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A Study to Evaluate SHR-1210 in Combination With Apatinib as First-Line Therapy in Patients With Advanced HCC

Phase 3
Completed
Conditions
Locally Advanced or Metastatic and Unresectable HCC
Interventions
Registration Number
NCT03764293
Lead Sponsor
Jiangsu HengRui Medicine Co., Ltd.
Brief Summary

This is a randomized, open-label, international, multi-center, phase III trial to evaluate the efficacy and safety of SHR-1210 plus apatinib mesylate versus sorafenib as first-line therapy in patients with advanced HCC.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
543
Inclusion Criteria
  • Histopathologically or cytologically confirmed advanced HCC
  • No previous systematic treatment for HCC
  • Have at least one measurable lesion (in accordance with RECIST v1.1)
  • BCLC stage B or C, and not suitable for surgical or local therapy, or has progressed following surgical and/or local therapy
  • ECOG-PS score 0 or 1
  • Child-Pugh Class: Grade A
  • Life Expectancy of at least 12 weeks
  • Subjects with HBV infection: HBV DNA<500 IU/ml or < 2500 copy/mL, and have received anti-HBV therapy for at least 14 days prior to enrollment in the study
  • Subjects with HCV-RNA(+) must receive antiviral therapy
  • Adequate organ function
Exclusion Criteria
  • Known hepatocholangiocarcinoma, sarcomatoid HCC, mixed cell carcinoma and lamellar cell carcinoma; other active malignant tumor except HCC within 5 years or simultaneously
  • Moderate-to-severe ascites with clinical symptoms
  • History of gastrointestinal hemorrhage within 6 months prior to the start of study treatment or clear tendency of gastrointestinal hemorrhage
  • Abdominal fistula, gastrointestinal perforation or intraperitoneal abscess within 6 months prior to the start of study treatment
  • Known genetic or acquired hemorrhage or thrombotic tendency
  • Thrombosis or thromboembolic event within 6 months prior to the start of study treatment
  • Cardiac clinical symptom or disease that is not well controlled
  • Hypertension that can not be well controlled through antihypertensive drugs
  • Factors to affect oral administration
  • History of hepatic encephalopathy
  • Previous or current presence of metastasis to central nervous system
  • HIV infection
  • Combined hepatitis B and hepatitis C co-infection
  • Be ready for or previously received organ or allogenic bone marrow transplantation
  • Interstitial lung disease that is symptomatic or may interfere with the detection and management of suspected drug-related pulmonary toxicity
  • Active known, or suspected autoimmune disease
  • Subjects with a condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications within 14 days of first administration of study treatment
  • Use of potent CYP3A4 inducers or inhibitors within 2 weeks prior to the signature of ICF
  • Known history of serious allergy to any monoclonal antibody or targeted anti-angiogenic drug
  • Severe infection within 4 weeks prior to the start of study treatment
  • Palliative radiotherapy for non-target lesions to control symptoms is allowed, but it must be completed at least 2 weeks prior to the start of study treatment
  • Treatment of other investigational product(s) within 28 days prior to the start of study treatment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ControlSorafenibSorafenib
SHR-1210SHR-1210SHR-1210+Apatinib
SHR-1210ApatinibSHR-1210+Apatinib
Primary Outcome Measures
NameTimeMethod
Overall Survival (OS)Up to approximately 3 years

OS was defined as the time from randomization to death from any cause.

Progression-free Survival (PFS) Evaluated by the Blinded Independent Review Committee (BIRC) Based on RECIST v1.1Up to approximately 3 years

PFS was defined as the time from randomization to the first occurrence of progressive disease (PD) by tumor image evaluation or death from any cause whichever occurs first as determined by BIRC according to RECIST v1.1. PD: at least a 20% increase in the sum of diameters of target lesions and the sum of diameters must also demonstrate an absolute increase of \>/= 5 millimeters (mm), or a measurable increase in a non-target lesion, or the appearance of new lesions.

Secondary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR)Up to approximately 3 years

ORR defined as the percentage of subjects with complete response (CR) or partial response (PR) evaluated by the BIRC or investigator based on RECIST v1.1. CR: disappearance of all target lesions. PR: At least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters, in the absence of CR. Overall Response (OR)=CR+PR.

