A Randomized, Double-Blinded, Placebo-Controlled Study of Sorafenib in Patients With Advanced Hepatocellular Carcinoma
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ClinicalTrials.gov Identifier: NCT00492752 |
Recruitment Status :
Completed
First Posted : June 27, 2007
Results First Posted : January 13, 2011
Last Update Posted : April 16, 2014
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The purpose of the study is
- Find out if patients receiving Sorafenib will live longer
- Find out if Sorafenib has any effect on patient reported outcomes
- Find out if Sorafenib prevents the growth or shrinks liver tumors and / or their metastases
- Determine the pharmacokinetics (PK) in patients with liver cancer
Condition or disease | Intervention/treatment | Phase |
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Carcinoma, Hepatocellular | Drug: Sorafenib (Nexavar, BAY43-9006) Drug: Placebo | Phase 3 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 226 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Triple (Participant, Investigator, Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | A Randomized, Double-blinded, Placebo-controlled Study of Sorafenib in Patients With Advanced Hepatocellular Carcinoma |
Study Start Date : | October 2005 |
Actual Primary Completion Date : | March 2007 |
Actual Study Completion Date : | July 2009 |
Arm | Intervention/treatment |
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Experimental: Sorafenib (Nexavar, BAY43-9006)
Sorafenib was administered orally at a dose of 400 mg (2 x 200 mg tablets) bid (twice daily); 2 dose reductions to predefined levels of 400 mg (2 x 200 mg tablets) once daily (od) and 400 mg (2 x 200 mg tablets) every 2 days were permitted for treatment-emergent adverse events related to study treatment.
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Drug: Sorafenib (Nexavar, BAY43-9006)
multikinase inhibitor; Sorafenib 400 mg (orally) twice daily |
Placebo Comparator: Placebo
Placebo tablets matching in appearance were orally administered bid (twice daily).
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Drug: Placebo
Matching placebo (orally) twice daily |
- Overall Survival [ Time Frame: From randomization of the first subject until the data cut-off date approximately 23 months after start of randomization ]Overall Survival (OS) was defined as the time from date of randomization to death due to any cause. Subjects still alive at the time of analysis were censored at their last date of last contact.
- Time to Symptomatic Progression (TTSP) [ Time Frame: From randomization of the first subject until the data cut-off date approximately 23 months after start of randomization ]Time to Symptomatic Progression (TTSP) was defined as the time from date of randomization to symptomatic progression. Subjects without symptomatic progression at the time of analysis were censored at their last date of tumor evaluation.
- Time to Progression (TTP) [ Time Frame: From randomization of the first subject until the data cut-off date approximately 23 months after start of randomization ]Time to progression (TTP) was defined as the time from date of randomization to radiologically documented disease progression. Subjects without progression at the time of analysis were censored at their last date of tumor evaluation。
- Disease Control [ Time Frame: From randomization of the first subject until the data cut-off date approximately 23 months after start of randomization ]Disease Control (DC) was defined as the total number of subjects whose best response was not Progressive Disease (PD: an increase in the sum of tumor lesions sizes) according to Response Evaluation Criteria in Solid Tumors (RECIST) (= total number of Complete Response (CR: disappearance of tumor lesions) + total number of Partial Response (PR: a decrease of at least 30% in the sum of tumor lesion sizes) + total number of Stable Disease (SD: steady state of disease); CR, PR, or SD had to be maintained for at least 28 days from the first demonstration of that rating).
- Change in Functional Assessment of Cancer Therapy (FACT) Hepatobiliary Symptom Index-8 (FHSI-8) Score From Baseline to Cycle 1 and Cycle 3 [ Time Frame: Baseline up to Cycle 1 and Cycle 3. From randomization of the first subject until the data cut-off date approximately 23 months after start of randomization ]The FHSI-8 questionnaire was completed at baseline and every 3 weeks during treatment and at the end of treatment visit only for subjects who withdrew for reasons other than symptomatic progression. Patient reported outcome was measured using the FHSI-8 score changes from baseline throughout the study period. FHSI-8 assesses hepatobiliary cancer symptoms with total score ranges from 0 to 32 (0 = the best quality of life; 32 = the worst quality of life with severe symptoms)..
- Change in Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) Score From Baseline to Cycle 3 and End of Treatment [ Time Frame: Baseline up to Cycle 3 and end of treatment. From randomization of the first subject until the data cut-off date approximately 23 months after start of randomization ]The FACT-Hep questionnaire was also completed to assess patient reported outcome. The FACT-Hep assesses hepatobiliary cancer-related quality of life. FACT-Hep total score ranges from 0 to 180 (0=All questions answered "Not at all"; 180=All questions answered "Very much").
- Number of Participants With Different Tumor Response [ Time Frame: From randomization/start of treatment of the first subject until approximately 23 months after randomization when the subjects on placebo were offered the option to crossover to sorafenib treatment ]Tumor Response (= Best Overall Response) of a subject was defined as the best tumor response (confirmed Complete Response (CR: disappearance of tumor lesions), confirmed* Partial Response (PR: a decrease of at least 30% in the sum of tumor lesion sizes), Stable Disease (SD: steady state of disease), or Progressive Disease (PD: an increase in the sum of tumor lesions sizes)) observed during trial period assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria.
- Duration of Response [ Time Frame: From randomization of the first subject until the data cut-off date approximately 23 months after start of randomization ]Duration of Response was defined as the time from date of first response (Complete Response (CR) or Partial Response (PR)) to the date when Progressive Disease (PD) is first documented, or to the date of death, whichever occurs first. Subjects still having CR or PR at the time of analysis were censored at their last tumor assessment.
- Time to Response [ Time Frame: From randomization of the first subject until the data cut-off date approximately 23 months after start of randomization ]Time to Response (TTR) for subjects who achieved a response (Complete Response (CR) or Partial Response (PR) ) was defined as the time from date of randomization to the earliest date that the response was first documented.
- Area Under the Curve From Time 0 to 12 Hours Post-dose (AUC 0-12) After 21 Days of Sorafenib Treatment [ Time Frame: PK assessments made at following times: pre-dose, 1 h, 2h, 4h, 8h,and 12h after at least 21 consecutive doses during Cycle 1 ]The AUC is a measure of systemic drug exposure, which is obtained by collecting a series of blood samples and measuring the concentrations of drug in each sample. A plot of concentration vs time after dosing is created, and the area under this curve is calculated by standard methods (eg, trapezoidal rule) to provide a measure of how much drug was in the bloodstream following dosing.
- Normalized Area Under the Curve (AUC Norm) After 21 Days of Sorafenib Treatment [ Time Frame: PK assessments made at following times: pre-dose, 1 h, 2h, 4h, 8h,and 12h after at least 21 consecutive doses during Cycle 1 ]The AUC is a measure of systemic drug exposure, which is obtained by collecting a series of blood samples and measuring the concentrations of drug in each sample. A plot of concentration vs time after dosing is created, and the area under this curve is calculated by standard methods (eg, trapezoidal rule) to provide a measure of how much drug was in the bloodstream following dosing.
- Maximum Concentration (Cmax) After 21 Days of Sorafenib Treatment [ Time Frame: PK assessments made at following times: pre-dose, 1 h, 2h, 4h, 8h,and 12h after at least 21 consecutive doses during Cycle 1 ]Cmax refers to the highest plasma concentration of drug reached after dosing. It is obtained by collecting a series of blood samples after dosing, and analyzing them for drug content by a sensitive and specific analytical method. The highest measured concentration is referred to as the Cmax.
- Normalized Maximum Concentration (Cmaxnorm) After 21 Days of Sorafenib Treatment [ Time Frame: PK assessments made at following times: pre-dose, 1 h, 2h, 4h, 8h,and 12h after at least 21 consecutive doses during Cycle 1 ]Cmaxnorm refers to the maximum plasma concentration of Sorafenib corrected for dose and body weight (Cmaxnorm = Cmax/(mg/kg)).
