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Hepatocellular Carcinoma on Cirrhosis With Child A/B7 and Hepatic Intra Arterial Injection of Idarubicin/Lipiodol Emulsion

Phase 2
Recruiting
Conditions
Carcinoma, Hepatocellular
Interventions
Registration Number
NCT03727633
Lead Sponsor
University Hospital, Montpellier
Brief Summary

The investigators propose in this trial to test a hepatic chemotherapy, consisting of the hepatic intra-arterial injection Idarubicin, emulsified with Lipiodol, lipid vector, without embolization in the treatment of non-metastatic, unresectable hepatocellular carcinoma on cirrhosis with Child-Pugh A/B7.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
53
Inclusion Criteria
  • Histologically-proven HCC or according to EASL criteria
  • Child-Pugh A or B7
  • Disease that is not suitable for resection, ablation or radiofrequency
  • Performance Status ECOG 0 or 1
  • BCLC A/B or C if Performance Status ECOG = 1
  • Measurable lesions according to mRECIST criteria
  • No previous treatment with chemotherapy, radiotherapy or transarterial embolization (with or without chemotherapy) or radioembolisation
  • Age superior or equal to 18 years
  • Platelets > 50,000/mm3, Polynuclear neutrophils > 1000/mm3, Creatininemia < 150umol/L, Bilirubinemia < 5 mg/dL
  • Absence of heart failure (Ultrasound LVEF > 50%)
  • Women of child-bearing age using an adequate method of contraception throughout treatment
  • Men using an adequate method of contraception throughout the treatment and at least 3 months after the end of treatment
  • Written informed consent
  • National health insurance cover
Exclusion Criteria
  • Advanced tumor disease (extrahepatic except pulmonary micronodules <7mm of tumoral portal vein thrombosis on positron emission tomography are not a contra-indication.)
  • Large HCC with liver invasion >50%
  • History of other cancer than HCC and excluding cancers known to have been cured for more than 5 years, or basocellular skin tumors or cervical cancer in situ treated with adequate and curative purpose
  • Advanced liver disease (Child B8, B9 or C)
  • Contra-indication for the MRI (Pacemaker or neurosensorial stimulator or implantable defibrillator, cochlear implant, ferromagnetic foreing body similar to the nervous structure)
  • Contra-indication to the injection of the gadolinium-based contrast agents (history of hypersensibility to the gadolinium chelates, meglumine).
  • Contra-indication to idarubicin (Hypersensibility to active substance or excipients, cardiopathy with myocardial insufficiency of less than 6 months, serious arrhythmias, serious renal or liver failure, yellow fever vaccine or any other live attenuated vaccine, persistente myelosuppression, previous treatments with idarubicin and/or other anthracyclines or anthracenediones at maximum cumulative doses, stomatitis)
  • Contra-indication to Lipiodol (Hypersensibility, proven hyperthyroidism, tromatic injuries, bleeding or recent bleeding)
  • Concomitant disease or uncontrolled severe clinical situation
  • Uncontrolled severe infection
  • Vascular anatomy makes it impossible to perform hepatic intra-arterial treatments
  • Pregnancy (Beta HCG positive) or breastfeeding
  • Patient who for psychological, social, family or geographical reasons cannot be followed regularly
  • Vulnerable person
  • Concomitant participation of the patient in another research involving the human person

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treatment armIdarubicin and Lipiodolhepatic intra-arterial injection of an emulsion of Idarubicine and Lipiodol
Primary Outcome Measures
NameTimeMethod
Percentage of participants presenting a disease control at 4 months4 months

The primary outcome is to evaluate the disease control rate (partial, complete or stable response) 4 months after the first cycle of chemo-lipiodol using mRECIST criteria.

Secondary Outcome Measures
NameTimeMethod
Quality of life questionnaire (QLQ) QLQ-C3012 months

Quality of life questionnaire at 12 months after the first cycle of chemo-lipiodol (QLQ-C30). Subscale minimum score is egal to 1 (not at all) and maximum score is egal to 4 (very much). The maximal score correspond to a better quality of life. Subscales are summed to compute a total score.

Objective response rate of chemo-lipiodol6 months

Objective response rate according to mRECIST at 6 months after the first cycle

Safety of chemo-lipiodol defined by NCI-CTCAE version 4.0312 months

Safety defined by NCI-CTCAE version 4.03 published 14 june 2010

best response at 6 months after the first cycle of chemo-lipiodol according to mRECIST6 months

The best response according to mRECIST at 6 months after the first cycle of chemo-lipiodol

Overall survival12 months

Overall survival at 12 months after the first cycle of chemo-lipiodol

Trial Locations

Locations (4)

CHU d'Angers

🇫🇷

Angers, France

CHU de Dijon

🇫🇷

Dijon, France

CHU de Nice

🇫🇷

Nice, France

CHU de Montpellier

🇫🇷

Montpellier, France

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