Hepatocellular Carcinoma Non-resectablePhase 1NCT03652467
The Safety and Efficacy of Deferoxamine for Treating Unresectable Hepatocellular Carcinoma
A Phase 1 study testing Conventional TACE and Deferoxamine and conventional TACE in people with Hepatocellular Carcinoma Non-resectable, run by Jinan Military General Hospital at 1 site in China.
Trial summary
To investigate the safety and efficacy of deferoxamine (DFO) combined with conventional transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hepatocellular Carcinoma Non-resectable
- What is being tested?
- Conventional TACE and Deferoxamine and conventional TACE
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 100 participants
- Where
- 1 siteChina
- Study dates
- 1 Sep 2018to 31 Dec 2023
- Phase
- Phase 1
- 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
- Adult patients, ≥ 18 years of age.
- The participant must have histologically-confirmed, unresectable HCC
- At least 1 measurable lesion, and overall tumor lesions occupying < 50% of liver volume
- The participant has provided signed informed consent
- No known allergy to contrast media
- Not pregnant
- No vascular anatomy or bleeding that would preclude catheter placement or emboli injection
Who cannot join
- Patients receiving concurrent radiotherapy or immunotherapy.
- Patients who have received previous chemotherapy, biological agents, or radiotherapy.
- Prior transarterial chemoembolisation (TACE) or transarterial embolisation (TAE).
- Prior liver transplantation or liver resection.
- Current or recent (within 10 days of study start) use of full-dose anticoagulants for therapeutic purposes.
- Patients with high risk esophageal/gastric varices.
- The participant has central nervous system (CNS) metastases or carcinomatous meningitis
- The participant has poorly-controlled hypertension [in other words (ie), blood pressure in abnormal range despite medical management]
Trial locations and contacts
1 site in 1 country.
China1 site, 1 recruiting
- Recruiting
960th hospital of PLA
Jinan, Shandong, 250031
Min Li, M.D., 13953176057, liminyingxiang@163.com
About this study
Official title: The Safety and Efficacy of Deferoxamine Combined With Conventional Transarterial Chemoembolization in Patients With Unresectable Hepatocellular Carcinoma
To investigate the safety and efficacy of deferoxamine (DFO) combined with conventional transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC).
Read the detailed description
DFO, an iron chelator, is considered as a potential drug to the treatment of HCC. Ferrum is an important transition metal for organisms and the liver plays a major role in its storage. However, in pathologic conditions, it will lead to hepatocyte injury through the free radicals generated by excess iron. In addition, excess iron accumulation in the liver increases toxic free iron, which is closely associated with hepatic inflammation, as well as the development and progression of HCC. Reduction of iron is likely an important therapeutic targets for treating HCC. Iron reduction therapy has been efficacious in both in animal HCC models and results of clinical studies also suggest potential efficacy for HCC. DFO chelates iron by forming a stable complex that prevents the iron from entering into further chemical reactions. The investigators assume that DFO, combined with TACE, may provide additional efficacy in patients with unresectable HCC.
- Conditions
- Hepatocellular Carcinoma Non-resectable
- Being tested
- Conventional TACE, Deferoxamine and conventional TACE
- Keywords
- Deferoxamine, Transarterial chemoembolization, Unresectable hepatocellular carcinoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Conventional TACEDrug
Also called TACE
Conventional chemoembolization drugs are injected through hepatic artery.
Deferoxamine and conventional TACEDrug
Also called Deferoxamine & TACE
Deferoxamine is injected before conventional transarterial chemoembolization.
| Study group | Role | What they receive |
|---|---|---|
| Deferoxamine | Experimental | Patients are treated with deferoxamine and conventional TACE. Receives: Drug: Deferoxamine and conventional TACE |
| Conventional TACE | Active comparator | Patients are treated with conventional TACE. Receives: Drug: Conventional TACE |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression Free Survival (PFS) in Participants With Unresectable Hepatocellular Cancer
PFS is defined as the time from the first day of therapy to the first evidence of disease progression or death from any cause. As classified according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria, disease progression is having at least a 20% increase in the sum of the longest diameter of target lesions and/or unequivocal progression of a non-target lesion and/or detection of a new lesion. Participants who are alive and without disease progression and participants who did not progress and are subsequently lost to follow-up are censored at the last objective tumor assessment.
