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| ID | Type | Description | Link |
|---|---|---|---|
| P30CA006973 | U.S. NIH Grant/Contract | View source | |
| JHOC-J0516 | |||
| HOC-05042805 |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
RATIONALE: Drugs used in chemotherapy, such as doxorubicin, work in different ways to stop the growth of tumor cells, either by killing the cells or stopping them from dividing. Chemoembolization kills tumor cells by blocking the blood flow to the tumor and keeping chemotherapy drugs near the tumor.
PURPOSE: This clinical trial is studying how well chemoembolization using doxorubicin works in treating patients with liver cancer that cannot be removed by surgery.
OBJECTIVES:
OUTLINE: This is a pilot study.
Patients undergo catheterization of the hepatic artery followed by chemoembolization comprising an infusion of GelSpheresâ„¢ beads mixed with doxorubicin hydrochloride into the target hepatic artery. Patients may receive up to 3 chemoembolization treatments.
After completion of study treatment, patients are followed at 1 month, every 2 months for 1 year, and then every 3 months during year 2.
PROJECTED ACCRUAL: A total of 20 patients will be accrued for this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Drug-eluting bead transarterial chemoembolization (DEB-TACE) | Experimental | Patients undergo DEB-TACE procedures utilizing LC Beads, polyvinyl alcohol microspheres with diameters of 100-300um or 300-500um, which are loaded with 100mg of doxorubicin hydrochloride and mixed with an equal volume of nonionic contrast media. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Drug-eluting beads loaded with doxorubicin hydrochloride | Device | Doxorubicin eluting beads |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety | Safety was assessed using the CTCAE v 3.0 criteria, reported are the number of participants that experienced at least 1 event that was grade 2 (moderate) or higher. | 1 month |
| Safety | Safety was assessed using the CTCAE v 3.0 criteria, reported are the number of participants that experienced at least 1 event that was grade 2 (moderate) or higher. | 6 months |
| Efficacy - Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Efficacy as assessed by radiographic tumor response using EASL criteria at baseline and at 1 month post-TACE Complete Response (CR): Achieving 100% tumor necrosis of targeted lesions Partial Response (PR): Demonstrating greater than 50% tumor necrosis in targeted lesions Progressive Disease (PD): Reappearance of or increased tumor enhancement greater than 25% in targeted lesions Stable Disease (SD): Not meeting requirements for CR or PR and not demonstrating evidence of progression in targeted lesions. | 1 month |
| Efficacy - Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) | Efficacy as assessed by radiographic tumor response using RECIST criteria at baseline, 1 month post treatment. Complete Response (CR): Disappearance of all lesions targeted by therapy Partial Response (PR): At least 30% decrease in the sum of longest diameter (LD) of lesions targeted by therapy Progressive Disease (PD): At least 20% increase in sum of LD of lesions targeted by therapy Stable Disease (SD): Neither sufficient shrinkage for PR nor sufficient increase for PD. | 1 month |
| Efficacy - Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) | Efficacy as assessed by radiographic tumor response using RECIST criteria at baseline, and at 6 months post treatment. Complete Response (CR): Disappearance of all lesions targeted by therapy Partial Response (PR): At least 30% decrease in the sum of longest diameter (LD) of lesions targeted by therapy Progressive Disease (PD): At least 20% increase in sum of LD of lesions targeted by therapy Stable Disease (SD): Neither sufficient shrinkage for PR nor sufficient increase for PD. |
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DISEASE CHARACTERISTICS:
Diagnosis of hepatocellular carcinoma (HCC) according to the European Association for the Study of Liver (EASL) disease diagnostic criteria AND the Okuda staging classification
No advanced disease, as defined by any of the following:
Barcelona Clinic Liver Cancer (BCLC) class C disease, as defined by the following:
BCLC class D disease, as defined by the following:
Diffuse HCC, defined as massive ill-defined tumor involvement
Child-Pugh Class C
Not eligible for radical therapies (e.g., resection, liver transplantation, or percutaneous therapies)
No significant liver decompensation
