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| ID | Type | Description | Link |
|---|---|---|---|
| 05-311 | Other Identifier | DFHCC IRB | |
| N02CO12400 | Other Grant/Funding Number | US NIH Grant/Contract Award Number | |
| CDR0000526405 | Registry Identifier | PDQ (Physician Data Query) |
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The study was stopped prior to 2nd stage.
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This phase II trial is studying how well AZD2171 works in treating patients with locally advanced unresectable or metastatic liver cancer. AZD2171 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor
PRIMARY OBJECTIVE:
I. Assess the progression free survival of patients with locally advanced unresectable or metastatic hepatocellular carcinoma treated with AZD2171.
SECONDARY OBJECTIVES:
I. Determine the toxicity of this drug in these patients. II. Determine, preliminarily, the efficacy of this drug, in terms of response rate, duration of response, and overall survival, in these patients.
III. Determine the blood flow changes and vascular permeability of the tumor in patients treated with this drug.
IV. Determine the pharmacokinetic profile of this drug in these patients.
OUTLINE: This is a multicenter study.
Patients receive oral AZD2171 once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Dynamic contrast-enhanced (DCE) MRI and CT perfusion scan of the liver are performed at baseline, 72 hours after the initial dose of AZD2171, and at the end of course 1. Blood samples for pharmacokinetic studies are collected periodically during study.
After the completion of study treatment, patients are followed every 3 months for 1 year.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AZD2171 | Experimental | Patients will receive AZD2171 (cediranib maleate) 30mg by mouth once a day. Treatment may continue for as long as benefit is shown. Patients will undergo MRI and CT scan of the liver before beginning treatment, 3 days after the first dose of AZD2171, and after finishing course one. Patients will also undergo blood collection periodically for laboratory studies. Laboratory biomarker analysis, computed tomography, dynamic contrast-enhanced magnetic resonance imaging, and pharmacological study will be performed. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cediranib maleate | Drug | Given orally |
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| Measure | Description | Time Frame |
|---|---|---|
| Progression-free Survival | Progression is defined as a 20% increase in the sum of the of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions by conventional RECIST based criteria, or death, which ever comes first. This design yields at least 90% power to detect a true 3-month PFS rate of at least 69%. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Response Rate | Number of patients who achieve either complete or partial response based on RECIST Criteria for target lesions assessed by MRI. Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR | Up to 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Andrew Zhu | Massachusetts General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Massachusetts General Hospital Cancer Center | Boston | Massachusetts | 02114 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23362324 | Result | Zhu AX, Ancukiewicz M, Supko JG, Sahani DV, Blaszkowsky LS, Meyerhardt JA, Abrams TA, McCleary NJ, Bhargava P, Muzikansky A, Sheehan S, Regan E, Vasudev E, Knowles M, Fuchs CS, Ryan DP, Jain RK, Duda DG. Efficacy, safety, pharmacokinetics, and biomarkers of cediranib monotherapy in advanced hepatocellular carcinoma: a phase II study. Clin Cancer Res. 2013 Mar 15;19(6):1557-66. doi: 10.1158/1078-0432.CCR-12-3041. Epub 2013 Jan 29. |
| Label | URL |
|---|---|
| pubmed article | View source |
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The study enrolled the targeted 17 patients for the first stage between May 2009 and January 2010. Patients were recruited in the outpatient clinics.
