LC Drug Eluting Bead for Regional Chemoembolization to Downstage Unresectable Hepatocellular Carcinoma (HCC) to Liver Transplantation
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 2
- 试验地点
- 1
- 主要终点
- The Number of Patients in the Cohort Effectively Downstaged to Transplant Eligibility With the LC BeadTM
研究概览
简要总结
Advanced HCC represents a high unmet medical need with a poor prognosis and few therapeutic options. Patients who present with HCC beyond the currently accepted Milan criteria are not eligible to be listed for liver transplantation. The proposed study offers local regional therapy to a defined population of patients beyond Milan criteria as an attempt to downstage them to eligibility for liver transplant.
详细描述
LC BeadTM is a new product specifically designed for TACE. LC BeadTM microspheres can be loaded with doxorubicin (Trade name: adriamycin), a chemotherapeutic anthracycline glycolide agent widely accepted for treatment of HCC. This novel bead slowly releases the ionically bound chemotherapeutic agent rather than administering a bolus of chemotherapy as is the case with many alternative methods of TACE. Thus, the LC BeadTM offers the potential advantage of less toxicity and prolonged tumor exposure.
This study offers local regional therapy to a defined population of patients beyond transplant criteria as an attempt to downstage them to eligibility for liver transplantation. This study will make an important contribution to understanding the beads' local effect as seen in the explanted livers of those patients who go on to receive a liver transplant. Additionally, we will examine the impact of this novel treatment tool on patients' quality of life.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
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
- 未提供
排除标准
- •HCC with gross vascular invasion or extrahepatic disease
- •Previous or concurrent cancer that is distinct in primary site or histology from HCC except cervical carcinoma in situ, treated basal-cell carcinoma of the skin, superficial bladder tumors (Ta, Tis & T1), and any cancer curatively treated > 3 years prior to entry is permitted
- •Renal failure requiring dialysis
- •Child-Pugh B9 or C hepatic impairment
- •History of cardiac disease: NYHA class 2 congestive heart failure, active coronary artery disease, cardiac arrhythmias requiring anti-arrhythmic therapy other than beta blockers or digoxin, and uncontrolled hypertension. Myocardial infarction more than 6 months prior to study entry is permitted.
- •Active clinically serious infections (> CTCAEv3 grade 2)
- •Known history of HIV
- •Known central nervous system tumors including metastatic brain disease
- •History of organ allograft
- •Substance abuse (current), psychological, or social conditions that may interfere with the patient's participation in the study or evaluation of the study results.
- •Allergy to the investigational agents or any agent given in association with this trial.
- •Pregnant or breast-feeding patients. Both men and women enrolled in this trial must use adequate barrier birth control measures during the course of the trial.
- •Uncontrolled hypertension defined as systolic blood pressure > 150mmHg or diastolic blood pressure > 90mmHg
- •Thrombolic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months
- •Pulmonary hemorrhage/bleeding event > CTCAE Grade 2 within 4 weeks of first dose of study drug
- •Any other hemorrhage/bleeding event > CTCAE Grade 3 within 4 weeks of first dose of study drug
- •Serious non-healing wound, ulcer, or bone fracture
- •Any contraindication for doxorubicin administration:
- •serum bilirubin > 3mg/dL
- •WBC < 3000 cells/mm3
- •neutrophil < 1500 cells/mm3
- •cardiac ejection fraction < 50 percent assessed by isotopic ventriculography, echocardiography or MRI
- •MUGA scan < 40% ejection fraction
- •Any contraindication for hepatic embolization procedures
- •Excluded therapies and medications, previous and concomitant:
- •Prior use of any systemic anti-cancer chemotherapy for HCC
- •Prior use of any systemic investigational agents for HCC
- •Major surgery within 6 weeks of start of study drug
- •Radiotherapy during study or within 3 weeks prior to start of study drug
- •Use of biological response modifiers such as granulocyte colony-stimulating factor (G-CSF)within 3 weeks prio to study entry
- •Autologous bone marrow transplant or stem cell rescue within four months of study drug initiation
- •Concomitant treatment with rifampin or St. John's wort
研究组 & 干预措施
LC Drug Eluting Bead, Regional Chemoembolization
Use of LC Drug-Eluting Beads for chemoembolization will provide a method for downstaging patients with hepatocellular carcinoma which is not amenable to surgical resection or local ablative therapy to liver transplant eligibility
干预措施: LC Bead loaded with doxorubicin (Drug)
结局指标
主要结局
The Number of Patients in the Cohort Effectively Downstaged to Transplant Eligibility With the LC BeadTM
时间窗: 36 months
Advanced HCC represents a high unmet medical need with a poor prognosis and few therapeutic options. Patients who present with HCC beyond the currently accepted Milan criteria are not eligible to be listed for liver transplantation. The proposed study offers local regional therapy to both a defined population of patients beyond Milan criteria as an attempt to downstage them to eligibility for liver transplant as well as those individuals within Milan criteria as an attempt to maintain their eligibility.
次要结局
- The Objective Tumor Response Rate in Patients With HCC Treated With LC BeadTM Using EASL and RECIST Criteria(36 months)
- Symptomatic and Quality-of-life Measures in Patients Treated With the LC BeadTM(36 months)
- The Local Effects of the LC BeadTM in the Explanted Liver of Those Patients Who go on to Receive Liver Transplantation(36 months)
研究者
David Geller, MD
David Geller, PI
University of Pittsburgh