Duration of Response (DOR)Up to approximately 3 years

DOR defined as time from the date of first record of objective response (CR or PR) to the first occurrence of radiological progression or death, whichever comes first, evaluated by the BIRC or investigator based on RECIST v1.1. Complete response (CR) was defined as Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) was defined as at least a 30% decrease in the sum of the diameter of TL, taking as reference the baseline sum of diameters.

Disease Control Rate (DCR)Up to approximately 3 years

DCR defined as the percentage of subjects with complete response, partial response or stable disease (SD) ≥ 8 weeks evaluated by the BIRC or investigator based on RECIST v1.1. Complete response (CR) was defined as Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial response (PR) was defined as at least a 30% decrease in the sum of the diameter of TL, taking as reference the baseline sum of diameters. Stable disease (SD) was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.

Trial Locations

Locations (121)

Renovatio Clinical

🇺🇸

The Woodlands, Texas, United States

The 940th Hospital of the joint logistic support force of People's Liberation Army

🇨🇳

Lanzhou, Gansu, China

Sun Yat-sen University Cancer Center

🇨🇳

Guangzhou, Guangdong, China

The first affiliated hospital of guangxi medical university

🇨🇳

Nanning, Guangxi, China

Harbin Medical University Cancer Hospital

🇨🇳

Harbin, Heilongjiang, China

Tongji hospital,Tongji Medical College,Huazhong University of Science&Technology

🇨🇳

Wuhan, Hubei, China

Hunan Cancer Hospital

🇨🇳

Changsha, Hunan, China

Eastern Theater General Hospital, Qinhuai District Medical Area

🇨🇳

Nanjing, Jiangsu, China

AZ Maria Middelares

🇧🇪

Gent, Belgium

West China Hospital of Sichuan University

🇨🇳

Chengdu, Si Chuan, China

Cliniques Universitaires de Bruxelles Hopital Erasme

🇧🇪

Bruxelles, Belgium

Centrum Onkologii-Instytut im.M.Sklodowskiej Curie

🇵🇱

Gliwice, Poland

Przychodnia Med-Polonia Sp. z o.o.

🇵🇱

Poznan, Poland

University of Maryland

🇺🇸

Baltimore, Maryland, United States

Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (Presidio Spedali Civili)

🇮🇹

Brescia, Italy

Azienda Ospedaliero-Universitaria

🇮🇹

Cagliari, Italy

The Catholic University of Korea, St. Vincent's Hospital

🇰🇷

Suwon-si, Gyeonggi-do, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

AZ Groeninge

🇧🇪

Kortrijk, Belgium

Pamela Youde Nethersole Eastern Hospital

🇭🇰

Hong Kong, Hong Kong

Azienda Ospedaliera Universitaria Careggi

🇮🇹

Firenze, Italy

Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico

🇮🇹

Milano, Italy

RBIH "Kursk regional clinical oncology dispensary" of Kursk Region Healthcare Committee

🇷🇺

Kursk, Russian Federation

CJSC Avicenna

🇷🇺

Novosibirsk, Russian Federation

BHI of Omsk region "Clinical Oncology Dispensary"

🇷🇺

Omsk, Russian Federation

Pavlov First Saint Petersburg State Medical University

🇷🇺

Saint-Petersburg, Russian Federation

National Cheng Kung University Hospital

🇨🇳

Tainan, Taiwan

Inonu Uni. Med. Fac.

🇹🇷

Malatya, Turkey

Communal Non-profit Enterprise Regional Center of Oncology

🇺🇦

Kharkiv, Ukraine

Communal Enterprise Volyn Regional Medical Center of Oncology of Volyn Regional Council

🇺🇦

Lutsk, Ukraine

Severance Hospital, Yonsei University Health System

🇰🇷

Seoul, Korea, Republic of

Charite Universitaetsmedizin Berlin - Campus Virchow-Klinikum Berlin

🇩🇪

Berlin, Germany

"VitaMed" LLC

🇷🇺

Moscow, Russian Federation

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

Korea University Anam Hospital

🇰🇷

Seoul, Korea, Republic of

Cliniques Universitaires Saint-Luc

🇧🇪

Bruxelles, Belgium

A.S.L. Napoli 1 Centro Ospedale del Mare

🇮🇹

Ponticelli, Napoli, Italy

Pratia MCM Krakow

🇵🇱

Krakow, Poland

SPb SBIH "City Clinical Oncological Dispensary"