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| ID | Title | Description |
|---|---|---|
| FG000 | Singe Arm Open Label Study With AZD2171 at 30 mg Daily. | Patients will receive AZD2171 by mouth once a day. Treatment may continue for as long as benefit is shown. Patients will undergo MRI and CT scan of the liver before beginning treatment, 3 days after the first dose of AZD2171, and after finishing course one. Patients will also undergo blood collection periodically for laboratory studies. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| laboratory biomarker analysis | Other | Peripheral blood was obtained from all patients enrolled for studies of early changes in circulating proangiogenic and proinflammatory molecules and cells. Blood samples were collected in EDTA-containing tubes before and after cediranib therapy on days 1 and 14 of cycle 1. Circulating VEGF, placental growth factor (PlGF), sVEGFR1, basic fibroblast growth factor (bFGF), interleukin (IL)-6, IL-8, transforming growth factor a ((TNF-a), gamma interferon (IFN-g) were measured using multiplex ELISA plates from Meso-Scale Discovery. Hepatocyte growth factor (HGF), insulin-like growth factor 1 (IGF-1), sVEGFR2, angiopoietin 2 (Ang-2), sTie2, soluble c-KIT, carbon anhydrase 9 (CAIX), and stromal cell-derived factor-1a (SDF1a) were measured using ELISA kits from R&D Systems. |
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| computed tomography | Procedure | computed tomography (CT) every 8 weeks to evaluate response and progression. |
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| dynamic contrast-enhanced magnetic resonance imaging | Procedure | Magnetic resonance imaging (MRI) every 8 weeks to evaluate response and progression. |
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| pharmacological study | Other | Blood samples to characterize the steady-state PK of cediranib were drawn from a peripheral vein shortly before patients received the dose on days 8 and 15 of cycle 1 and at the following times relative to dosing on day 1 of cycle 2: 5 min and 1, 2, 4, 6, 8, and 24 hours, with the last sample collected before taking the next daily dose. |
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| Overall Survival | Overall survival will be calculated using the Kaplan-Meier method, and confidence limits for survival estimates will be calculated using the Greenwood formula. | The time from study entry until death from any cause, assessed up to 1 year |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Singe Arm Open Label Study With AZD2171 at 30 mg Daily | Patients will receive AZD2171 (cediranib maleate) by mouth once a day. Treatment may continue for as long as benefit is shown. Patients will undergo MRI and CT scan of the liver before beginning treatment, 3 days after the first dose of AZD2171, and after finishing course one. Patients will also undergo blood collection periodically for laboratory studies. Laboratory biomarker analysis, computed tomography, dynamic contrast-enhanced magnetic resonance imaging, and pharmacological study will be performed. cediranib maleate: Given orally laboratory biomarker analysis computed tomography dynamic contrast-enhanced magnetic resonance imaging pharmacological study |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Age, Continuous | Median | Full Range | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Eastern Cooperative Oncology Group | Grade ECOG 0 Fully active, able to carry on all pre-disease performance without restriction
| Median | Full Range | units on a scale |
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| Cancer Of Liver Italian Program (CLIP) | CLIP score calculated by assigning a score (0, 1 or 2) to each of 4 clinical factors and then adding the 4 scores to arrive at the CLIP score. Higher values in each of the 4 clinical factors represent a worse outcome. CLIP score range (0-6) w/ higher values=worse outcome
| Median | Full Range | units on a scale |
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| 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 | Progression-free Survival | Progression is defined as a 20% increase in the sum of the of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions by conventional RECIST based criteria, or death, which ever comes first. This design yields at least 90% power to detect a true 3-month PFS rate of at least 69%. | The number of patients who were progression free at 3 months was determined. 13 of 17 patients (77%) were progression free at 3 months. | Posted | Number | 95% Confidence Interval | percentage of participants | 3 months |
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| Secondary | Response Rate | Number of patients who achieve either complete or partial response based on RECIST Criteria for target lesions assessed by MRI. Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR | Patients receiving AZD2171 (cediranib maleate) | Posted | Number | participants with confirmed response | Up to 1 year |
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| Secondary | Overall Survival | Overall survival will be calculated using the Kaplan-Meier method, and confidence limits for survival estimates will be calculated using the Greenwood formula. | Posted | Median | 95% Confidence Interval | months | The time from study entry until death from any cause, assessed up to 1 year |
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| Post-Hoc | Discontinued Treatment Due to SAE | Participants that discontinued treatment due to a Serious Adverse Event (SAE) | Posted | Number | Participants | May 2009 through January 2010 |
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A total of 77 treatment cycles were administered, with a median of 3 cycles per patient (range: 1-15). Twelve of 17 patients required dose interruptions and subsequent reductions for the following reasons: gr 3 elevated AST (3), gr 3 hyperbilirubinemia (3), gr 3 elevated ALT (2), gr 3 dehydration (1), gr 2 diarrhea (1), and gr 1 proteinuria (2).
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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 | Singe Arm Open Label Study With AZD2171 at 30 mg Daily | