Hepatocellular CancerPhase 2NCT03971201
A Randomized Phase II Trial of Surgery Plus Sorafenib vs. Sorafenib Alone for Hepatocellular Cancer (HCC) With Portal Vein Invasion
A Phase 2 study testing hepatic resection and Sorafenib in people with Hepatocellular Cancer, run by White Plains Hospital at 1 site in China.
Trial summary
Patients with HCC with portal vein involvement not involving the bifurcation (vP1-vP3) and no evidence of extra-hepatic spread will be enrolled. Patients will be required to have Child's A liver function and no significant portal hypertension. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hepatocellular Cancer
- What is being tested?
- hepatic resection and Sorafenib
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 200 participants
- Where
- 1 siteChina
- Study dates
- 6 Sep 2019to 30 Jun 2023
- Phase
- Phase 2
- 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
- Diagnosis of HCC A) 1st diagnosis of HCC - no prior treatments of HCC B) Diagnosis made by contrast enhanced CT or MRI with arterial and portal phases
- Arterial enhancement
- Venous washout
- Expanding/enhancing tumor thrombus seen in portal vein Extent of HCC spread A) Vp1-3 (Japanese system) - VP1-2 (Cheng criteria - Shanghai) B) No involvement of main portal vein Vp4 (Japanese system) - Vp3 Shanghai C) No evidence of extra-hepatic spread in abdomen D) No evidence of hepatic vein or vena cava invasion Need for Biopsy A) Patients not meeting above criteria B) Absence of underlying liver disease Demographics A) Age ≥ 18 Women of reproductive age A) Negative pregnancy test B) Must be on birth control for duration of study Able to provide informed consent No prior malignancy A) Excluding basal/squamous cell skin cancers B) Excluding superficial bladder cancer C) Excluding cervical cancer Underlying liver disease A) HBV, HCV, alcohol, or none B) All HBV patients must be placed on anti-viral therapy prior to any treatment and continue through entire study C) Co-infection HBV with HCV excluded D) HIV infection excluded Liver function/Performance status A) Child's A or B7 liver function B) Absence of clinical portal hypertension
- Platelet count ≥ 100,000 b. No evidence of varices or splenomegaly on imaging c. No ascites ECOG performance status 0-1 Tumor characteristics A) Size of largest tumor ≤ 10cm B) <50% of liver volume involved by tumor C) Multiple tumors allowed D) All tumors all confined to same lobe as PV involvement E) Hepatic Vein or Inferior Vena Cava involvement excluded Non-contrast CT of chest A) No lung metastases B) Involvement of gallbladder and diaphragm allowed C) Involvement of omentum allowed D) Involvement of abdominal wall allowed E) Involvement of colon, stomach, duodenum excluded
Who cannot join
- Unable to provide informed consent Age <18 years Unable to take anti-viral medication for hepatitis B Unable to take sorafenib Medically unfit for surgery Prior malignancy other than those specifically allowed by study Prior treatment of HCC Tumor characteristics A) HCC >10cm B) Bilobar tumor C) Mixed cholangiocarcinoma HCC D) Extra-hepatic tumor E) Tumor involving stomach, duodenum or colon F) Tumor involving hepatic veins or vena cava G) Tumor involving portal vein bifurcation
- Liver disease A) Liver function decompensated beyond Child's B7 B) Significant portal hypertension - splenomegaly, varices, ascites or platelet count <100,000 C) Co-infection with HBV and HCV D) Co-infection with HIV ECOG performance status >1
Trial locations and contacts
1 site in 1 country.
China1 site, 1 recruiting
- Recruiting
Eastern Hepatobiliary Surgery Hospital
Shanghai
Shuqun Cheng, MD
About this study
Patients with HCC with portal vein involvement not involving the bifurcation (vP1-vP3) and no evidence of extra-hepatic spread will be enrolled. Patients will be required to have Child's A liver function and no significant portal hypertension. Patients will be randomly assigned with a 1:1 ratio to either surgery followed by adjuvant sorafenib or sorafenib alone. Patients will be followed by serial imaging. The primary end-point is overall survival.