🇷🇺

Saint-Petersburg, Russian Federation

Baskent University Adana Application and Research Center

🇹🇷

Adana, Turkey

Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital

🇹🇷

Istanbul, Turkey

CNCE of SRC Sumy Reg Clinical Oncology Dispensary, SSU, Chair of Oncology and Radiology

🇺🇦

Sumy, Ukraine

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Ajou University Hospital

🇰🇷

Suwon, Gyeonggi-do, Korea, Republic of

Dong-A University Hospital

🇰🇷

Busan, Korea, Republic of

SBHI Chelyabinsk Regional Clinical Center for Oncology and Nuclear Medicine

🇷🇺

Chelyabinsk, Russian Federation

Kaohsiung Chang Gung Memorial Hospital

🇨🇳

Kaohsiung, Taiwan

Istanbul University Cerrahpasa - Cerrahpasa Medical Faculty

🇹🇷

Istanbul, Turkey

FBI "Scientific Research Institute of Oncology n. a. N. N. Petrov"

🇷🇺

Saint-Petersburg, Russian Federation

SBIH Republican Clinical Oncological Dispensary of the MoH of Republic Bashkortostan

🇷🇺

Ufa, Russian Federation

E-DA Cancer Hospital

🇨🇳

Kaohsiung, Taiwan

Dr. Abdurrahman Yurtaslan Oncology Teaching and Research Hospital

🇹🇷

Ankara, Turkey

CNE"City Clin Hosp#4"of Dnipro City Council Dept of Chemotherapy SI Dnipropetrovsk MA of MOHU

🇺🇦

Dnipro, Ukraine

SBIH " Clinical Oncological Dispensary # 1"

🇷🇺

Krasnodar, Russian Federation

Chang Gung Memorial Hospital, Chiayi

🇨🇳

Chiayi City, Taiwan

Chang Gung Memorial Hospital, Linkou

🇨🇳

Taoyuan, Taiwan

CI of Healthcare Regional Clinical Specialized Dispensary of the Radiation Protection

🇺🇦

Kharkiv, Ukraine

Communal Institution Odesa Regional Clinical Hospital

🇺🇦

Odesa, Ukraine

SBIH of Moscow city "Moscow city oncology hospital №62" of Moscow Healthcare departement

🇷🇺

Moscow, Russian Federation

University of California San Diego (UCSD)-Moores Cancer Center

🇺🇸

La Jolla, California, United States

Beverly Hills Cancer Center

🇺🇸

Beverly Hills, California, United States

Wuhan Union Hospital,Tongji Medical College,Huazhong University of Science&Technology

🇨🇳

Wuhan, Hubei, China

The First Hospital Affiliated To AMU

🇨🇳

Chongqing, Chongqing, China

Fujian Medical University Union Hospital

🇨🇳

Fuzhou, Fujian, China

The Fourth Hospital of Hebei Medical University

🇨🇳

Shijiazhuang, Hebei, China

UZA

🇧🇪

Edegem, Belgium

Anhui Provincal Cancer Hospital

🇨🇳

Hefei, Anhui, China

The Center for Cancer and Blood Disorders

🇺🇸

Fort Worth, Texas, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Anhui Provincal Hospital

🇨🇳

Hefei, Anhui, China

The First Affiliated Hospital Of Anhui Medical University

🇨🇳

Hefei, Anhui, China

The Second Affiliated Hospital Of Anhui Medical University

🇨🇳

Hefei, Anhui, China

The Second Hospital Affiliated To AMU

🇨🇳

Chongqing, Chongqing, China

Beijing cancer Hospital

🇨🇳

Beijing, Beijing, China

Peking University International Hospital

🇨🇳

Beijing, Beijing, China

The Second Affiliated Hospital of ChongQing Medical University

🇨🇳

Chongqing, Chongqing, China

The First Hospital of Jilin University

🇨🇳

Changchun, Jilin, China

Jilin Cancer Hospital

🇨🇳

Changchun, Jilin, China

Azienda Ospedaliera Universitaria Integrata Verona (Ospedale Borgo Roma)

