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Advanced HBV-Related Hepatocellular Carcinoma (HCC)Phase 3NCT03236636

The Phase III Study of Icaritin Versus HUACHANSU PIAN in Hepatocellular Carcinoma Subjects

A Phase 3 study testing Icaritin and HUACHANSU PIAN in people with Advanced HBV-Related Hepatocellular Carcinoma (HCC), run by Beijing Shenogen Biomedical Co., Ltd at 28 sites in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The enriched HBV-related advanced HCC patient population (composite biomarker score ≥ 2) and overall survival (OS) were compared between the two groups. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Icaritin and HUACHANSU PIAN
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
312 participants
Where
28 sitesChina
Study dates
8 Sep 2017to 30 Dec 2022
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Only patients who meet all the following criteria are included in the study:
  • 1) Age≥18years, no gender restriction; 2) Advanced or metastatic HCC patients in strict compliance with the "Primary Liver Cancer Diagnosis and Treatment Standard" (2017 Edition) issued by the National Health and Family Planning Commission, clinical diagnostic criteria and/or diagnosed by pathology /cytology, patients who fail to undergo liver surgery and/or other local treatment (ablation or hepatic artery intervention), or patients who have recurrence and progression after surgery and/or other local treatment; 3) Not previously accepted first-line system therapy (systemic chemotherapy, molecular targeting, immunotherapy and research medication, etc.) for advanced or metastatic HCC, including but not limited to systematic chemotherapy with oxaliplatin, sorafenib, PD-1/PD-L1 antibody, Icaritin and cinobufotalin, etc.; 4) Liver surgery was performed more than 3 months ago, ablation or interventional treatment of hepatic artery was performed more than 4 weeks ago, and the adverse reactions returned to normal; After surgery or other local treatment, if patients have gone beyond the norm for systemic adjuvant chemotherapy, it will need more than 6 months after the chemotherapy, and disease progression and / or metastasis have occurred; 5) For patients who are not suitable for first-line treatment of advanced HCC which is recommended in "Primary Liver Cancer Diagnosis and Treatment Standard." issued by the National Health and Family Planning Commission, it's mainly due to partial blood test indicators (See the relaxed scope in 11th inclusion criteria ) or other indicators (Including mild ascites and so on) which are not suitable for the existing first-line standard treatment; Or in particular cases, the patients insist on refusing to accept the existing first-line standard treatment(For example, patients feel that their physical condition is weak and / or economic constraints, which must be strictly mastered and controlled); 6) 2 weeks before the first medication of the trial, there is no use of modern Chinese medicine preparation with liver cancer indication, including Delisheng injection, Kanglaite injection or soft capsule, Aidi injection or Considi injection, elemene injection/oral liquid, 1) 7) no use of blood transfusion or blood products, no use of hematopoietic stimulating factor, no transfusion of albumin or blood products 14 days before screening; 8) According to the evaluation criteria of solid tumor reaction (RECIST 1.1), it has at least one measurable target lesion, which defined as non-lymph node lesions with the longest diameter larger than 10mm, lymph node lesions with the short diameter larger than 15mm; the lesions previously received local treatment such as ablation or hepatic artery interventional therapy should be detected by computed tomography (CT) / magnetic resonance imaging (MRI) and according to RECIST1.1, It's sure that disease progression has occurred and the longest diameter is more than 1.0cm,it can be used as a measurable target lesions; 9) The Child-Pugh score of liver function is grade A or better grade B (score≤7); 10) The ECOG score of physical condition is 0-1; 11) Expected survival time≥12 weeks; 12) The function of the main organs is basically normal and meets the following requirements:
  • ①Marrow: There is no blood transfusion and use of hematopoietic cell stimulating agent, including granulocyte colony stimulating factor (G-CSF)within 14 days before screening, platelet≥60×10E9/L, hemoglobin≥ 85g/L, white blood cell≥3.0×10E9/L; After a thorough measurement of the patient's condition, the above three items can be appropriately relaxed by the principal researchers at the research centre as: platelet 50 ~60×10E9/L, hemoglobin 80~85g/L, white blood cell 2.5 ~3.0×10E9/L (contains critical values);
  • ②Liver: Total bilirubin≤1.5 times of the upper limit of normal(ULN), Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)≤5 × ULN; albumin≥ 28g/L;
  • ④ Kidney: Serum creatinine≤ 1.5 x ULN, or creatinine clearance rate≥ 50ml/min; 13) If HBV-DNA≥104 copies/ml(2000IU/ml), antiviral therapy must be done first, the patient can be included in the group until HBV-DNA<104 copies /ml(2000IU/ml); and continue to take antiviral drugs, monitor liver function and hepatitis B virus load; 14) Women of childbearing age must receive pregnancy tests 14 days before treatment and the results are negative; Men of childbearing age need effective contraception during treatment and within 3 months after treatment; 15) Patients are volunteered to join the study, sign the informed consent, have good compliance and cooperate with follow-up; 16) The subjects do not participate in other clinical trials within 4 weeks before screening; If the subject fails in other test screening, but meets the requirements of this test, then can be enrolled.