- Time of Maximum Concentration (Tmax) After 21 Days of Sorafenib Treatment [ Time Frame: PK assessments made at following times: pre-dose, 1 h, 2h, 4h, 8h,and 12h after at least 21 consecutive doses during Cycle 1 ]Tmax refers to the time after dosing when a drug attains its maximum concentration in the blood. It is obtained by collecting a series of blood samples at various times after dosing, and measuring them for drug content. The time corresponding to the highest measurable concentration (Cmax) is referred to as Tmax.
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Ages eligible for study: 18 years and above, Genders eligible for study: both
- Patients who have a life expectancy of at least 12 weeks
- Patients with advanced Hepatocellular carcinoma (HCC) (unresectable, and/or metastatic) which has been histologically or cytologically documented
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Patients must have at least one tumor lesion that meets both of the following criteria
- Accurately measured in at least one dimension according to Response Evaluation Criteria in Solid Tumors (RECIST)
- Not been previously treated with local therapy
- Patients who have received local therapy, such as surgery, radiation therapy, hepatic arterial embolization, chemoembolization, radiofrequency ablation, percutaneous ethanol injection or cryoablation are eligible. Previously treated lesions will not be selected as target lesions. Local therapy must be completed at least 4 weeks prior to the baseline scan
- Patients who have an Eastern Co-operative Oncology Group (ECOG) Performance Status of 0, 1, or 2
Exclusion Criteria:
- Previous or concurrent cancer that is distinct in primary site or histology from HCC, EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors (Ta [Noninvasive papillary carcinoma], Tis [Carcinoma in situ: "flat tumor"]&T1 [Tumor invades subepithelial connective tissue]). Any cancer curatively treated > 3 years prior to entry is permitted
- History of cardiac disease
- Active clinically serious infections
- Known history of human immunodeficiency virus (HIV) infection
- Known central nervous system (CNS) tumors including metastatic brain disease
- Patients with clinically significant gastrointestinal bleeding within 30 days prior to study entry
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00492752
China, Anhui | |
Hefei, Anhui, China, 230022 | |
China, Guangdong | |
Guangzhou, Guangdong, China, 510060 | |
Guangzhou, Guangdong, China, 510515 | |
China, Hubei | |
Wuhan, Hubei, China, 430030 | |
China, Jiangsu | |
Nanjing, Jiangsu, China, 210003 | |
Nanjing, Jiangsu, China, 210009 | |
China, Liaoning | |
Dalian, Liaoning, China, 116011 | |
Dalian, Liaoning, China, 116027 | |
China, Zhejiang | |
Hangzhou, Zhejiang, China, 310016 | |
China | |
Beijing, China, 100021 | |
Beijing, China, 100039 | |
Chongqing, China, 400038 | |
Shanghai, China, 200003 | |
Shanghai, China, 200032 | |
Tianjin, China | |
Korea, Republic of | |
Seoul, Seoul Teugbyeolsi, Korea, Republic of, 152-703 | |
Daegu, Korea, Republic of, 702-701 | |
Seoul, Korea, Republic of, 138-736 | |
Taiwan | |
Changhua, Taiwan, 500 | |
Tainan, Taiwan, 736 | |
Taipei, Taiwan, 10016 | |
Taipei, Taiwan, 251 | |
Taoyuan, Taiwan, 333 |
Study Director: | Bayer Study Director | Bayer |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Bayer |
ClinicalTrials.gov Identifier: | NCT00492752 |
Other Study ID Numbers: |
11849 |
First Posted: | June 27, 2007 Key Record Dates |
Results First Posted: | January 13, 2011 |
Last Update Posted: | April 16, 2014 |
Last Verified: | March 2014 |
Carcinoma Carcinoma, Hepatocellular Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Adenocarcinoma Liver Neoplasms Digestive System Neoplasms |
Neoplasms by Site Digestive System Diseases Liver Diseases Sorafenib Antineoplastic Agents Protein Kinase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |