesis is supported by recent animal studies. Inadequate RFA has been shown to promote rapid progression of residual tumors. Adjuvant Sorafenib postponed time to recurrence by inhibition of hypoxia inducible factor-1and vascular endothelial growth factor A (VEGFA). In a multifocal tumor model of HCC, RFA and Sorafenib alone resulted in a significant volume reduction of non-RFA-targeted tumors, but this effect was enhanced when both modalities were combined. This phenomenon was also demonstrated by more recent study on human subject.

Besides the advantages, Sorafenib initially promoted necrosis, delayed tissue repair after RFA and adversely affected normal liver parenchyma, which could result in increased RFA toxicity and limit its use in patients with HCC who have undergone RFA. Thus, the overall advantages of RFA plus Sorafenib need to be weighed against its adverse effects. In this investigation, we evaluated the safety and efficacy of a combination Sorafenib and RFA therapy in patients with Barcelona Clinic Liver Cancer (BCLC) Stage 0 -B1 HCC in a multicenter prospective cohort study.

Outcome measures: Post-RFA tumor recurrence

Conditions

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HCC

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Sorafenib+RFA

We give radiofrequency ablation plus Sorafenib for the treatment of HCC

Group Type EXPERIMENTAL

radiofrequency ablation plus Sorafenib

Intervention Type PROCEDURE

To treat HCC with the combination of radiofrequency ablation and sorafenib

RFA alone

We give Radiofrequency ablation alone for the treatment of HCC

Group Type ACTIVE_COMPARATOR

Radiofrequency ablation

Intervention Type PROCEDURE

To treat HCC with radiofrequency ablation alone.

Interventions

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radiofrequency ablation plus Sorafenib

To treat HCC with the combination of radiofrequency ablation and sorafenib

Intervention Type PROCEDURE

Radiofrequency ablation

To treat HCC with radiofrequency ablation alone.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Authorization of Informed Consent
* HCC diagnosed by biopsy or Image findings
* BCLC stage 0 to B1
* This time was the primary treatment of HCC. Had no history of any tumor specific therapy,including RFA,Hepatectomy,TACE,HIFU,and Transplantation
* Child Pugh A or B
* ECOG 0 to 2
* single lesion less than or equal to 5 cm,2 to 3 nodules, maximal size less than equal to 3cm
* Male or female (without pregnancy)
* Ages between 18 to 70 years
* Capable of take medicines
* anticipate at least survival of 12 weeks
* Unwilling to receive surgical resection or liver transplantation
* Potentially curable disease by RFA
* Sorafenib administrated less than 4 weeks before or after RFA procedures
* For any excuse,subject should take Sorafenib at least for 4 weeks

Exclusion Criteria

* A cancer embolus in major hepatic vessels or extrahepatic metastases
* Tumor number more than 4 or tumor size larger than 5 cm
* A present or past history of uncontrollable ascites, hepatic encephalopathy or variceal bleeding
* A history of a secondary malignancy
* Severe dysfunction of the heart, kidney or other organs
* Active infection except viral hepatitis
* Any treatment history of target lesion including chemotherapy and TACE
* Pregnancy
* received other trials on gene therapy
* have received operation less than 4 weeks
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Southwest Hospital, China

OTHER

Sponsor Role lead

Responsible Party

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feng xiaobin

Dr Xiaobin Feng

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Southwest Hospital

Chongqing, Chongqing Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xiaobin Feng, Docter

Role: CONTACT

86-23-68765297

Facility Contacts

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Xiaobin Feng

Role: primary

Other Identifiers

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SWHB008

Identifier Type: -

Identifier Source: org_study_id

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