Preserved liver function (Child-Pugh class A-B)
No other active primary tumor
Arteries supplying the lesion must be large enough to accept GelSpheresâ„¢ beads
PATIENT CHARACTERISTICS:
Bilirubin ≤ 3 mg/dL
Albumin > 2.0 g/dL
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 5 times the upper limit of normal (ULN)
Alkaline phosphatase ≤ 5 times the upper limit of normal (ULN)
No active gastrointestinal bleeding
No encephalopathy
No contraindication to hepatic embolization procedures, as indicated by any of the following:
No contraindication to doxorubicin hydrochloride administration, as indicated by any of the following:
Not pregnant
No known allergy to contrast media
No intolerance to occlusion procedures
No vascular anatomy or bleeding that would preclude catheter placement or emboli injection, as indicated by any of the following:
PRIOR CONCURRENT THERAPY:
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| Name | Affiliation | Role |
|---|---|---|
| Jeffrey F. Geschwind, MD | Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Baltimore | Maryland | 21231-2410 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20010173 | Result | Reyes DK, Vossen JA, Kamel IR, Azad NS, Wahlin TA, Torbenson MS, Choti MA, Geschwind JF. Single-center phase II trial of transarterial chemoembolization with drug-eluting beads for patients with unresectable hepatocellular carcinoma: initial experience in the United States. Cancer J. 2009 Nov-Dec;15(6):526-32. doi: 10.1097/PPO.0b013e3181c5214b. |
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20 patients with unresectable hepatocellular carcinoma (HCC) were enrolled at Johns Hopkins Hospital to undergo treatment with drug-eluting beads (DEBs) infused with doxorubicin. The last patient was enrolled in Dec 2007.
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| ID | Title | Description |
|---|---|---|
| FG000 | Drug-eluting Bead Transarterial Chemoembolziation (DEB-TACE) | Patients undergo DEB-TACE procedures utilizing LC Beads, polyvinyl alcohol microspheres with diameters of 100-300um or 300-500um, which are loaded with 100mg of doxorubicin hydrochloride and mixed with an equal volume of nonionic contrast media. doxorubicin hydrochloride: Doxorubicin eluting beads |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Drug-eluting Bead Transarterial Chemoembolziation (DEB-TACE) | Patients undergo DEB-TACE procedures utilizing LC Beads, polyvinyl alcohol microspheres with diameters of 100-300um or 300-500um, which are loaded with 100mg of doxorubicin hydrochloride and mixed with an equal volume of nonionic contrast media. doxorubicin hydrochloride: Doxorubicin eluting beads |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Safety | Safety was assessed using the CTCAE v 3.0 criteria, reported are the number of participants that experienced at least 1 event that was grade 2 (moderate) or higher. | 19 of 20 patients were assessed at 1 month. | Posted | Count of Participants | Participants | 1 month |
|
3 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Drug-eluting Bead Transarterial Chemoembolziation (DEB-TACE) | Patients undergo DEB-TACE procedures utilizing LC Beads, polyvinyl alcohol microspheres with diameters of 100-300um or 300-500um, which are loaded with 100mg of doxorubicin hydrochloride and mixed with an equal volume of nonionic contrast media. doxorubicin hydrochloride: Doxorubicin eluting beads |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Liver failure | Hepatobiliary disorders | CTCAE (3.0) | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fatigue | General disorders | CTCAE (3.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Jean-Francois Geschwind, MD | Yale University | 203-785-5865 | jeff.geschwind@yale.edu |
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| ID | Term |
|---|---|
| D008113 | Liver Neoplasms |
| D006528 | Carcinoma, Hepatocellular |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
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| 6 months |
| Efficacy - Overall Survival | Presented are the counts of patients that have survived up to 1 year. | 1 Year |
| Efficacy - Overall Survival | Presented are the counts of patients that have survived up to 2 years. | 2 Years |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| Barcelona Clinic Liver Cancer (BCLC) grade | The Barcelona Clinic Liver Cancer (BCLC) grades are used to assess those with Hepatocellular carcinoma (HCC). Grade A is the least severe, grade B is moderate and grade C is advanced. | Count of Participants | Participants |