Who cannot join

  • Patients who meet any of the following criteria are not allowed to enter the test:
  • Imaging examination shows that HCC liver tumors are huge (≥60% of the liver volume), or cancer embolus of portal trunk (occupying ≥50% of the vascular diameter), or cancer embolus invading mesenteric vein or inferior vena cava;
  • Middle or higher ascites which is clinically significant, it requires therapeutic abdominal paracentesis /drainage, or the Child-Pugh score > 2;
  • Local anticancer therapy (including surgery, ablation, hepatic arterial chemotherapy, embolization or radiotherapy) or major surgery was performed 28 days prior to randomization;
  • Hepatocholangiocarcinoma and fibrolamellar cell carcinoma; In the past 5 years or at the same time, there were other malignancies, except cervical carcinoma in situ, previously treated basal cell carcinoma and superficial bladder tumor (Ta, Tis, T1);
  • Pregnant or lactating women;
Show all 19Show fewer
  • The patient suffers from CTCAE classification type II or above myocardial ischemia or myocardial infarction, poorly controlled arrhythmia; and/or NYHA standard III to IV cardiac dysfunction.
  • Allograft transplants including liver transplantation were performed previously, or a liver transplant was planned during the trial;
  • Hepatic encephalopathy and / or hepatic nephropathy occurred within 6 months;
  • Patient with active hepatitis C, that is, anti -HCV positive or HCV-RNA positive and abnormal liver function;
  • Human immunodeficiency virus (HIV) tests are positive or severe infection requiring systemic treatment with antibiotics;
  • Inability to swallow, chronic diarrhea or intestinal obstruction that significantly affecting medication intake and absorption;
  • Having a history of digestive tract bleeding within 6 months, or with a clear gastrointestinal bleeding tendency, including local active ulcerative lesions, positive fecal occult blood;
  • The patient has or is suspected to have known active autoimmune disease;
  • If a central nervous system metastasis is known and a metastasis of the central nervous system is suspected, the cranial MRI examination should be performed to exclude it;
  • Abnormal coagulation function: international normalized ratio (INR) >1.5 or prothrombin time (PT) >16S;
  • There is a history of schizophrenia or psychotropic substance abuse;
  • Known to be allergic or intolerant to Icaritin or cinobufotalin and excipients;
  • Other conditions that researchers believe discourage patients from participating in trials.

Trial locations and contacts

28 sites in 1 country.

28 sites in 1 country

China28 sites, 27 recruiting
  • Cancer Hospital Chinese Academy of Medical Sciences

