E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
hepatocellular carcinoma and Child Pugh score B |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10019828 |
E.1.2 | Term | Hepatocellular carcinoma non-resectable |
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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 |
To determine the rate of patients with drug-related toxicity with NCI CTCAE grade ≥ 3 |
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E.2.2 | Secondary objectives of the trial |
– Time to progression (TTP) – progression-free survival (PFS) – response rate (EASL/RECIST) – disease control rate (DCR: CR, PR or SD ≥ 8 weeks as best overall response (BOR)) – EASL/RECIST – Overall Survival (OS) – Cumulative dose – Average Daily Dose – Quality of Life – Safety
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Subjects with proven HCC not suitable for loco-regional treatment options, resection or liver transplantation. Diagnosis of HCC can be made either histologically or according to EASL criteria. 2. Child-Pugh stage B 3. Age > 18 years 4. ECOG Performance Status of 0 to 2 5. Life expectancy of at least 12 weeks 6. Subjects with at least one uni-dimensional (for RECIST) measurable lesion. Lesions must be measured by MRI or CT 7. Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to screening: - Hemoglobin > 9.0 g/dl - Absolute neutrophil count (ANC) >1,500/mm3 - Platelet count 50,000/μl - Total bilirubin < 3 times the upper limit of normal - ALT and AST < 5 x upper limit of normal - Alkaline phosphatase < 4 x upper limit of normal - PT-INR/PTT < 1.5 x upper limit of normal - Serum creatinine < 1.5 x upper limit of normal, creatinine clearance > 60 ml/min 8. Signed and dated informed consent before the start of specific protocol procedures
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E.4 | Principal exclusion criteria |
Excluded medical conditions: 1. Child-Pugh stages A and C 2. Patients eligible for loco-regional treatment options, resection or transplantation 3. Patients with portal vein thrombosis exceeding thrombosis of a single intrahepatic branch 4. Patients with esophageal varices grade II (with high risk signs) or grade III without prior prophylactic band ligation 5. Acute variceal bleeding within the last 4 weeks 6. Ascites not adequately controlled by diuretic therapy 7. Encephalopathy > grade I 8. Uncontrolled arterial hypertension with systolic blood pressure >160 mmHg or diastolic blood pressure > 90 mm Hg despite optimal treatment 9. History of cardiac disease: a) congestive heart failure > NYHA class 2; b) active CAD (MI more than 6 mo prior to study entry is allowed); c) cardiac arrhythmias requiring anti-arrhythmic therapy (beta blockers or digoxin are permitted), or d) uncontrolled hypertension (defined as blood pressure ≥ 160 mmHg systolic and/or ≥ 90 mmHg diastolic on medication) 10. History of HIV infection 11. Active clinically serious infections (> grade 2 NCI-CTC version 3.0) 12. Symptomatic metastatic brain or meningeal tumors (unless the patient is > 6 months from definitive therapy, has a negative imaging study within 4 weeks of study entry and is clinically stable with respect to the tumor at the time of study entry) 13. Patients with seizure disorder requiring medication (such as steroids or anti-epileptics) 14. History of organ allograft. 15. Patients with evidence or history of bleeding diathesis 16. Serious non-healing wound, fracture, or ulcer 17. Major surgery within the last 4 weeks 18. Thrombotic or embolic events within the last 6 months 19. Patients undergoing renal dialysis 20. Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors [Ta, Tis & T1] or any cancer curatively treated > 3 years prior to study entry. 21. Pregnant or breast-feeding patients. Women of childbearing potential must have a negative pregnancy test performed within 7 days of the start of treatment. Both men and women enrolled in this trial must use adequate barrier birth control measures during the course of the trial (and men for at least 3 months after last administration of study medication). 22. Any condition that is unstable or could jeopardize the safety of the patient and their compliance in the study 23. Known severe hypersensitivity to sorafenib or any of the excipients 24. Patients unable to swallow oral medications. 25. Participation in another clinical study within 30 days of enrollment 26. Patients unable to give written informed consent 27. Patients that are placed in institutions by the order of a judge or other regulatory authority.
Excluded therapies and medications, previous and concomitant: 1. Anticancer chemotherapy or immunotherapy or targeted therapy (except study medication) during the study or within 4 weeks of study entry. 2. Radiotherapy during study or within 3 weeks of start of study drug. (Palliative radiotherapy will be allowed). 3. Major surgery within 4 weeks of start of study 4. Autologous bone marrow transplant or stem cell rescue within 4 months of study 5. Use of biologic response modifiers, such as G-CSF, within 3 week 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 2 months prior to the study or during the study] 6. Patients receiving anticoagulation therapy, such as warfarin, phenprocoumon or heparin, or ASS >100 mg/d 7. Investigational drug therapy outside of this trial during or within 4 weeks of study entry 8. Prior exposure to the study drug. 9. Any St. John’s wort containing remedy
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of patients with drug-related toxicity with NCI CTCAE grade ≥ 3 will be derived with the 95% confidence interval. Furthermore all treatment-emergent and drug-related adverse events and serious AEs as well as safety laboratory parameters will be summarized by CTC grade
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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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
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 | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
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.8.4.1 | Number of sites anticipated in Member State concerned | 15 |
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 | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | No |
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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After discontinuation of treatment with study medication, each patient will be followed every 3 months until death. Follow-up stops 3 months after LPLV. |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | |