E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
advanced hepatocellular carcinoma |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 7.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10049010 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective is to evaluate the effect of doxorubicin plus sorafenib or doxorubicin plus placebo on time to progression (TTP) in patients with advanced hepatocellular carcinoma |
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E.2.2 | Secondary objectives of the trial |
The secondary efficacy objectives are to assess the following variables between patients treated with doxorubicin plus sorafenib versus doxorubicin plus placebo: To evaluate •overall survival (OS) •Progression Free Survival (PFS) •the overall response rate (proportion of patients with confirmed partial and complete responses as per the RECIST criteria ) To evaluate in an exploratory manner the relative TTP,TTSP,RR and overall survival between the 2 study populations •the time to symptomatic progression (TTSP) as measured by the Functional Assessment of Cancer Therapy Hepatobiliary Symptom Index-8 (FHSI-8) To determine •overall response duration and time to objective response •overall disease control rate |
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
•Male or female patients > 18 years of age •Patients who have a life expectancy of at least 12 weeks •Patients with advanced HCC (unresectable, and/or metastatic) which have been histologically or cytologically documented. Patients must have at least one tumor lesion that meets both of the following criteria: •The lesion can be accurately measured in at least one dimension according to the Response Evaluation Criteria in Solid Tumors (RECIST) •The lesion has not been previously treated with local therapy (such as surgery, radiation therapy, hepatic arterial therapy, chemoembolization, radiofrequency ablation, percutaneous ethanol injection or cryoablation).
•Patients who have received local therapy except chemoembolization, such as surgery, radiation therapy, hepatic arterial embolization, radiofrequency ablation, percutaneous ethanol injection or cryoablation are eligible, provided that they either have a target lesion which has not been subjected to local therapy and/or the target lesion(s) within the field of the local therapy has shown an increase of 25% in the size. Local therapy must be completed at least 4 weeks prior to the baseline scan. •Patients who have an Eastern Co-operative Oncology Group (ECOG) performance status of 0, 1, or 2
•Cirrhotic status of Child-Pugh class A only •Patients who are felt, by the treating investigator, to be appropriate for single agent doxorubicin treatment. The following laboratory parameters must be met : •Platelet count >= 75x 109/L •Absolute neutrophil count (ANC) > 1500 /mm3 •Hemoglobin >= 8.5 g/dl •Total bilirubin <= 3 mg/dl within 24 hours of doxorubicin treatment •ALT and AST < 5 x the upper limit of normal •Amylase and lipase < 1.5 x the upper limit of normal •Serum creatinine < 1.5 x upper limit of normal •PT-INR <=1.7. Patients who are being therapeutically anticoagulated with an agent such as coumadin or heparin will be allowed to participate provided that no prior evidence of underlying abnormality in these parameters exists.
•Patients who give written informed consent prior to any study specific screening procedures with the understanding that the patient has the right to withdraw from the study at any time, without prejudice.
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E.4 | Principal exclusion criteria |
•Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study. However cervical carcinoma in situ, treated basal cell carcinoma, melanoma in situ, superficial bladder tumors [Ta, Tis & T1] or any cancer curatively treated > 3 years prior to entry is permitted. •History of cardiac disease: congestive heart failure > class II New York Heart Assocation (NYHA); active coronary artery disease (CAD) (6 months post myocardial infarction prior to study entry); cardiac arrhythmias requiring anti-arrhythmic therapy other than beta blockers or digoxin, or uncontrolled hypertension •Serious myocardial dysfunction, defined as scientigraphically (MUGA, myocardial scintigram) determined absolute left ventricular ejection fraction (LVEF) below 45% or a LVEF below the normal limit •Active clinically serious infections (> grade 2 NCI-CTCAE version 3.0) •Known history of human immunodeficiency virus (HIV) infection •Known CNS tumors including metastatic brain disease •Patients with clinically significant gastrointestinal bleeding within 30 days prior to study entry. •Patients with seizure disorder requiring medication (such as anti-epileptics) •History of organ allograft •Substance abuse, medical, psychological or social conditions that may interfere with the patient’s participation in the study or evaluation of the study results •Known or suspected allergy to the investigational agent or any agent given in association with this trial •Patients unable to swallow oral medications •Any condition that is unstable or which could jeopardize the safety of the patient and his/her compliance in the study •Pregnant or breast-feeding patients. Women of childbearing potential must have a negative pregnancy test performed within seven days prior to the start of study drug. Both men and women enrolled in this trial must use adequate barrier birth control measures during the course of the trial •Prior use of any systemic anti-cancer treatment for HCC, eg. chemotherapy, immunotherapy or hormonal therapy (except that hormonal therapy for supportive care is permitted). Antiviral treatment is allowed, however interferon therapy must be stopped at least four weeks prior to randomisation. •Prior local chemoembolization treatment •Prior use of Raf-kinase inhibitors (RKI), VEGF inhibitors, MEK inhibitors or Farnesyl transferase inhibitors •Major surgery within 4 weeks of start of study drug •Radiotherapy during study or within 3 weeks of start of study drug. [Palliative radiotherapy will be allowed as described in the Prior and Concomitant Therapy section 4.5.7] •Use of biologic response modifiers, such as G-CSF, within 3 weeks of study entry. [G-CSF and other hematopoietic growth factors may be used in the management of acute toxicity such as febrile neutropenia when clinically indicated or at the discretion of the investigator, however they may not be substituted for a required dose reduction.] Patients taking chronic erythropoietin are permitted provided no dose adjustment is undertaken within 1 month prior to the study or during the study •Autologous bone marrow transplant or stem cell rescue within four months of start of study drug •Investigational drug therapy for any disease during or within 30 days prior to start of study drug •Concomitant treatment with rifampin or St John’s Wort
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E.5 End points |
E.5.1 | Primary end point(s) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 26 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 26 |