Read the detailed description
Trial design
Surgery + sorafenib vs. sorafenib 100 patients per arm Centralized randomization by CRO Need to call CRO for treatment allocation Primary end-point - OS Secondary end-point Progression free survival (PFS) Randomized 1:1 Stratification Vp1-2 vs. Vp3 AFP ≤400 vs AFP >400 Intention to treat Surgery aborted or R1-2 resection will remain in surgical arm No cross over CT scan chest/abdomen 4 weeks after surgery as post-operative baseline Will not alter treatment allocation Will allow for PFS measurement in surgical arm CT scan chest/abdomen pelvis Q 12 weeks after initiation sorafenib Patients progressing on sorafenib allowed 2nd line treatment Regorafenib or lenvatinib - if approved in China Dose reduction sorafenib as per protocol
- Conditions
- Hepatocellular Cancer
- Being tested
- hepatic resection, Sorafenib
- Keywords
- portal vein invasion
- Medical subject headings
- Liver Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
hepatic resectionProcedure or surgery
removal of portion of liver containing cancer
SorafenibDrug
sorafenib either as adjuvant therapy after resection or as only treatment
| Study group | Role | What they receive |
|---|---|---|
| Surgery plus sorafenib | Experimental | surgical resection followed by adjuvant sorafenib Receives: Procedure: hepatic resection; Drug: Sorafenib |
| sorafenib only | Active comparator | sorafenib only Receives: Drug: Sorafenib |
What is being measured
The primary outcome is the main question the study is designed to answer.
overall survival
time from randomization to death
Measured: 2-3 year
Secondary outcomes (1)
progression free survival
time from initiation of intervention until progression as defined by RESIST
Measured: 3-12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Jun 2019
- Study start6 Sep 2019
- Primary completion31 Dec 2022 (estimated)
- Study completion30 Jun 2023 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Hepatocellular CancerStudies 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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 200 participants (estimated)
Sponsor and investigators
- Lead sponsor
- White Plains Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Eastern Hepatobiliary Surgery Hospital, Sun Yat-sen University, West China Hospital, Cancer Hospital of Guangxi Medical University, Anhui Provincial Hospital, Fujian Cancer Hospital, Wenzhou People's Hospital
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03971201
- Sponsor's protocol ID
- 20190507
- Status last verified
- Apr 2021
- First submitted
- 31 May 2019
- Last updated
- 14 Apr 2021
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No: Data will not be shared
Study at a glance
From the registry record, last updated by the sponsor on 14 Apr 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Phase II Trial of Surgery Plus Sorafenib vs. Sorafenib Alone for Hepatocellular Cancer (HCC) With Portal Vein Invasion
- ClinicalTrials.gov ID
- NCT03971201
- Acronym / sponsor ID
- 20190507
- Conditions
- Hepatocellular Cancer
- Keywords
- portal vein invasion
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 200 participants (estimated)
- Lead sponsor
- White Plains HospitalUniversity, hospital or other
- Collaborators
- Eastern Hepatobiliary Surgery Hospital, Sun Yat-sen University, West China Hospital, Cancer Hospital of Guangxi Medical University, Anhui Provincial Hospital, Fujian Cancer Hospital, Wenzhou People's Hospital
- Study start
- 6 Sep 2019 (actual)
- Primary completion
- 31 Dec 2022 (estimated)
- Study completion
- 30 Jun 2023 (estimated)
- First posted
- 3 Jun 2019 (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.
Patients with HCC with portal vein involvement not involving the bifurcation (vP1-vP3) and no evidence of extra-hepatic spread will be enrolled. Patients will be required to have Child's A liver function and no significant portal hypertension. Patients will be randomly assigned with a 1:1 ratio to either surgery followed by adjuvant sorafenib or sorafenib alone. Patients will be followed by serial imaging. The primary end-point is overall survival.
