NCT02329860已完成3 期
A Randomized, Double Blind, Placebo Controlled, Multicenter Phase III Study (AHELP) of Apatinib in Patients With Hepatocellular Carcinoma After Systemic Therapy（Chemotherapy and/or Targeted Therapy）
适应症
干预措施
相关药物
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 入组人数
- 400
- 试验地点
- 1
- 主要终点
- Overall Survival
研究概览
简要总结
This was a multicenter, randomized, double-blind, phase III trial. This clinical study evaluates the efficacy and safety of Apatinib in patients with advanced liver cancer who have progressed on Systemic Therapy (Chemotherapy and/or Targeted Therapy).
Approximately 400 patients who meet the entry criteria will be randomly assigned in a 2:1 ratio to Apatinib or placebo (1/3 chance to receive placebo).
Primary endpoint of the study is overall survival.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Triple (Participant, Care Provider, Investigator)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •≥ 18 years old.
- •Conform to the clinical diagnosis standard strictly or histological or cytological confirmation of HCC (hepatocellular carcinoma) who cannot benefit from treatments of established efficacy with higher priority such as resection, local ablation,and with at least one uni-dimensional measurable lesion by computed tomography (CT) scan or magnetic resonance imaging (MRI) according to RECIST 1.
- •Failure or intolerance to prior treatment with chemotherapy and/or targeted therapy (Failure is defined as documented radiological progression according to the radiology charter. Intolerance is defined as ≥ grade 4 hematologic toxicities, ≥ grade 3 non-hematologic toxicities ≥ grade 2 heart, liver or kidney damage).
- •Systemic therapy must have been completed ≥2 weeks before randomization (AEs due to prior treatment ≤ grade 1).
- •Liver function status Child-Pugh Class A or B (score≤7).
- •Barcelona Clinic Liver Cancer stage Category B or C.
- •Eastern Cooperative Oncology Group Performance Status of 0 or 1 within 1 week before randomization.
- •Life expectancy of at least 12 weeks.
- •HBV DNA ≤ 2000IU/ml or 1×10E+4 copy/ml.
- •Adequate bone marrow, liver and renal function as assessed by the following laboratory tests conducted within 1 week before randomization.
- •HB ≥ 90g/L; ANC≥1.5×10E+9/L; PLT≥80×10E+9/L; ALB ≥ 29g/L; ALT and AST < 5×ULN; TBIL ≤1.5×ULN; Cr ≤1.5×ULN
- •Women of childbearing potential and men must agree to use adequate contraception .
排除标准
- •Any local treatment (included but not limited: resection, radiotherapy, TAE, TACE, TAI, RFA or PEI) within 4 weeks of randomization.
- •Known hepatic duct carcinoma, mixed cell carcinoma or fibrolamellar hepatocellular carcinoma, known history or suffering from other cancer(except of cured skin basal cell carcinoma or carcinoma in situ of cervix).
- •Patients who will receive liver transplantation.
- •Ascites with clinical symptoms, i.e. require Abdominal paracentesis or drainage treatment such as or Child-Pugh Score>
- •Hypertension and unable to be controlled within normal level following treatment of anti-hypertension agents (systolic blood pressure > 140 mmHg, diastolic blood pressure > 90 mmHg).
- •Suffered from grade II or above myocardial ischemia or myocardial infarction, uncontrolled arrhythmias (including QT interval male ≥ 450 ms, female≥ 470 ms).
- •Grade III-IV cardiac insufficiency, according to NYHA criteria or echocardiography check: LVEF<50%.
- •Factors to affect oral administration（such as Patients unable to swallow oral medications, chronic diarrhea and ileus etc. situations evidently affect drug oral medication and absorption）.
- •Previous digestive tract bleeding history within 6 months or evident gastrointestinal bleeding tendency, such as,：Esophageal varices with bleeding risk, local active ulcerative lesions, fecal occult blood≥（++）；if fecal occult blood（+），gastroscope check is required.
- •The Within 28 days ahead of randomization, experience abdomen fistula, gastrointestinal perforation, or abdominal abscess
- •Coagulation abnormalities (INR > 1.5 x ULN, or PT > ULN +4 seconds), with bleeding tendency or are receiving thrombolytic or anticoagulant therapy;
- •Occurrence of central nervous system metastatic or known brain metastatic;
- •Objective evidence of previous or current pulmonary fibrosis history, interstitial pneumonia, Pneumoconiosis, radiation pneumonitis, drug-related pneumonia, Pulmonary function damaged seriously etc.
- •Proteinuria ≥ (++) or 24 hours total urine protein > 1.0 g.
- •Received powerful inhibitor of CYP3A4 within 7 days or powerful inducer of CYP3A4 within 12 days before randomization.
- •Pregnant or breast-feeding women; patients with fertility will not or there is no way to adopt effective contraceptive measures.
- •Mental disorders history, or Psychotropic drug abuse history.
- •Patients who has bone metastasis, has received Palliative radiotherapy (radiotherapy area > 5% marrow area).
研究组 & 干预措施
Apatinib
Experimental
750 mg orally (p.o.) every day (qd), 28 days as one cycle
干预措施: Apatinib (Drug)
Placebo
Placebo Comparator
orally (p.o.) every day (qd), 28 days as one cycle
干预措施: Placebo (Drug)
结局指标
主要结局
Overall Survival
时间窗: Approximately 36 months
次要结局
- Time to Progression（TTP）(Approximately 36 months)
- Progression Free Survival (PFS)(Approximately 36 months)
- Objective Response Rate(Approximately 36 months)
- Disease Control Rate(Approximately 36 months)
研究者
研究点 (1)
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