Measured: First dose to date of progressive disease or death due to any cause [every 3 cycles up to 36 months (1 cycle=2 weeks)]
Secondary outcomes (8)
Time to Progression
The time from first day of therapy to the first date of objective evidence of progressive disease (PD) by Response Evaluation Criteria In Solid Tumors (RECIST) criteria. PD is defined as having at least a 20% increase in sum of longest diameter of target lesions and/or unequivocal progression of a non-target lesion and/or detection of new lesion. Time to PD is censored at the date of death or study discontinuation.
Measured: First dose to date of PD [every 3 cycles up to 36 months (1 cycle=2 weeks)]
Overall Survival
Overall survival (OS) is the duration from first dose to death due to any cause. OS is censored at last contact date for participants who are alive at the end of follow-up period or lost to follow-up.
Measured: First dose to date of death up to 36 months
Percentage of Participants With Complete Response or Partial Response
Objective response rate (ORR) is defined as the percentage of participants with a confirmed best overall response of complete response (CR) or partial response (PR). As classified according to Response using Response Evaluation Criteria In Solid Tumors (RECIST) criteria, CR is the disappearance of all target and non-target lesions and any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 millimeters (mm) and normalization of tumor marker level of non-target lesions. PR is having at least a 30% decrease in sum of longest diameter of target lesions.
Measured: First dose to date of objective progressive disease (PD) or death up to 36 months
Duration of Response
Duration of response is the interval from the date of initial documented response [complete response (CR) , partial response (PR) or Stable disease] to the first documented date of disease progression, initiation of other (or additional) antitumor therapy is first reported, or death due to any cause. As classified according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria, CR is the disappearance of all target lesions, PR is having at least a 30% decrease in the sum of the longest diameter of target lesions, and stable disease is defined as neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease. Disease progression is having at least a 20% increase in the sum of the longest diameter of target lesions and/or unequivocal progression of a non-target lesion and/or detection of a new lesion. Data are censored for participants who did not progress or die.
Measured: Time of first response (CR, PR or Stable disease) to disease progression, or death due to any cause [every 3 cycles up to 36 months (1 cycle=2 weeks)]
Tumor Necrosis
Tumor necrosis is quantified in liver lesions greater than 2 cm at Baseline. When MRI showed many cut surfaces for a single tumor, tumor size and the size of necrotic area is measured by accumulation of the serial sections containing the tumor. Lipiodol accumulation without contrast enhance in tumor after TACE is regarded as an indication of necrosis. Tumor necrosis is assessed at Baseline and 1-3 days prior to the next scheduled transarterial chemoembolisation (TACE) till disease progression. The extent of tumor necrosis is presented as the percentage of the tumor volume at Baseline.
Measured: Baseline to the end of the study (up to 3 years, 36 months)
Number of Participants With Iron Reduction of Liver
The iron of liver will be measured by MRI, where R2* and QSM is applied to present the quantity of iron. Iron reduction is assessed at Baseline and 1-3 days prior to the next scheduled transarterial chemoembolisation. The test will be repeated 1 -3 days after the therapy. The reduction of liver iron will be calculated accordingly.
Measured: Baseline to the end of the study (up to 3 years, 36 months)
The Prognostic Value of Reduction of Liver Iron
The iron of liver will be measured by MRI, where R2* and QSM is applied to present the quantity of iron. All patients will undergo MRI before TACE, and the test will be repeated 1 -3 days after the therapy till disease progression. The reduction of liver iron will be calculated accordingly. Based on the measurements mentioned above, the prognostic value of reduction of liver iron will be analyzed.
Measured: Prior to TACE at baseline, 1 -3 days after the therapy
Number of Participants With Drug-Related Treatment-Emergent Adverse Events
Data presented are the number of participants who experienced treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), Grade 3 or higher TEAEs, or adverse events (AEs) leading to discontinuation of treatment that are considered by the investigator to be related to ramucirumab. A summary of SAEs and other nonserious AEs, regardless of causality, is located in the Reported Adverse Events section.
Measured: First dose to 36 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Aug 2018
- Study start1 Sep 2018
- Primary completion1 Sep 2022 (estimated)
- Study completion31 Dec 2023 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Hepatocellular Carcinoma Non-resectableStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Jinan Military General Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Li Min, Jinan Military General Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03652467
- Sponsor's protocol ID
- JNZY20181245
- Status last verified
- Feb 2019
- First submitted
- 22 Aug 2018
- Last updated
- 22 Feb 2019
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 22 Feb 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Safety and Efficacy of Deferoxamine Combined With Conventional Transarterial Chemoembolization in Patients With Unresectable Hepatocellular Carcinoma
- ClinicalTrials.gov ID
- NCT03652467
- Acronym / sponsor ID
- JNZY20181245
- Conditions
- Hepatocellular Carcinoma Non-resectable
- Keywords
- Deferoxamine, Transarterial chemoembolization, Unresectable hepatocellular carcinoma
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- Jinan Military General HospitalUniversity, hospital or other
- Study start
- 1 Sep 2018 (actual)
- Primary completion
- 1 Sep 2022 (estimated)
- Study completion
- 31 Dec 2023 (estimated)
- First posted
- 29 Aug 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To investigate the safety and efficacy of deferoxamine (DFO) combined with conventional transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC).