    Beijing, Beijing Municipality, 100021

    Chengxu Cui, MD, +86 010-87788120, 13701212251@139.com

    Chengxu Cui, MD

    Recruiting
  • Beijing Hospital

    Beijing, Beijing Municipality

    Yunbo Zhao

    Yunbo Zhao

    Recruiting
  • General Hospital of Chinese Armed Police Forces

    Beijing, Beijing Municipality

    Terminated
  • Guang'anmen Hospital of China Academy of Chinese Medical Sciences

    Beijing, Beijing Municipality

    Wei Hou

    Wei Hou

    Recruiting
  • Peking University Cancer Hospital

    Beijing, Beijing Municipality

    Chunyi Hao

    Chunyi Hao

    Recruiting
  • First Hospital of Jilin University

    Changchun, Jilin

    Wei Li

    Wei Li

    Recruiting
  • The Third Xiangya Hospital of Central South University

    Changsha, Hunan

    Peiguo Cao

    Peiguo Cao

    Recruiting
  • West China Hospital of Sichuan University

    Chengdu, Sichuan

    Ying Zhang

    Ying Zhang

    Recruiting
  • Chifeng Municipal Hospital

    Chifeng, Neimenggu

    Hongbo Ji

    Hongbo Ji

    Recruiting
  • Chongqing Traditional Chinese Medicine Hospital

    Chongqing, Chongqing Municipality

    Lingzhan Meng

    Lingzhan Meng

    Recruiting
  • The First People's Hospital of Foshan

    Foshan, Guangdong

    Bin Hu

    Bin Hu

    Recruiting
  • Nanfang Hospital of Southern Medical University

    Guangzhou

    Yabing Guo

    Yabing Guo

    Recruiting
  • Affiliated Hospital of Guilin Medical University

    Guilin, Guangxi

    Qian Chen

    Qian Chen

    Recruiting
  • Haikou People's Hospital

    Haikou, Hainan

    Juan Meng

    Juan Meng

    Recruiting
  • The Affiliated Hospital of Hangzhou Normal University

    Hangzhou, Zhejiang

    Gongying Chen

    Gongying Chen

    Recruiting
  • Anhui Provincial Hospital

    Hefei, Anhui

    Yueyin Pan

    Yueyin Pan

    Recruiting
  • The First Affiliated Hospital of Anhui Medical University

    Hefei, Anhui

    Kangsheng Gu

    Kangsheng Gu

    Recruiting
  • Jinan Central Hospital

    Jinan, Shandong

    Yuping Sun

    Yuping Sun

    Recruiting
  • Yunnan Provincial Hospital of Traditional Chinese Medicine

    Kunming, Yunnan

    Yi Li

    Yi Li

    Recruiting
  • Linyi Cancer Hospital

    Linyi, Shandong

    Jianhua Shi

    Jianhua Shi

    Recruiting
  • Eastern Theater General Hospital,QinHuai District Medical Area

    Nanjing, Jiangsu, 210002

    Shukui Qin, MD, 025-84453932, qinsk@csco.org.cn

    Shukui Qin, MD

    Recruiting
  • The First Affiliated Hospital with Nanjing Medical University

    Nanjing, Jiangsu

    Yongqian Su

    Yongqian Su

    Recruiting
  • Guangxi Medical University Affiliated Tumor Hospital

    Nanning, Guangxi

    Bangde Xiang

    Bangde Xiang

    Recruiting
  • The Affiliated Tumor Hospital of Nantong University

    Nantong, Jiangsu

    Aibing Xu

    Aibing Xu

    Recruiting
  • Fudan University Shanghai Cancer Center

    Shanghai, Shanghai Municipality

    Zhiqiang Meng

    Zhiqiang Meng

    Recruiting
  • The Sixth People's Hospital in Shenyang

    Shenyang, Liaoning

    Wei Wu

    Wei Wu

    Recruiting
  • The Fourth Hospital of Hebei Medical University

    Shijiazhuang, Hebei

    Ruixing Zhang

    Ruixing Zhang

    Recruiting
  • The First Affiliated Hospital of Zhengzhou University

    Zhengzhou, Henan

    Wang Ma

    Wang Ma

    Recruiting

Other trials in China

About this study

Official title: Comparison of Efficacy and Safety of Icaritin Versus Cinobufotalin in First-line Treatment of Advanced Hepatocellular Carcinoma Subjects: a Multicenter, Randomized, Double-blind, Double-dummy Phase III Clinical Trial

The enriched HBV-related advanced HCC patient population (composite biomarker score ≥ 2) and overall survival (OS) were compared between the two groups.

Read the detailed description

The basis of enrichment design adjustment : The latest published literature shows that the heterogeneity and immune tolerance of patients with hepatitis B virus (HBV) - related HCC are significantly correlated with a number of cytokines, including helper T cell subgroup 1 / 2 (Th1 / Th2) related factors. Moreover, the accumulated data show that the immunomodulatory effect of flavonoids including Icaritin is related to Th1 / Th2 factors. At the same time, the recent REACH2 study published in Lancet Oncology has successfully used serum alpha fetoprotein (AFP≥400) to enrich patients with advanced HCC. Based on the updated published data and our phase II clinical trial data, considering that the ongoing clinical trials are still in a blind state and no statistical analysis has been conducted, with consulting of clinical experts, regulatory agency advice, the protocol was amended and approved into adaptive enrichment design. Before unblended and SAP, the amendment protocol was prospectively pre-defined including sample size, patient population (CBS score positive), and event number for interim and final analysis. combined with the latest FDA clinical trial enrichment design guidelines (2019), several experts recommended to use the composite biomarkers, including IFN-γ , TNF - α and AFP, which may demonstrate the clinical advantages of the immunomodulation therapy with Icaritin for HBV-related advanced HCC patients in China with poor prognosis, but currently lack of treatment options.

