Transcatheter Arterial Chemoembolization (TACE) in Combination With Arsenic Trioxide Versus TACE in the Treatment of Middle-advanced Primary Hepatocellular Carcinoma (HCC) Patients

NCT ID: NCT02956772

Last Updated: 2017-02-23

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

PHASE2

Total Enrollment

190 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-30

Study Completion Date

2020-11-30

Brief Summary

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A multicentre, randomized, open-label, parallel-group, active controlled study.

Detailed Description

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Primary hepatocellular carcinoma (HCC) is one of the most common types of cancer and accounts for significant morbidity and mortality worldwide. Notably, more than half of the new HCC cases and deaths develop in China. Transarterial chemoembolization (TACE) has been proposed as the first-line therapeutic strategy for the treatment of patients with unresectable HCC. However, TACE has several limitations itself which might be potentially associated with tumor metastasis and relapse.

Recent studies have demonstrated that arsenic trioxide (As2O3) can act as the first-line therapeutic option in the treatment of acute promyelocytic leukemia. Thereafter, several small studies in China showed promising clinical benefits when As2O3 is administrated among the HCC patients. With these preliminary results, the investigators are planning to carry out a multicenter randomized controlled trial through which to explore the potential efficacy and safety of adjuvant As2O3 treatment for HCC patients.

Conditions

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Primary Hepatocellular Carcinoma

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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TACE plus Arsenic Trioxide

Patients in this group are to receive a single dose of TACE treatment on day 1, followed by arsenic trioxide at 10 mg/day for 14 days (day 8-21). TACE treatment is repeated every 9 weeks while arsenic trioxide every 3 weeks for treatment duration of 27 weeks. At least 3 cycles of arsenic trioxide are administrated.

Group Type EXPERIMENTAL

TACE

Intervention Type DRUG

After the puncture of femoral artery via Seldinger method, a catheter was inserted and digital celiac axis or hepatic arteriography performed. Then a microcatheter was used to infuse chemotherapeutic agent (30 to 60 mg of pirarubicin) mixed with 5 to 20 mL of Lipiodol Ultra-Fluid. Embosphere microspheres (size of 100 to 300 um) were inserted for embolization.

Arsenic trioxide

Intervention Type DRUG

Arsenic trioxide 10 mg is put into 500 ml saline solution and then administrated by continuous intravenous drip for 5 hours during a treatment day.

TACE

Patients in this group are to receive a single dose of TACE treatment on day 1. TACE treatment is repeated every 9 weeks for 27 weeks.

Group Type ACTIVE_COMPARATOR

TACE

Intervention Type DRUG

After the puncture of femoral artery via Seldinger method, a catheter was inserted and digital celiac axis or hepatic arteriography performed. Then a microcatheter was used to infuse chemotherapeutic agent (30 to 60 mg of pirarubicin) mixed with 5 to 20 mL of Lipiodol Ultra-Fluid. Embosphere microspheres (size of 100 to 300 um) were inserted for embolization.

Interventions

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TACE

After the puncture of femoral artery via Seldinger method, a catheter was inserted and digital celiac axis or hepatic arteriography performed. Then a microcatheter was used to infuse chemotherapeutic agent (30 to 60 mg of pirarubicin) mixed with 5 to 20 mL of Lipiodol Ultra-Fluid. Embosphere microspheres (size of 100 to 300 um) were inserted for embolization.

Intervention Type DRUG

Arsenic trioxide

Arsenic trioxide 10 mg is put into 500 ml saline solution and then administrated by continuous intravenous drip for 5 hours during a treatment day.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Subject is 18-80 years old.
2. Subject has no portal stem vein tumor thrombus.
3. Subject has primary middle-advanced liver cancer of Barcelona Clinic Liver Cancer stages B/C inappropriate for surgical resection or other locoregional therapy and still presents with tumor lesions in the liver.
4. Subject has evaluable tumor lesion(s) (using Magnetic Resonance Imaging /Computed Tomography) according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) Version 1.1: single lesion size ≥5cm or at least one lesion of \>3cm in size when 2-3 lesions exist or there are 4 or more lesions.
5. Subject has an Eastern Cooperative Oncology Group (ECOG) performance status ≤1, Fibrosis index based on 4 factors (FIB-4)≤6 and an expected survival time of 12 weeks or more.
6. Haematology: white blood cell count ≥3.0×10\^9/L; hemoglobin≥10 g/dL; blood platelet count≥80×10\^9/L
7. Blood biochemistry: serum albumin ≥2.8 g/dL, total bilirubin ≤2 mg/dL or ≤34.2 umol/L, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2 times of upper limit of normal (ULN); amylase and lipase ≤ 1.5 times of ULN; serum creatinine ≤2.0 mg/dL or \< 1.5 times of ULN; estimated creatinine clearance ≥60 mL/min.
8. International normalized ratio (INR) is ≤ 2.3 or prothrombin time (PT) is ≤3 seconds than upper limit of normal control.
9. Echocardiogram indicated a left ventricular ejection fraction (LVEF) of \>50%.
10. Subject has a liver function Child-Pugh class A or B.
11. Subject is not pregnant or lactating.
12. Female subjects must be infertile or agree to take effective contraceptives; male subjects and their partners of reproductive potential must also agree to use appropriate contraceptives.
13. Subject had no second tumor in the last 5 years, excluding skin basal cell carcinoma or skin squamous carcinoma or any other carcinoma in situ.
14. Subject had no history of systemic chemotherapy.
15. Subject has no any other concomitant anticancer therapies, such as local radiotherapy, systemic chemotherapy and molecular targeted therapy.
16. Subject and (or) guardian is able to understand this study and willing to provide written, informed consent to participate in this clinical study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hunan Provincial People's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xiang Hua

Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hua Xiang, Dr.

Role: PRINCIPAL_INVESTIGATOR

Hunan Provincial People's Hospital

Locations

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Guizhou Cancer Hospital

Guiyang, Guizhou, China

Site Status

Guizhou Province Tumor Hospital

Guiyang, Guizhou, China

Site Status

Hunan Provincial People's Hospital

Changsha, Hunan, China

Site Status

Hunan Cancer Hospital

Changsha, Hunan, China

Site Status

Xiangya Hospital Central South University

Changsha, Hunan, China

Site Status

The First Affiliated Hospital of University of South China

Hengyang, Hunan, China

Site Status

Jiangsu Province Hospital

Nanjing, Jiangsu, China

Site Status

Xinjiang Medical University Cancer Hospital

Ürümqi, Xinjiang, China

Site Status

The Tumor Hospital of Yunnan Province

Kunming, Yunnan, China

Site Status

Countries

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China

Central Contacts

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Lin Long, Dr.

Role: CONTACT

86-13507476175

Hua Xiang, Dr.

Role: CONTACT

85-13667367061

Facility Contacts

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Shi Zhou, Dr.

Role: primary

Junxiang Li, Dr.

Role: primary

Hua Xiang, Dr.

Role: primary

+86-13667367061

Lin Long, Dr.

Role: backup

+86-13507476175

Guowen LI, Dr.

Role: primary

Chunhui Zhou, Dr.

Role: primary

Youhua Wu, Dr.

Role: primary

Zhen-Qiang Yang, Dr.

Role: primary

Shufa Yang, Dr.

Role: primary

Ming Huang, Dr.

Role: primary

Other Identifiers

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RACE16001

Identifier Type: -

Identifier Source: org_study_id

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