|
| Units |
|---|
| Counts |
|---|
| Participants |
|
|
| Primary | Safety | Safety was assessed using the CTCAE v 3.0 criteria, reported are the number of participants that experienced at least 1 event that was grade 2 (moderate) or higher. | 19 of 20 patients were assessed at 6 months. | Posted | Count of Participants | Participants | 6 months |
|
|
|
| Primary | Efficacy - Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Efficacy as assessed by radiographic tumor response using EASL criteria at baseline and at 1 month post-TACE Complete Response (CR): Achieving 100% tumor necrosis of targeted lesions Partial Response (PR): Demonstrating greater than 50% tumor necrosis in targeted lesions Progressive Disease (PD): Reappearance of or increased tumor enhancement greater than 25% in targeted lesions Stable Disease (SD): Not meeting requirements for CR or PR and not demonstrating evidence of progression in targeted lesions. | 19 of 20 patients were assessed at 1 month. | Posted | Count of Participants | Participants | 1 month |
|
|
|
| Primary | Efficacy - Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) | Efficacy as assessed by radiographic tumor response using RECIST criteria at baseline, 1 month post treatment. Complete Response (CR): Disappearance of all lesions targeted by therapy Partial Response (PR): At least 30% decrease in the sum of longest diameter (LD) of lesions targeted by therapy Progressive Disease (PD): At least 20% increase in sum of LD of lesions targeted by therapy Stable Disease (SD): Neither sufficient shrinkage for PR nor sufficient increase for PD. | 19 of 20 patients were assessed at 1 month. | Posted | Count of Participants | Participants | 1 month |
|
|
|
| Primary | Efficacy - Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) | Efficacy as assessed by radiographic tumor response using RECIST criteria at baseline, and at 6 months post treatment. Complete Response (CR): Disappearance of all lesions targeted by therapy Partial Response (PR): At least 30% decrease in the sum of longest diameter (LD) of lesions targeted by therapy Progressive Disease (PD): At least 20% increase in sum of LD of lesions targeted by therapy Stable Disease (SD): Neither sufficient shrinkage for PR nor sufficient increase for PD. | 19 of 20 patients were assessed. | Posted | Count of Participants | Participants | 6 months |
|
|
|
| Primary | Efficacy - Overall Survival | Presented are the counts of patients that have survived up to 1 year. | 20 patients were assessed. | Posted | Count of Participants | Participants | 1 Year |
|
|
|
| Primary | Efficacy - Overall Survival | Presented are the counts of patients that have survived up to 2 years. | 20 patients were assessed. | Posted | Count of Participants | Participants | 2 Years |
|
|
|
| 2 |
| 20 |
| 2 |
| 20 |
| 20 |
| 20 |
| Cholecystitis | Hepatobiliary disorders | CTCAE (3.0) | Systematic Assessment |
|
| Post-embolization syndrome | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
|
| Abdominal pain | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
|
| Fever | General disorders | CTCAE (3.0) | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
|
| Anemia | Blood and lymphatic system disorders | CTCAE (3.0) | Systematic Assessment |
|
| Leukocytopenia | Investigations | CTCAE (3.0) | Systematic Assessment |
|
| Thrombocytopenia | Investigations | CTCAE (3.0) | Systematic Assessment |
|
| Elevated liver enzymes | Investigations | CTCAE (3.0) | Systematic Assessment |
|
| Anorexia | Metabolism and nutrition disorders | CTCAE (3.0) | Systematic Assessment |
|
| Weight loss | Investigations | CTCAE (3.0) | Systematic Assessment |
|
| Alopecia | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Systematic Assessment |
|
| Decreased libido | Psychiatric disorders | CTCAE (3.0) | Systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
|
| Gastroenteritis | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
|
| Pancreatitis | Gastrointestinal disorders | CTCAE (3.0) | Systematic Assessment |
|
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| D008107 |
| Liver Diseases |
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| Title | Measurements |
|---|---|
|
| 1 month post-TACE : Progressive Disease |
|
| Disease control rate (CR + PR + SD) |
|
| Title | Measurements |
|---|---|
|
| 1 month post-TACE : Progressive Disease |
|
| Disease control rate (CR + PR + SD) |
|
| Title | Measurements |
|---|---|
|
| 6 months post-TACE : Progressive Disease (PD) |
|
| Disease control rate (CR + PR + SD) |
|