A Phase 2 Study of cabozantinib in Japanese Participants With Advanced Hepatocellular Carcinoma
- Conditions
- Advanced hepatocellular carcinoma
- Registration Number
- JPRN-jRCT2080223960
- Lead Sponsor
- Takeda Pharmaceutical Company Limited
- Brief Summary
The efficacy and safety results of this study indicate a favorable benefit/risk profile for cabozantinib at a dose of 60 mg/day in Japanese patients with advanced HCC who have received prior systemic anticancer therapy. It should be noted that patients without indication for the second-line therapy in the HCC guideline 2017 (version 4), e.g.patient who are sorafenib intolerant, with AFP less than 400 ng/mL, were enrolled in this Study Cabozantinib-2003.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- completed
- Sex
- All
- Target Recruitment
- 34
1. Male or female Japanese participants 20 years of age or older on the day of consent.
2. Histological or cytological diagnosis of HCC (results of a previous biopsy will be accepted).
3. Measurable disease per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as determined by the investigator.
4. Participants who have disease that is not amenable to a curative treatment approach (eg, transplant, surgery, radiofrequency ablation).
5. Participants who have received 1 or 2 prior anticancer therapies for advanced HCC.
- Cohort A: participants who have received prior sorafenib.
- Cohort B: participants who have not received prior sorafenib.
Note: Additional prior systemic therapies used as adjuvant or local therapy are allowed.
6. Radiographic progression following prior systemic anticancer therapy for advanced HCC.
7. Recovery to =8. Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1, and life expectancy of at least 3 months.
9. Child-Pugh Score of A.
10. Adequate organ and marrow function at Screening (within 10 days before Week 1 Day 1):
a) Absolute neutrophil count (ANC) >=1,200/mm^3.
b) Platelets >=60,000/mm^3.
c) Hemoglobin >=8 g/dL.
d) Serum creatinine =<1.5 x upper limit of normal (ULN) or calculated creatinine clearance >=40 mL/min using the Cockroft-Gault equation.
e) Urine protein-to-creatinine ratio (UPCR) =<1 mg/mg Cr.
f) Total bilirubin =<2 mg/dL.
g) Serum albumin >=2.8 g/dL.
h) Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =<5.0 x ULN.
i) Hemoglobin A1c (HbA1c) =<8% (if HbA1c results are unavailable [eg, hemoglobin variant], a fasting serum glucose =<160 mg/dL).
11. Antiviral therapy per local standard of care if active hepatitis B virus (HBV) infection.
12. Female participants who:
a) Are postmenopausal (natural amenorrhea, not due to other medical reasons) for at least 1 year before the Screening visit, OR
b) Are surgically sterile, OR
c) If they are of childbearing potential, agree to practice 1 highly effective method of birth control with a condom, which is an effective barrier method of contraception, at the same time, from the time of signing the informed consent through 4 months after the last dose of study drug, OR
d) Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the participant, from the time of signing the informed consent through 4 months after the last dose of study drug. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods], condoms only, withdrawal, spermicides only, and lactational amenorrhea are not acceptable methods of contraception.)
Male participants, even if surgically sterilized (ie, status postvasectomy), who:
e) Agree to practice effective barrier contraception during the entire study treatment period and through 4 months after the last dose of study drug. If their partner are of childbearing potential, their female partner should use 1 highly effective method of birth control at the same time, OR
f) Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the participant, from the time of signing the informed consent through 4 months after the last dose of study drug. (Periodic abstinence [e
1. Fibrolamellar carcinoma or mixed hepatocellular cholangiocarcinoma.
2. Any type of anticancer agent within 14 days before the first day of study drug administration (Week 1 Day 1).
3. Radiation therapy within 28 days (14 days for radiation for bone metastases) or radionuclide treatment (eg, I-131 or Y-90) within 42 days before Week 1 Day 1 (participant is excluded if there are any clinically relevant ongoing complications from prior radiation therapy).
4. Prior Cabozantinib treatment.
5. Treatment with any investigational products (excluding anticancer products approved in Japan) within 28 days before Week 1 Day 1.
6. Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy and/or surgery (including radiosurgery) and stable for at least 3 months before Week 1 Day 1. Eligible participants must be without corticosteroid treatment at Week 1 Day 1.
7. Concomitant anticoagulation, with oral anticoagulants (eg, warfarin, direct thrombin and Factor Xa inhibitors) or platelet inhibitors (eg, clopidogrel).
Note: Low-dose aspirin for prophylactic use (per local applicable guidelines) and low-dose, low molecular weight heparins (LMWH) are permitted (LMWH has not been approved for the use for cardioprotection in Japan). Anticoagulation with therapeutic doses of LMWH is allowed in participants without radiographic evidence of brain metastasis, who are on a stable dose of LMWH for at least 12 weeks before Week 1 Day 1, and who have had no complications from a thromboembolic event or the anticoagulation regimen.
8. Participants who have uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions:
a) Cardiovascular disorders including
i. Symptomatic congestive heart failure, unstable angina pectoris, or serious cardiac arrhythmias.
ii. Uncontrolled hypertension defined as sustained blood pressure (BP) >150 mm Hg systolic, or >100 mm Hg diastolic despite optimal antihypertensive treatment.
iii. Stroke (including transient ischemic attack [TIA]), myocardial infarction, or other ischemic event within 6 months before Week 1 Day 1.
iv. Thromboembolic event within 3 months before Week 1 Day 1.
v. A left-ventricular ejection fraction =<50%.
b) Gastrointestinal (GI) disorders including those associated with a high risk of perforation or fistula formation:
i. Tumors invading the GI tract, active peptic ulcer disease, inflammatory bowel disease (eg, Crohn's disease), diverticulitis, cholecystitis, symptomatic cholangitis or appendicitis, acute pancreatitis or acute obstruction of the pancreatic duct or common bile duct, or gastric outlet obstruction.
ii. Abdominal fistula, GI perforation, bowel obstruction, intra-abdominal abscess within 6 months before Week 1 Day 1.
Note: Complete healing of an intra-abdominal abscess must be confirmed prior to Week 1 Day 1.
c) Major surgery within 2 months before Week 1 Day 1. Complete healing from major surgery must have occurred 1 month before Week 1 Day 1. Complete healing from minor surgery (eg, simple excision, tooth extraction) must have occurred at least 7 days before Week 1 Day 1. Participants with clinically relevant complications from prior surgery are not eligible.
d) Cavitating pulmonary lesion(s) or endobronchial disease.
e) Lesion invading a major blood vessel including, but not limited to: inferior vena cava, pulmonary artery, or aorta. Participants with invasion or thromboses of portal/hepatic vasculature attributed t
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method