🇮🇹

Verona, Italy

Seoul National University Bundang Hospital Gyeonggi-do

🇰🇷

Seongnam-si, Gyeonggi-do, Korea, Republic of

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

🇮🇹

Roma, Italy

Azienda Ospedaliera Universitaria Policlinico Sant'Orsola Malpighi IRCCS

🇮🇹

Bologna, Italy

Centrum Zdrowia MDM

🇵🇱

Warszawa, Poland

Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie - Państwowy Instytut Badawczy

🇵🇱

Warszawa, Poland

NZOZ Centrum Badan Klinicznych

🇵🇱

Wroclaw, Poland

SBIH of Arkhangelsk region "Arkhangelsk Clinical Oncological Dispensary"

🇷🇺

Arkhangelsk, Russian Federation

Hospital Universitario Clinico San Carlos

🇪🇸

Madrid, Spain

Irkutsk Regional Oncology Dispensary

🇷🇺

Irkutsk, Russian Federation

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitari i Politecnic La Fe

🇪🇸

Valencia, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Changhua Christian Medical Foundation Changhua Christian Hospital

🇨🇳

Changhua, Taiwan

Ankara City Hospital

🇹🇷

Ankara, Turkey

Zaporizhzhya City Clinical Hospital #3

🇺🇦

Zaporizhzhia, Ukraine

Medical Center of Limited Liability Company Medical Center Concilium Medical

🇺🇦

Kyiv, Ukraine

Hospital Universitario HM Madrid Sanchinarro

🇪🇸

Madrid, Spain

University of California - Irvine

🇺🇸

Orange, California, United States

Cornell University Weill Cornell Medical College

🇺🇸

New York, New York, United States

Chinese Academy of Medical Sciences Cancer Hospital

🇨🇳

Beijing, Beijing, China

TheThird Affiliated Hospital ,Army Medical University

🇨🇳

Chongqing, Chongqing, China

Sun Yat-sen Memorial Hospital, Sun Yat-Sen University

🇨🇳

Guangzhou, Guangdong, China

NanFang Hospital of Southern Medical University

🇨🇳

Guangzhou, Guangdong, China

The Sixth People's Hospital of Shengyang

🇨🇳

Shengyang, Liaoning, China

The First Affiliated Hospital Of Nanchang University

🇨🇳

Nanchang, Jiangxi, China

Shandong Cancer Hospital Affiliated to Shandong University

🇨🇳

Jinan, Shandong, China

Fudan University Shanghai Cancer Center

🇨🇳

Shanghai, Shanghai, China

Liaoning Cancer Hospital

🇨🇳

Shenyang, Liaoning, China

Zhongshan Hospital, Fudan University

🇨🇳

Shanghai, Shanghai, China

Shanghai Changhai Hospital

🇨🇳

Shanghai, Shanghai, China

Sichuan Cancer Hospital&Institute

🇨🇳

Chengdu, Sichuan, China

Sir Run Run Shaw Hospital

🇨🇳

Hangzhou, Zhejiang, China

ZheJiang Cancer Hospital

🇨🇳

Hangzhou, Zhejiang, China

The First Affiliated Hospital, Zhejiang University

🇨🇳

Hangzhou, Zhejiang, China

The Chinese University of Hong Kong

🇭🇰

Shatin, Hong Kong

Tuen Mun Hospital

🇭🇰

Hong Kong, Hong Kong

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Centrum Medyczne Pratia Gdynia

🇵🇱

Gdynia, Poland

Wielkopolskie Centrum Onkologii

🇵🇱

Poznan, Poland

Hospital Universitario Reina Sofia

🇪🇸

Cordoba, Córdoba, Spain

Hospital Universitario Ramon y Cajal

🇪🇸

Madrid, Spain

The University of Hong Kong

🇭🇰

Hong Kong, Hong Kong

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