Detailed description
DFO, an iron chelator, is considered as a potential drug to the treatment of HCC. Ferrum is an important transition metal for organisms and the liver plays a major role in its storage. However, in pathologic conditions, it will lead to hepatocyte injury through the free radicals generated by excess iron. In addition, excess iron accumulation in the liver increases toxic free iron, which is closely associated with hepatic inflammation, as well as the development and progression of HCC. Reduction of iron is likely an important therapeutic targets for treating HCC. Iron reduction therapy has been efficacious in both in animal HCC models and results of clinical studies also suggest potential efficacy for HCC. DFO chelates iron by forming a stable complex that prevents the iron from entering into further chemical reactions. The investigators assume that DFO, combined with TACE, may provide additional efficacy in patients with unresectable HCC.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Deferoxamine | Experimental | Drug: Deferoxamine and conventional TACEPatients are treated with deferoxamine and conventional TACE. |
| Conventional TACE | Active comparator | Drug: Conventional TACEPatients are treated with conventional TACE. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Adult patients, ≥ 18 years of age.
- The participant must have histologically-confirmed, unresectable HCC
- At least 1 measurable lesion, and overall tumor lesions occupying < 50% of liver volume
- The participant has provided signed informed consent
- No known allergy to contrast media
Key exclusion criteria (8 listed)
- Patients receiving concurrent radiotherapy or immunotherapy.
- Patients who have received previous chemotherapy, biological agents, or radiotherapy.
- Prior transarterial chemoembolisation (TACE) or transarterial embolisation (TAE).
- Prior liver transplantation or liver resection.
- Current or recent (within 10 days of study start) use of full-dose anticoagulants for therapeutic purposes.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Conventional TACEAlso: TACEConventional chemoembolization drugs are injected through hepatic artery. | Drug | Conventional TACE |
| Deferoxamine and conventional TACEAlso: Deferoxamine & TACEDeferoxamine is injected before conventional transarterial chemoembolization. | Drug | Deferoxamine |
Primary outcome
Progression Free Survival (PFS) in Participants With Unresectable Hepatocellular Cancer
Time frame: First dose to date of progressive disease or death due to any cause [every 3 cycles up to 36 months (1 cycle=2 weeks)]
PFS is defined as the time from the first day of therapy to the first evidence of disease progression or death from any cause. As classified according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria, disease progression is having at least a 20% increase in the sum of the longest diameter of target lesions and/or unequivocal progression of a non-target lesion and/or detection of a new lesion. Participants who are alive and without disease progression and participants who did not progress and are subsequently lost to follow-up are censored at the last objective tumor assessment.
8 secondary outcomes
Time to Progression
Time frame: First dose to date of PD [every 3 cycles up to 36 months (1 cycle=2 weeks)]
Overall Survival
Time frame: First dose to date of death up to 36 months
Percentage of Participants With Complete Response or Partial Response
Time frame: First dose to date of objective progressive disease (PD) or death up to 36 months
Duration of Response
Time frame: Time of first response (CR, PR or Stable disease) to disease progression, or death due to any cause [every 3 cycles up to 36 months (1 cycle=2 weeks)]
Tumor Necrosis
Time frame: Baseline to the end of the study (up to 3 years, 36 months)
Number of Participants With Iron Reduction of Liver
Time frame: Baseline to the end of the study (up to 3 years, 36 months)
The Prognostic Value of Reduction of Liver Iron
Time frame: Prior to TACE at baseline, 1 -3 days after the therapy
Number of Participants With Drug-Related Treatment-Emergent Adverse Events
Time frame: First dose to 36 months
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Feb 2019.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing Conventional TACE and Deferoxamine and conventional TACE in people with Hepatocellular Carcinoma Non-resectable, run by Jinan Military General Hospital at 1 site 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 7 inclusion and 8 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 22 Feb 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
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?
Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Progression Free Survival (PFS) in Participants With Unresectable Hepatocellular Cancer (time frame: First dose to date of progressive disease or death due to any cause [every 3 cycles up to 36 months (1 cycle=2 weeks)]). 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 22 Feb 2019.