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Selective Internal Radiation Therapy and 188Re-SSS Lipiodol Treatment for Liver Cancer (Lip-Re2)

Phase 2
Recruiting
Conditions
Hepatocellular Carcinoma Non-resectable
Interventions
Combination Product: Selective Internal Radiation Therapy with 188Re-SSS lipiodol
Registration Number
NCT05797870
Lead Sponsor
Center Eugene Marquis
Brief Summary

The goal of this monocentric interventional study is to evaluate the efficacy, in terms of objective response rate, of the 188Re-SSS lipiodol SIRT in patients with non-operable HCC.

Detailed Description

This study is an open-labelled treatment administration study conducted with an exact one-stage one-arm study plan.

The study plans to included 35 patients and to treated 26 patients (take into account screen failures and SIRT contraindications).

The treatment is delivered by a one-day procedure leading to the injection of 188Re-SSS lipiodol. In details, the patient is hospitalized for one night. Two steps are performed while the patient is hospitalized: the pre-treatment simulation step and the treatment step itself.

After treatment, patients are followed until progression, new systemic or locoregional (in the same treatment area) antineoplastic therapy or death, within a maximum 24-month period following the SIRT.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
35
Inclusion Criteria
  • Age ≥ 18
  • ECOG Performance Status 0-1
  • HCC with histological diagnosis or non-invasive diagnosis according to AASLD criteria
  • Non operable and not accessible to ablation therapy
  • At least one measurable lesion using mRECIST
  • Tumor involvement <50% of the liver
  • BCLC classification A to C
  • Compensated cirrhosis (Child Pugh A or B7), if cirrhosis present
  • Registration with a social security scheme
  • Written and informed consent of the patient or his/her legal representative
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Exclusion Criteria
  • Inadequate hematological, hepatic, renal, thyroid and coagulation functions:

    1. Hemoglobin < 8,5 g/dl
    2. Granulocytes < 1500/mm3
    3. Platelets< 50 000 /mm3
    4. Bilirubin level ≥ 35 mol/l
    5. Transaminases > 6 UNL
    6. Creatinine > 1,5 UNL
    7. TSH < 0,2 µUI/L
  • Chronic respiratory insufficiency history

  • Known hemophilia with exophytic tumor > 1 cm

  • Extra-hepatic metastasis except hilum node < 2 cm

  • Lung shunt >20% evaluated with 99mTc albumin macroaggregate (MAA)

  • Poor tumor targeting with 99mTc albumin macroaggregate (MAA)

  • Previous SIRT

  • Previous systemic treatment within 4 weeks before radioembolization

  • More than 2 previous TACE (or embolization), in the area to be treated

  • Other neoplasia except if complete remission from at least one year

  • Contraindication related to the technique, in particular severe arterial pathology of the lower limbs or the aorta contraindicating or making difficult an arteriography by femoral approach

  • Pregnant woman or likely to be or breastfeeding, or male or female patients of reproductive potential without effective contraception from screening to 1 month after the end of the treatment

  • Minors, individual deprived of liberty, or under any kind of guardianship or trusteeship.

  • Patients unable to submit to medical follow-up of the study for social, medical or psychological reasons.

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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
188Re-SSS lipiodol SIRTSelective Internal Radiation Therapy with 188Re-SSS lipiodolPatients in the experimental arm will be treated with 188Re-SSS lipiodol Selective Internal Radiotherapy (SIRT).
Primary Outcome Measures
NameTimeMethod
The objective response ratethrough study completion, an average of 4 year

Defined as the best overall response occurring within 6 months' post 188Re-SSS lipiodol injection according to the modified RECIST criteria for hepatocellular carcinoma

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Centre de Lutte contre le Cancer Eugène Marquis

🇫🇷

Rennes, Bretagne, France

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