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Hepatocellular CarcinomaNCT05631613

Lipiodol-TACE With Idarubicin Based On a Specific Emulsion Ratio for Hepatocellular Carcinoma

An observational study of Hepatocellular Carcinoma, run by Zhongda Hospital at 1 site 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 The sponsor has not verified this record for over two years, so it may be out of date.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 purpose of this observational study is to evaluate properties of lipiodol-idarubicin emulsion mixed with the best regimen obtained in vitro study, including stability, viscosity,visibility under X-ray and deposition, in order to maximize the efficacy of idarubicin-cTACE for HCC. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Hepatocellular Carcinoma
What is being tested?
cTACE(conventional transarterial chemoembolization)
How many people
40 participants
Where
1 siteChina
Study dates
28 Dec 2022to 30 Apr 2023
How long will I take part?
1 Week
Phase
Observational
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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: patients treated by lipiodol TACE with idarubicin for HCC

Who may be able to join

  • Confirmed diagnosis of HCC according to histopathology or CNLC guidelines (2022 Edition);
  • One of the following cases:
  • 1)CNLC stage IIb-IIIa, part of stage IIIb, and CNLC stage Ib and IIa patient who is unable or unwilling to receive surgical treatment due to other reasons (such as advanced age, severe liver cirrhosis, etc.); 2).Child-Pugh class A or B; 3).ECOG PS of 0 - 2; 4)The main portal vein has not been completely obstructed, with abundant collateral vessels, or restore the blood flow by portal vein stent placement 3.At least one measurable lesion (enable to assess lipiodol deposition); 4.Be willing to participate in this study.

Who cannot join

  • Non-HCC patients treated with TACE
  • Incomplete clinical and imaging data
  • Poor image quality or other difficulties in assessing intratumoral lipiodol deposition, including:
  • 1) A large amount of lipiodol was deposited around the lesion 2) Diffuse tumor distribution 3) Intratumoral lipiodol deposition from previous TACE 4) Metal artifacts from previous operations

Trial locations and contacts

1 site in 1 country.

Hui-Yan Dong, MD(studying) contact

+86-02583272121

ljxxdhy@126.com

China1 site, 1 recruiting
  • Zhongda Hospital, Southeast University

    Nanjing, Jiangsu, 210009

    Recruiting

Other trials in China

About this study

Official title: Transarterial Chemoembolization With Lipiodol-Idarubicin Emulsion Based On a Specific Ratio for Hepatocellular Carcinoma:a Prospective, Observational Study

The purpose of this observational study is to evaluate properties of lipiodol-idarubicin emulsion mixed with the best regimen obtained in vitro study, including stability, viscosity,visibility under X-ray and deposition, in order to maximize the efficacy of idarubicin-cTACE for HCC.

Read the detailed description

Idarubicin is a DNA topoisomerase II inhibitor that promotes DNA strand breakage, trapping cells in the G2 phase of the cell cycle and inducing DNA cleavage and cell apoptosis. Preclinical studies have shown that idarubicin has higher antitumor activity than epirubicin, especially against SUN-449 human hepatoma cells.

In recent years, foreign scholars have conducted a series of explorations in the treatment of hepatocellular carcinoma with lipiodol-idarubicin emulsion, and have obtained positive results.

However, in China, idarbicin has just been applied to TACE.Many interventional physicians are accustomed to directly use contrast agents to dissolve anthracyclines in order to improve tracer performance of chemotherapeutic agent-lipiodol emulsion under X-ray and reduce intraoperative reflux and misembolization. Meanwhile, due to the high density of the nonionic contrast media, the lipiodol emulsion can be deposited in the lesion for a long time. The Clinical Practice Guidelines for transcatheter arterial chemoembolization (TACE) Treatment of hepatocellular carcinoma in China (2021 edition) also recommended to prepare the chemotherapeutic drug-lipiodol emulsion according to the standard of " dissolving drug in nonionic contrast agent then mixed with lipiodol to make an emulsion with a ratio of 1:2".

At present, there is a lack of detailed objective data on the complete physical properties of the lipiodol-idarubicin emulsion, and some physicians and centers even make the emulsion based only on their habits and preferences.These all may affect the physical properties of the lipiodol emulsion, including intraoperative stability and viscosity of the emulsion, then eventually affect the operation of surgeon and the release behavior of chemotherapeutic drugs, and ultimately influence the efficacy of TACE.Therefore, the purpose of this prospective, observational study is to evaluate properties of lipiodol-idarubicin emulsion mixed with the best regimen obtained in vitro study, including stability, viscosity,visibility under X-ray and deposition, in order to maximize the efficacy of idarubicin-cTACE for HCC.

