Sorafenib Monotherapy vs. TACE-sorafenib Sequential Therapy for HCC With Metastasis

NCT ID: NCT03518502

Last Updated: 2018-05-08

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

130 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-03-01

Study Completion Date

2022-02-28

Brief Summary

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Sorafenib is the standard therapy for hepatocellular carcinoma (HCC) with extrahepatic metastasis (EHM). However, addition of transarterial chemoembolization (TACE) may be beneficial for controlling intrahepatic tumour. The investigators aimed to compare the efficacy between the sorafenib monotherapy and TACE-sorafenib sequential therapy in HCC patients with EHM.

Detailed Description

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Sorafenib is the standard therapy for hepatocellular carcinoma (HCC) with extrahepatic metastasis (EHM). However, transarterial chemoembolization (TACE) which is a standard therapy for intermediate stage may be beneficial for controlling intrahepatic tumour, thereby providing chance of improving survival in HCC patients with EHM.

The investigators aimed to compare the efficacy between the sorafenib monotherapy and TACE-sorafenib sequential therapy in HCC patients with EHM.

This study is a prospective randomized controlled study being conducted at 6 tertiary hospitals in South Korea. HCC patients with EHM are being enrolled and randomized into sorafenib monotherapy or TACE-sorafenib sequential therapy group. Patients with main portal vein invasion, Child-Pugh class B or C, and history of TACE or previous systemic therapy are being excluded. The sorafenib monotherapy group receives sorafenib immediately after randomization while the TACE-sorafenib group receives 2\~4 times of TACE before starting sorafenib. Response evaluation are performed every 2 months, and time to progression (TTP), progression free survival (PFS), median survival time (MST), and overall survival (OS) which is the primary outcome measure will be compared.

Conditions

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Hepatocellular Carcinoma Metastasis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Sorafenib monotherapy vs. transarterial chemoembolization-sorafenib sequential therapy
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Sorafenib monotherapy arm

The sorafenib monotherapy group receives sorafenib immediately after randomization.

Group Type ACTIVE_COMPARATOR

Sorafenib

Intervention Type DRUG

Standard therapy for advanced HCC

TACE-sorafenib sequential therapy arm

TACE(transarterial chemoembolization )-sorafenib group receives 2\~4 times of TACE before starting sorafenib.

Group Type EXPERIMENTAL

transarterial chemoembolization (TACE)

Intervention Type PROCEDURE

Standard therapy for intermediate HCC, but nor for advanced HCC

Sorafenib

Intervention Type DRUG

Standard therapy for advanced HCC

Interventions

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transarterial chemoembolization (TACE)

Standard therapy for intermediate HCC, but nor for advanced HCC

Intervention Type PROCEDURE

Sorafenib

Standard therapy for advanced HCC

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients with hepatocellular carcinoma by the European Association for the Study of the Liver (EASL) criteria or pathology
* One or more extrahepatic metastatic lesion by proven radiologically or histologically
* No serious coagulation abnormalities
* Performance status 0 or 1 by Eastern Cooperative Oncology Group(ECOG) criteria
* Child-Pugh score 5 or 6
* Serum creatinine \<1.5mg/dL
* Age between 18 \~ 75 years old
* No other life-threatening medical illness

Exclusion Criteria

* Patients with main portal vein invasion
* Child-Pugh class B or C
* History of TACE or previous systemic chemotherapy including sorafenib
* Age \>75 years old
* Cardiovascular diseases
* History of gastrointestinal bleeding within 2 weeks
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Korean Liver Cancer Study Group

OTHER

Sponsor Role collaborator

Korea University

OTHER

Sponsor Role lead

Responsible Party

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Hyung Joon Yim

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hyung Joon Yim, M.D.

Role: PRINCIPAL_INVESTIGATOR

Korea University Ansan Hospital

Locations

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Korea University Ansan Hospital

Ansan, Gyeonggi-do, South Korea

Site Status RECRUITING

Soonchunghyang University Bucheon Hospital

Bucheon-si, Gyeonggi-do, South Korea

Site Status RECRUITING

Keimyung University Dongsan Hospital

Daegu, , South Korea

Site Status RECRUITING

Chonnam National University Hwasoon Hospital

Gwangju, , South Korea

Site Status RECRUITING

Seoul Saint Marry Hospital, the Catholic University of Korea

Seoul, , South Korea

Site Status RECRUITING

Severance Hospital, Yonsei University

Seoul, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Hyung Joon Yim, M.D.

Role: CONTACT

82-31-412-6565

Facility Contacts

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Hyung Joon Yim, M.D.

Role: primary

82-31-412-6565

Sang Jun Suh, M.D.

Role: backup

82-31-412-4926

Young-Seok Kim

Role: primary

Woo Jin Chung

Role: primary

Sung-Bum Cho, M.D.

Role: primary

Si-Hyun Bae

Role: primary

Jun Yong Park, M.D.

Role: primary

References

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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 RESULT
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 RESULT
PMID: 11981766 (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 RESULT
PMID: 12091661 (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 RESULT
PMID: 12540794 (View on PubMed)

Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, de Oliveira AC, Santoro A, Raoul JL, Forner A, Schwartz M, Porta C, Zeuzem S, Bolondi L, Greten TF, Galle PR, Seitz JF, Borbath I, Haussinger D, Giannaris T, Shan M, Moscovici M, Voliotis D, Bruix J; SHARP Investigators Study Group. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008 Jul 24;359(4):378-90. doi: 10.1056/NEJMoa0708857.

Reference Type RESULT
PMID: 18650514 (View on PubMed)

Cheng AL, Kang YK, Chen Z, Tsao CJ, Qin S, Kim JS, Luo R, Feng J, Ye S, Yang TS, Xu J, Sun Y, Liang H, Liu J, Wang J, Tak WY, Pan H, Burock K, Zou J, Voliotis D, Guan Z. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol. 2009 Jan;10(1):25-34. doi: 10.1016/S1470-2045(08)70285-7. Epub 2008 Dec 16.

Reference Type RESULT
PMID: 19095497 (View on PubMed)

Cabrera R, Pannu DS, Caridi J, Firpi RJ, Soldevila-Pico C, Morelli G, Clark V, Suman A, George TJ Jr, Nelson DR. The combination of sorafenib with transarterial chemoembolisation for hepatocellular carcinoma. Aliment Pharmacol Ther. 2011 Jul;34(2):205-13. doi: 10.1111/j.1365-2036.2011.04697.x. Epub 2011 May 23.

Reference Type RESULT
PMID: 21605146 (View on PubMed)

Other Identifiers

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2012AS0313

Identifier Type: -

Identifier Source: org_study_id

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