Analysis of the Role of Hepatocyte SLAMF3 Receptor and Drug Resistance Proteins (MDR) in Resistance to Treatment With Sorafenib in CHC Patients

Withdrawn

• Conditions: Hepatocellular Carcinoma; Hepatocyte Receptor
• Interventions: Other: Study on samples of tumor and peri-tumor tissues from patients with hepatocellular carcinoma

• Registration Number: NCT03113604
• Lead Sponsor: Centre Hospitalier Universitaire, Amiens

Brief Summary

Primary liver cancer or hepatocellular carcinoma (HCC) is the 7th most common cancer in humans; 9th in women (figures from the Association for Research against Cancer ARC). This cancer is a major public health problem on a global scale. Patients, whose diagnosis is often late, are at advanced stages of the pathology, even those who benefit from locoregional treatments have a poor prognosis and suffer from a lack of curative therapeutic strategies. CHC is highly refractory to cytotoxic chemotherapy and so far the response rates to conventional systemic chemotherapy has provided a clinical benefit where survival was prolonged by more than 25% in patients with advanced CHC. Further efforts are needed to effectively manage HCC. Knowledge of the mechanisms regulating proliferation and inhibiting the sensitivity of transformed cells to apoptosis is the key to the development of more effective therapeutic strategies.

Several new therapies, called targeted therapies, are tested in clinical trials. Currently, the most effective molecular agent for targeting the Raf pathway is sorafenib capable of also inhibiting tyrosine kinases of VEGFR and PDGFR. Sorafenib, a multikinase inhibitor, decreases the proliferation of tumor cells in vitro that inhibit the activity of targets present in tumor cells (CRAF, BRAF, V600E BRAF, c-KIT, and FLT-3) and tumor vascularization VEGFR-2, VEGFR-3, and PDGFR-beta). Despite the real benefit of this treatment, its efficacy (three months of overall survival) and its indication remain limited to Child-Pugh A, WHO 0-2 patients in whom curative treatment is contraindicated. In addition, several patients have resistance to Sorafenib and thus find themselves in therapeutic failure, thus limiting the therapeutic choice for these patients.

Resistance to treatment with Sorafenib limits the therapeutic choice. The mechanisms responsible for this resistance remain to be elucidated. Drug resistance proteins, MDR Multi-Drug Resistance, is a family of molecules whose expression increases in the cancer cell and ensures the repression of chemotherapy molecules outside the target cancer cell. This family includes the proteins ABCG2, MDR and MRP1. Our in vitro studies show that treatment of CHC Huh-7 cells with Sorafenib (10 mM) induces the specific expression of the transcripts of the MRP-1 protein without any effect on the expression of the ABCG2 and MDR protein. In addition, sorafenib has an effect on the expression of hepatocyte SLAMF3 receptor transcripts, a receptor recently identified in hepatocyte tissue. Indeed, it has been shown that the expression of SLAMF3 is lowered in the cancerous tissue compared to the healthy tissue and that the reintroduction of a strong expression in the cancer cell inhibits its proliferation by inhibiting the MAPK Erk pathway, Cancer cells to apoptosis and inhibits the uptake of tumor masses in the Nude mouse (I. Marcq, et al., 2013).

Detailed Description

Not available

Study Timeline

• Study Start: 2015-11-20
• Primary Completion: 2016-11-20
• Study Completion: 2016-11-20
• Status Verified: 2017-04
• Study First Submitted: 2017-04-10
• Study First Submitted QC: 2017-04-10
• Last Update Submitted: 2017-04-10
• Study First Posted: 2017-04-13
• Last Update Posted: 2017-04-13

Recruitment & Eligibility

• Status: WITHDRAWN
• Sex: All
• Target Recruitment: Not specified

Inclusion Criteria

• Patients over 18 years of age,
• Diagnosis of hepatocellular carcinoma (histological or non-invasive criteria of Barcelona),

Group 1: Tumor and peri-tumor tissue samples from patients with untreated CHCs sorafenib

• Patients who received treatment other than sorafenib (chemo-embolization, radiofrequency, resection, ...),

Group 2: Tumor and peri-tumor tissue samples from patients with non-sorafenib CHC

• Patients treated with sorafenib,
• Patients not responding to treatment with sorafenib

Group 3: Tumor and peri-tumor tissue samples from patients with CHCs responding to sorafenib

• Patients treated with sorafenib,
• Patients responding to treatment with sorafenib

Exclusion Criteria

• Age <18 years,
• Patients who do not have liver biopsy specimens (PBH) available at the tumor bank,
• Patients who have refused to use their samples for biomedical research,
• Pregnancy and breast feeding

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Patients with untreated CHC not sorafenib	Study on samples of tumor and peri-tumor tissues from patients with hepatocellular carcinoma	-
Patients with CHCs responding to sorafenib	Study on samples of tumor and peri-tumor tissues from patients with hepatocellular carcinoma	-
Patients with non-sorafenib CHC	Study on samples of tumor and peri-tumor tissues from patients with hepatocellular carcinoma	-

Primary Outcome Measures

Name	Time	Method
Rate of expression of SLAM3 and MDR transcripts, correlation with the responder status or not with Sorafenib	1 day

Trial Locations

Locations (1)

CHU Amiens Picardie; 🇫🇷 Amiens, Picardie, France