Sorafenib Plus Doxorubicin in Patients With Advanced Hepatocellular Carcinoma With Disease Progression on Sorafenib

Sponsor

Memorial Sloan Kettering Cancer Center (Other)

Overall Status

Active, not recruiting

CT.gov ID

NCT01840592

Collaborator

Bayer (Industry), National Comprehensive Cancer Network (Other)

Enrollment

Locations

Arm

120

Anticipated Duration (Months)

Patients Per Site

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of this study is to find out what effects, good and/or bad, the combination of the drug sorafenib in combination with the drug doxorubicin might have on the growth and spread of liver cancer (HCC).

Condition or Disease	Intervention/Treatment	Phase
Hepatocellular Carcinoma	Drug: Sorafenib Drug: Doxorubicin	Phase 2

Study Design

Study Type:

Interventional

Actual Enrollment :

30 participants

Allocation:

N/A

Intervention Model:

Single Group Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

Phase II Study of Sorafenib Plus Doxorubicin in Patients With Advanced Hepatocellular Carcinoma With Disease Progression on Sorafenib

Actual Study Start Date :

Apr 1, 2013

Anticipated Primary Completion Date :

Apr 1, 2023

Anticipated Study Completion Date :

Apr 1, 2023

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Sorafenib plus Doxorubicin Doxorubicin 60 mg/m2 IV on Day 1 of each 3 weeks cycle until unacceptable toxicity Sorafenib 400 mg PO BID or last dose patient from previous sorafenib based therapy, until unacceptable toxicity or disease progression, after which sorafenib can be continued as a single agent.	Drug: Sorafenib Drug: Doxorubicin

Arm

Intervention/Treatment

Experimental: Sorafenib plus Doxorubicin

Doxorubicin 60 mg/m2 IV on Day 1 of each 3 weeks cycle until unacceptable toxicity Sorafenib 400 mg PO BID or last dose patient from previous sorafenib based therapy, until unacceptable toxicity or disease progression, after which sorafenib can be continued as a single agent.

Drug: Sorafenib

Drug: Doxorubicin

Outcome Measures

Primary Outcome Measures

overall survival [6 months]

Secondary Outcome Measures

median time to progression [2 years]
median progression free survival [2 years]
median overall survival [2 years]
toxicity [2 years]
Toxicity rate will be reported by type and severity according to the NCI common toxicity criteria version 4 and descriptive statistics will be provided.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Diagnosis of HCC confirmed histologically, excluding mixed HCC histology (e.g. HCC plus cholangiocarcinoma) or fibrolamellar variant.
Prior treatment with sorafenib as single agent or in combination, with no less than 200 mg once every other day dose of sorafenib, with radiologic evidence of progression of disease.
Measurable disease using RECIST 1.1 criteria.
Non-cirrhotic or no more than Child-Pugh A cirrhosis.
Expected survival of at least 3 months.
Age ≥ 18 years.
KPS ≥ 70%
Fully recovered from any prior surgery and/or radiation and none within 2 weeks of initiating treatment.
Patients may have been treated with locoregional liver directed therapies such as embolization, chemo-embolization including drug-eluting beads doxorubicin chemoembolization (prior non drug eluting beads chemoembolization with doxorubicin is excluded), radiation, radioactive microspheres, etc., provided that they either have a target lesion that has not been subjected to local therapy and/or the target lesion(s) within the field of the local therapy has shown an increase of ≥25% in the size since last treatment. Such therapy must be completed at least 4 weeks prior to treatment initiation. Patients that have received palliative radiation therapy to the bone need not wait 4 weeks to begin protocol therapy.
Informed consent must be obtained prior to study initiation.
Total bilirubin ≤3.0 mg/dL and no evidence of bile obstruction.
Absolute neutrophil count (ANC) ≥1,500/μL.
Platelets ≥75,000/μL.
Serum creatinine ≤ 1.5 x the upper limit of normal range, or, if serum creatinine >1.5 x the upper limit of normal range, then the creatinine clearance must be ≥ 60 mL/min.
Subjects with active hepatitis B or C on anti-viremic compounds may remain on such treatment, except for interferon.
Patients with a history of hypertension should be well controlled (< 140/90 mmHg) on a regimen of anti-hypertensive therapy.
Brain metastases are allowed if well controlled and without seizures.
Prior palliative radiation therapy to bone sites is allowed as long as it is completed more than two weeks ago.

Exclusion Criteria:

Significant cardiac disease:
Congestive heart failure > Class II New York Heart Association (NYHA).
Myocardial infarction within 6 months prior to study entry.
Cardiac arrhythmias requiring anti-arrhythmic therapy other than beta blockers or digoxin.
Serious myocardial dysfunction, defined as scintigraphically (MUGA, myocardial scintigram) or echocardiogram determined absolute left ventricular ejection fraction (LVEF) below normal (<50%).
Participation in concurrent investigational studies.
Prior loco-regional therapy including drug-eluting beads doxorubicin chemoembolization (prior non drug eluting beads chemoembolization with doxorubicin is excluded) is allowed.
Prior exposure to systemic intravenously given doxorubicin.
Pregnancy or lactation.
Uncontrolled inter-current illness or psychiatric illness or social situations that would limit compliance with study requirements.
Subjects with history of another primary cancer, with the exception of: a) curatively resected non-melanoma skin cancer; b) curatively treated cervical carcinoma in situ; or c) other primary solid tumor with no known active disease present in the opinion of the investigator will not affect patient outcome in the setting of current HCC diagnosis. Allografts, including but not limited to liver and bone marrow transplants.
Bleeding esophageal or gastric varices within 30 days prior to treatment initiation.

Concomitant treatment with Rifampin or St John's Wort. Patients should discontinue these drugs at least 4 weeks prior to starting protocol treatment.

Subjects known to be HIV positive.
History of bleeding diathesis.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Memorial Sloan Kettering Cancer Center at Basking Ridge	Basking Ridge	New Jersey	United States
2	Memorial Sloan Kettering Cancer Center @ Suffolk	Commack	New York	United States	11725
3	Memorial Sloan Kettering West Harrison	Harrison	New York	United States	10604
4	Memorial Sloan Kettering Cancer Center	New York	New York	United States	10065
5	Memorial Sloan Kettering Cancer Center at Mercy Medical Center	Rockville Centre	New York	United States	11570
6	Memorial Sloan Kettering Cancer Center at Phelps Memorial Hospital Center	Sleepy Hollow	New York	United States	10591