Italian Multicentric Prospective Study Of Validation Of Angiogenesis Polymorphisms In HCC Patients Treated With Sorafenib
试验速览
- 阶段
- 不适用
- 入组人数
- 160
- 试验地点
- 10
- 主要终点
- PFS
研究概览
简要总结
Sorafenib represents the standard care for advanced hepatocellular carcinoma (HCC). However, molecular predictors of sorafenib efficacy have not yet been identified.
The primary aim of the study is to validate the prognostic or predictive role of eNOS,Ang2, HIF-1, VEGF and VEGFR polymorphisms in relation to clinical outcome (progression-free survival, PFS) of HCC patients treated with sorafenib.
详细描述
Sorafenib is a multikinase inhibitor acting on vascular endothelial growth factor receptors (VEGFR) and platelet-derived growth factor receptor beta (PDGFRβ) involved in tumor cell proliferation and tumor angiogenesis.
Angiogenesis is a cascade of linked and sequential steps ultimately leading to tumour neovascularisation. Preclinical data suggested that significant HCC growth is dependent on angiogenesis, and an increase in tumour dimension may induce vascular endothelial cell proliferation.
Vascular endothelial growth factor (VEGF)-driven pathway has been demonstrated to play a major role in tumour angiogenesis. In fact, VEGF as a potent permeability factor promotes cell migration during invasion and as an endothelial growth factor stimulates endothelial cell proliferation, inducing the budding of new blood vessels around the growing tumour masses .
Single nucleotide polymorphisms (SNPs) in VEGF and VEGF receptor (VEGFR) genes have also been correlated to tumour neoangiogenesis through different biological mechanisms.
In the ALICE-1 study HCC patients receiving sorafenib were tested for VEGF-A, VEGF-C and VEGFR-1,2,3 SNPs. At univariate analysis VEGF-A alleles C of rs25648, T of rs833061, C of rs699947, C of rs2010963, VEGF-C alleles T of rs4604006, G of rs664393, VEGFR-2 alleles C of rs2071559, C of rs2305948 were significant predictors of PFS and overall survival (OS). At multivariate analysis rs2010963, rs4604006 and Barcelona Clinic Liver Cancer (BCLC) stage resulted to be independent factors influencing PFS and OS.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
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
- •Signed and dated informed consent.
- •Ability to understand and the willingness to sign a written informed consent document.
- •Male or Female, aged >18 years.
- •Eastern Cooperative Oncology Group (ECOG) performance status score of 2 or less.
- •Life expectancy of 12 weeks or more.
- •Adequate hematologic function.
- •Patients were required to have at least one untreated target lesion that could be measured in one dimension, according to the Response Evaluation Criteria in Solid Tumors (RECIST version 1.1).
- •Concomitant antiviral systemic therapy was allowed.
- •Resolution of all acute toxic effects of any prior local treatment.
- •HCC diagnosed according to the AASLD and/or EASL criteria.
排除标准
- •Previous or concurrent cancer that is distinct in primary site or histology from HCC.
- •Renal failure requiring hemo- or peritoneal dialysis.
- •Presence of recent (< 6 months) or current cardiac failure Known history of human immunodeficiency virus (HIV) infection.
- •Known central nervous system tumors including metastatic brain disease.
- •Patients with clinically significant gastrointestinal bleeding within 30 days prior to study entry.
- •Any prior local therapy within 4 weeks of study entry.
- •Pregnancy or breastfeeding.
结局指标
主要结局
PFS
时间窗: up to three years
prognostic/predictive role of eNOS,Ang2, HIF-1, VEGF and VEGFR polymorphisms in relation to Progression Free Survival
次要结局
- OS(up to three years)