Efficacy Study of TACE to Treat Hepatocellular Carcinoma After Operation

NCT ID: NCT02631499

Last Updated: 2015-12-22

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

PHASE4

Total Enrollment

256 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-31

Study Completion Date

2019-12-31

Brief Summary

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This study is designed to prospectively evaluate whether post-hepatectomy adjuvant transcatheter arterial chemoembolization (TACE) is effective in reducing early recurrence in HCC patients with preoperative CTC ≥2.

Detailed Description

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Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide, and associated morbidity and mortality rates have escalated in recent years. Despite improvements in surveillance and clinical treatment strategies, the prognosis of HCC remains very poor due to high incidence of recurrence and metastasis. Recent clinical studies have provided evidence that circulating tumor cell (CTC) may directly participate in the metastasis cascade in various types of malignancies. The investigators previous data indicated that HCC patients with preoperative CTC levels ≥2 suffered significantly earlier recurrence (within 1 year) than patients with lower levels. However, the benefits of postoperative adjuvant therapies in preventing early recurrence in patients with preoperative CTC ≥2 remain to be elucidated. Transarterial chemoembolisation (TACE) is an effective palliative treatment for HCC. The investigators design a randomised controlled trial evaluating the efficacy of using TACE after hepatectomy to reduce early recurrence rates in HCC patients with preoperative CTC level ≥2.

Conditions

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Carcinoma, Hepatocellular Neoplastic Cells, Circulating

Keywords

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Circulating Tumor Cells Hepatoectomy TACE prognosis relapse Chemoembolization, Therapeutic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Adjuvant TACE

TACE will be performed 4-6 weeks after hepatectomy in patients with preoperative CTC ≥2 Epirubicin, lipiodol and gelatin sponge articles are used in TACE.

Group Type EXPERIMENTAL

TACE

Intervention Type PROCEDURE

TACE is performed 4-6 weeks after hepatectomy. Epirubicin and lipiodol are used in TACE.

Epirubicin

Intervention Type DRUG

Epirubicin is a chemotherapy drug used in TACE

lipiodol

Intervention Type DRUG

lipiodol is a kind of embolization material used in TACE

Control

no interventions were assigned after hepatectomy

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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TACE

TACE is performed 4-6 weeks after hepatectomy. Epirubicin and lipiodol are used in TACE.

Intervention Type PROCEDURE

Epirubicin

Epirubicin is a chemotherapy drug used in TACE

Intervention Type DRUG

lipiodol

lipiodol is a kind of embolization material used in TACE

Intervention Type DRUG

Other Intervention Names

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Transcatheter Arterial Chemoembolization Chemoembolization EADM Ultra-fluid lipiodol

Eligibility Criteria

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Inclusion Criteria

* HCC patients received curative hepatectomy with negative resection margin
* Age from 18 to 75
* Child-Pugh class A
* ASA class I to II
* ECOG performance status Grade 0 or 1
* Preoperative CTC level ≥2 per 7.5 ml peripheral blood
* No residual tumor revealed by hepatic arterial angiography 4-6 weeks after hepatectomy

Exclusion Criteria

* Patients diagnosed with other types of malignancies besides HCC
* Patients receiving concomitant local ablation or previous TACE
* Main portal vein tumor thrombus extraction during hepatectomy
* Hepatic arterial angiography before adjuvant TACE treatment reveals residual tumors.
* Presence of extra-hepatic or lymphatic metastasis
* Impaired liver function with either clinically detected ascites, hepatic encephalopathy, serum albumin \< 25g/L or bilirubin \> 50micromol/L
* Renal impairment with creatinine \> 200micromol/L
* Severe concurrent medical illness persisting \> 6 weeks after hepatectomy
* History of other cancer
* Hepatic artery anomaly making TACE not possible
* Allergy to 5-Fluorouracil, Epirubicin or lipiodol
* Pregnant woman
* Informed consent not available
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Zhongshan Hospital

OTHER

Sponsor Role collaborator

Johnson & Johnson Medical, China

INDUSTRY

Sponsor Role collaborator

Fudan University

OTHER

Sponsor Role lead

Responsible Party

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Jia Fan

President of Shanghai Zhongshan Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jia Fan, MD & PhD

Role: PRINCIPAL_INVESTIGATOR

Shanghai Zhongshan Hospital, Fudan University

Locations

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Sun Yat-Sen University Cancer Center

Guangzhou, Guangdong, China

Site Status

Nantong Tumor Hospital

Nantong, Jiangsu, China

Site Status

The First Affiliated Hospital of Soochow University

Suzhou, Jiangsu, China

Site Status

Eastern Hepatobiliary Surgery Hospital, Second Military Medical University

Shanghai, Shanghai Municipality, China

Site Status

Xinhua Hospital, Affliated with Shanghai Jiao Tong University, School of Medicine

Shanghai, Shanghai Municipality, China

Site Status

Zhongshan hospital, Fudan University

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

Central Contacts

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Xin-Rong Yang, MD & PhD

Role: CONTACT

Phone: 008618616881978

Email: [email protected]

Yun-Fan Sun, MD & PhD

Role: CONTACT

Phone: 008613162601787

Email: [email protected]

References

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Sun YF, Xu Y, Yang XR, Guo W, Zhang X, Qiu SJ, Shi RY, Hu B, Zhou J, Fan J. Circulating stem cell-like epithelial cell adhesion molecule-positive tumor cells indicate poor prognosis of hepatocellular carcinoma after curative resection. Hepatology. 2013 Apr;57(4):1458-68. doi: 10.1002/hep.26151. Epub 2013 Mar 4.

Reference Type BACKGROUND
PMID: 23175471 (View on PubMed)

Zhong C, Guo RP, Li JQ, Shi M, Wei W, Chen MS, Zhang YQ. A randomized controlled trial of hepatectomy with adjuvant transcatheter arterial chemoembolization versus hepatectomy alone for Stage III A hepatocellular carcinoma. J Cancer Res Clin Oncol. 2009 Oct;135(10):1437-45. doi: 10.1007/s00432-009-0588-2. Epub 2009 May 1.

Reference Type BACKGROUND
PMID: 19408012 (View on PubMed)

Ren ZG, Lin ZY, Xia JL, Ye SL, Ma ZC, Ye QH, Qin LX, Wu ZQ, Fan J, Tang ZY. Postoperative adjuvant arterial chemoembolization improves survival of hepatocellular carcinoma patients with risk factors for residual tumor: a retrospective control study. World J Gastroenterol. 2004 Oct 1;10(19):2791-4. doi: 10.3748/wjg.v10.i19.2791.

Reference Type BACKGROUND
PMID: 15334671 (View on PubMed)

Other Identifiers

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CTC-HE-TACE

Identifier Type: -

Identifier Source: org_study_id