Being tested
cTACE(conventional transarterial chemoembolization)
Keywords
Hepatocellular Carcinoma, Transarterial chemoembolization, Idarubicin, Lipiodol emulsion, prospective study
Medical subject headings
Carcinoma, Hepatocellular

What participants receive

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

  • cTACE(conventional transarterial chemoembolization)Procedure or surgery

    transarterial chemoembolization with lipiodol-idarubicin emulsion

Study groups in NCT05631613
Study groupRoleWhat they receive
Water for Injection -Idarubicin -LipiodolIdarubicin is first dissolved in water for injection to make a solvent of 1mg/ml, which is then mixed with lipiodol to make an emulsion with a ratio of 1:2. Lipiodol-idarubicin emulsion is slowly injected, followed by embolization with embolic agents.
Receives: Procedure: cTACE(conventional transarterial chemoembolization)
Nonionic Contrast Agent -Idarubicin -LipiodolIdarubicin is first dissolved in nonionic contrast agent to make a solvent of 1mg/ml, which is then mixed with lipiodol to make an emulsion with a ratio of 1:2. Lipiodol-idarubicin emulsion is slowly injected, followed by embolization with embolic agents.
Receives: Procedure: cTACE(conventional transarterial chemoembolization)

What is being measured

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

  1. Deposition of of lipiodol-idarubicin emulsion

    1. Assessed by two or more senior radiologists as described in previous works: Excellent:>90%;Good:50%-90%;Poor:<50% 2.3D quantitative assessments of intratumoral lipiodol-emusion using the software 3d-slicer: V1=Volume of tumor (cm3) V2=volume of lipiodol deposition (cm3) Degree of iodized oil uptake:Intratumoral lipiodol retention(%)=V1/V2

    Measured: intraoperative and up to 7 days

Secondary outcomes (3)
  1. Stability of lipiodol-idarubicin emulsion

    Observe and assess the separation of emulsion(when it occures, record the percentage of aqueous phase, the persisting emulsion and the oily phase)

    Measured: intraoperative

  2. Viscosity of lipiodol-idarubicin emulsion

    Observe the tube-adhesion of emulsion.The subjective perception of injection is evaluated by questionnaire.

    Measured: intraoperative

  3. Visibility of lipiodol-idarubicin emulsion under X-ray: image quality

    Assessed by two or more senior radiologists according to Subjective Relative Evaluation of Images.

    Measured: intraoperative and up to 7 days

Timeline

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

  1. First posted30 Nov 2022
  2. Study start28 Dec 2022
  3. Primary completion31 Mar 2023 (estimated)
  4. Study completion30 Apr 2023 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
40 participants (estimated)
Target duration
1 Week
IDs, dates and publications
ClinicalTrials.gov ID
NCT05631613
Sponsor's protocol ID
Idarubicin-cTACE
Status last verified
Dec 2022
First submitted
15 Aug 2022
Last updated
29 Dec 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.

    PubMed 33538338
  • Mak LY, Wong DK, Pollicino T, Raimondo G, Hollinger FB, Yuen MF. Occult hepatitis B infection and hepatocellular carcinoma: Epidemiology, virology, hepatocarcinogenesis and clinical significance. J Hepatol. 2020 Oct;73(4):952-964. doi: 10.1016/j.jhep.2020.05.042. Epub 2020 Jun 3.

    PubMed 32504662
  • Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Niksic M, Bonaventure A, Valkov M, Johnson CJ, Esteve J, Ogunbiyi OJ, Azevedo E Silva G, Chen WQ, Eser S, Engholm G, Stiller CA, Monnereau A, Woods RR, Visser O, Lim GH, Aitken J, Weir HK, Coleman MP; CONCORD Working Group. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018 Mar 17;391(10125):1023-1075. doi: 10.1016/S0140-6736(17)33326-3. Epub 2018 Jan 31.

    PubMed 29395269
  • Reig M, Forner A, Rimola J, Ferrer-Fabrega J, Burrel M, Garcia-Criado A, Kelley RK, Galle PR, Mazzaferro V, Salem R, Sangro B, Singal AG, Vogel A, Fuster J, Ayuso C, Bruix J. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol. 2022 Mar;76(3):681-693. doi: 10.1016/j.jhep.2021.11.018. Epub 2021 Nov 19.

    PubMed 34801630
  • Lu J, Zhao M, Arai Y, Zhong BY, Zhu HD, Qi XL, de Baere T, Pua U, Yoon HK, Madoff DC, Teng GJ; International Society of Multidisciplinary Interventional Oncology (ISMIO). Clinical practice of transarterial chemoembolization for hepatocellular carcinoma: consensus statement from an international expert panel of International Society of Multidisciplinary Interventional Oncology (ISMIO). Hepatobiliary Surg Nutr. 2021 Oct;10(5):661-671. doi: 10.21037/hbsn-21-260.

    PubMed 34760969
  • Chen C, Lu L, Yan S, Yi H, Yao H, Wu D, He G, Tao X, Deng X. Autophagy and doxorubicin resistance in cancer. Anticancer Drugs. 2018 Jan;29(1):1-9. doi: 10.1097/CAD.0000000000000572.

    PubMed 29099416
  • Zhong S, Li C, Han X, Li X, Yang YG, Wang H. Idarubicin Stimulates Cell Cycle- and TET2-Dependent Oxidation of DNA 5-Methylcytosine in Cancer Cells. Chem Res Toxicol. 2019 May 20;32(5):861-868. doi: 10.1021/acs.chemrestox.9b00012. Epub 2019 Mar 11.

    PubMed 30816036
  • Armenian S, Bhatia S. Predicting and Preventing Anthracycline-Related Cardiotoxicity. Am Soc Clin Oncol Educ Book. 2018 May 23;38:3-12. doi: 10.1200/EDBK_100015.

    PubMed 30231396
  • Feng F, Jiang Q, Jia H, Sun H, Chai Y, Li X, Rong G, Zhang Y, Li Z. Which is the best combination of TACE and Sorafenib for advanced hepatocellular carcinoma treatment? A systematic review and network meta-analysis. Pharmacol Res. 2018 Sep;135:89-101. doi: 10.1016/j.phrs.2018.06.021. Epub 2018 Jun 26.

    PubMed 29959032
  • Mizutani H, Shiga C, Imai M, Ikemura K, Kitamura Y, Ohta K, Miyazawa D, Sakanashi M, Tahira T, Maeda T, Hiraku Y, Kawanishi S. Idarubicin, an Anthracycline, Induces Oxidative DNA Damage in the Presence of Copper (II). Anticancer Res. 2020 Oct;40(10):5399-5404. doi: 10.21873/anticanres.14548.

    PubMed 32988859
  • Boulin M, Guiu S, Chauffert B, Aho S, Cercueil JP, Ghiringhelli F, Krause D, Fagnoni P, Hillon P, Bedenne L, Guiu B. Screening of anticancer drugs for chemoembolization of hepatocellular carcinoma. Anticancer Drugs. 2011 Sep;22(8):741-8. doi: 10.1097/CAD.0b013e328346a0c5.

    PubMed 21487286
  • Boulin M, Schmitt A, Delhom E, Cercueil JP, Wendremaire M, Imbs DC, Fohlen A, Panaro F, Herrero A, Denys A, Guiu B. Improved stability of lipiodol-drug emulsion for transarterial chemoembolisation of hepatocellular carcinoma results in improved pharmacokinetic profile: Proof of concept using idarubicin. Eur Radiol. 2016 Feb;26(2):601-9. doi: 10.1007/s00330-015-3855-4. Epub 2015 Jun 11.

    PubMed 26060065
  • Favelier S, Boulin M, Hamza S, Cercueil JP, Cherblanc V, Lepage C, Hillon P, Chauffert B, Krause D, Guiu B. Lipiodol trans-arterial chemoembolization of hepatocellular carcinoma with idarubicin: first experience. Cardiovasc Intervent Radiol. 2013 Aug;36(4):1039-46. doi: 10.1007/s00270-012-0532-8. Epub 2012 Dec 8.

    PubMed 23224215
  • Tavernier J, Fagnoni P, Chabrot P, Guiu B, Vadot L, Aho S, Boyer L, Abergel A, Hillon P, Sautou V, Boulin M. Comparison of two transarterial chemoembolization strategies for hepatocellular carcinoma. Anticancer Res. 2014 Dec;34(12):7247-53.

    PubMed 25503156
  • Guiu B, Jouve JL, Schmitt A, Minello A, Bonnetain F, Cassinotto C, Piron L, Cercueil JP, Loffroy R, Latournerie M, Wendremaire M, Lepage C, Boulin M. Intra-arterial idarubicin_lipiodol without embolisation in hepatocellular carcinoma: The LIDA-B phase I trial. J Hepatol. 2018 Jun;68(6):1163-1171. doi: 10.1016/j.jhep.2018.01.022. Epub 2018 Feb 8.

    PubMed 29427728

Questions about this trial

What is this clinical trial studying?

An observational study of Hepatocellular Carcinoma, run by Zhongda 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 3 inclusion and 4 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 29 Dec 2022. 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.

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 Hai-Dong Zhu, MD (+86-02583272121, zhuhaidong9509@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Deposition of of lipiodol-idarubicin emulsion (time frame: intraoperative and up to 7 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05631613, which also lists 18 linked publications.

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 29 Dec 2022.

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