Definition of enriched HBV-related advanced HCC patient:

Patient with serum composite biomarker score (CBS)≥2

Enrichment design amendment:

Based on our previous phase II data of Icaritin collected from HBV-related advanced HCC patients and the related literature, we assume that the mOS of the enriched population (CBS≥2) is 420 days (14 months) in the experimental group and 240 days (8 months) in the HUACHASHU control group; the HR of the experimental group relative to the control group is 0.57. A total of 106 target death events and 130 evaluable subjects were required for the enrichment. Once the amendment protocol be effective, the enriched and non-enriched patients will be continuously randomized into the experimental and the control arms accordingly (1:1). When the number of enrolled cases reaches 280, or 60% of events (64) of 106 deaths has been observed in the enriched population, interim analysis will be performed.

Being tested
Icaritin, HUACHANSU PIAN

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • IcaritinDrug

    Also called SNG-162

    Icaritin:600mg/time, 6 capsules/time(6×100mg/capsule), 2 times/day(30 minutes after breakfast, lunch and dinner), take orally, continuous administration until reach the standard of termination.

  • HUACHANSU PIANDrug

    Also called HUACHANSU PIAN(999)

    HUACHANSU PIAN:Take orally 4 tablets/time(0.3g/tablet), 3 times/day(30 minutes after breakfast, lunch and dinner), continuous administration until reach the standard of termination.

Study groups in NCT03236636
Study groupRoleWhat they receive
IcaritinExperimentalIcaritin:600mg/time, 6 capsules/time(6×100mg/capsule), 2 times/day(30 minutes after breakfast, lunch and dinner), take orally, continuous administration until reach the standard of termination.
Receives: Drug: Icaritin
HUACHANSU PIANActive comparatorHUANCHANSU PIAN:Take orally 4 tablets/time(0.3g/tablet), 3 times/day(30 minutes after breakfast, lunch and dinner), continuous administration until reach the standard of termination.
Receives: Drug: HUACHANSU PIAN

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall survival (OS)

    OS is defined as the time from randomization to died from any cause. For the subjects who failed to visit, deletion is performed on the final date of knowing the survival of the subjects, for subjects who still survive, deletion is performed on the data expiration date.

    Measured: 2-4 years

Secondary outcomes (6)
  1. Progression-free survival (PFS)

    PFS is defined as the date from randomization to the first radiographic record of disease progression or death (whichever occurs first). See the Statistical Analysis Plan (SAP) for the definition of PFS deletion rule.

    Measured: 2-3 years

  2. Time to progress(TTP)

    TTP is defined as the date from randomization to the first radiographic record of disease progression, see the Statistical Analysis Plan(SAP) for the definition of TTP deletion rule.

    Measured: 2-3 years

  3. Overall response rate (ORR)

    ORR is defined as the proportion of subjects achieving optimal overall efficacy such as CR or partial remission (PR).

    Measured: 2-3 years

  4. Overall disease control rate (DCR)

    DCR is defined as the proportion of subjects achieving optimal overall efficacy such as CR, PR or stable disease (SD).

    Measured: 2-3 years

  5. Assessment on Quality of life 1

    Quality of life (QOL) changes: Quality of life scores are assessed with EORTC QLQ-C30 and compared with baseline values.

    Measured: 2-4 years

  6. Assessment on Quality of life 2

    Quality of life (QOL) changes: Quality of life scores are assessed with EORTCQLQ-HCC-18 and compared with baseline values.

    Measured: 2-4 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Aug 2017
  2. Study start8 Sep 2017
  3. Primary completion30 Dec 2022 (estimated)
  4. Study completion30 Dec 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
multicenter, randomized, double-blind, double-dummy, adaptive enrichment design
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
312 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03236636
Sponsor's protocol ID
SNG1705ICR-1
Status last verified
Jan 2021
First submitted
26 Jul 2017
Last updated
27 Jan 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Icaritin and HUACHANSU PIAN in people with Advanced HBV-Related Hepatocellular Carcinoma (HCC), run by Beijing Shenogen Biomedical Co., Ltd at 28 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 27 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 28 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Yan Sun, MD (+86 10 67781331, suny@csco.org.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall survival (OS) (time frame: 2-4 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jan 2021.

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