Detailed description
Trial design
Surgery + sorafenib vs. sorafenib 100 patients per arm Centralized randomization by CRO Need to call CRO for treatment allocation Primary end-point - OS Secondary end-point Progression free survival (PFS) Randomized 1:1 Stratification Vp1-2 vs. Vp3 AFP ≤400 vs AFP >400 Intention to treat Surgery aborted or R1-2 resection will remain in surgical arm No cross over CT scan chest/abdomen 4 weeks after surgery as post-operative baseline Will not alter treatment allocation Will allow for PFS measurement in surgical arm CT scan chest/abdomen pelvis Q 12 weeks after initiation sorafenib Patients progressing on sorafenib allowed 2nd line treatment Regorafenib or lenvatinib - if approved in China Dose reduction sorafenib as per protocol
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Surgery plus sorafenib | Experimental | Procedure: hepatic resection, Drug: Sorafenibsurgical resection followed by adjuvant sorafenib |
| sorafenib only | Active comparator | Drug: Sorafenibsorafenib only |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Diagnosis of HCC A) 1st diagnosis of HCC - no prior treatments of HCC B) Diagnosis made by contrast enhanced CT or MRI with arterial and portal phases
- Arterial enhancement
- Venous washout
- Expanding/enhancing tumor thrombus seen in portal vein Extent of HCC spread A) Vp1-3 (Japanese system) - VP1-2 (Cheng criteria - Shanghai) B) No involvement of main portal vein Vp4 (Japanese system) - Vp3 Shanghai C) No evidence of extra-hepatic spread in abdomen D) No evidence of hepatic vein or vena cava invasion Need for Biopsy A) Patients not meeting above criteria B) Absence of underlying liver disease Demographics A) Age ≥ 18 Women of reproductive age A) Negative pregnancy test B) Must be on birth control for duration of study Able to provide informed consent No prior malignancy A) Excluding basal/squamous cell skin cancers B) Excluding superficial bladder cancer C) Excluding cervical cancer Underlying liver disease A) HBV, HCV, alcohol, or none B) All HBV patients must be placed on anti-viral therapy prior to any treatment and continue through entire study C) Co-infection HBV with HCV excluded D) HIV infection excluded Liver function/Performance status A) Child's A or B7 liver function B) Absence of clinical portal hypertension
- Platelet count ≥ 100,000 b. No evidence of varices or splenomegaly on imaging c. No ascites ECOG performance status 0-1 Tumor characteristics A) Size of largest tumor ≤ 10cm B) <50% of liver volume involved by tumor C) Multiple tumors allowed D) All tumors all confined to same lobe as PV involvement E) Hepatic Vein or Inferior Vena Cava involvement excluded Non-contrast CT of chest A) No lung metastases B) Involvement of gallbladder and diaphragm allowed C) Involvement of omentum allowed D) Involvement of abdominal wall allowed E) Involvement of colon, stomach, duodenum excluded
Key exclusion criteria (2 listed)
- Unable to provide informed consent Age <18 years Unable to take anti-viral medication for hepatitis B Unable to take sorafenib Medically unfit for surgery Prior malignancy other than those specifically allowed by study Prior treatment of HCC Tumor characteristics A) HCC >10cm B) Bilobar tumor C) Mixed cholangiocarcinoma HCC D) Extra-hepatic tumor E) Tumor involving stomach, duodenum or colon F) Tumor involving hepatic veins or vena cava G) Tumor involving portal vein bifurcation
- Liver disease A) Liver function decompensated beyond Child's B7 B) Significant portal hypertension - splenomegaly, varices, ascites or platelet count <100,000 C) Co-infection with HBV and HCV D) Co-infection with HIV ECOG performance status >1
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 |
|---|---|---|
| hepatic resectionremoval of portion of liver containing cancer | Procedure or surgery | Surgery plus sorafenib |
| Sorafenibsorafenib either as adjuvant therapy after resection or as only treatment | Drug | Surgery plus sorafenib, sorafenib only |
Primary outcome
overall survival
Time frame: 2-3 year
time from randomization to death
1 secondary outcome
progression free survival
Time frame: 3-12 months
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Apr 2021.
- Individual participant dataSharing planned: No. Data will not be shared
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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 2 study testing hepatic resection and Sorafenib in people with Hepatocellular Cancer, run by White Plains 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 5 inclusion and 2 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 14 Apr 2021. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 Wei-Hua Guan, MD (+8613501673307, weiyu.wang@tigermed.net), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
overall survival (time frame: 2-3 year). 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 14 Apr 2021.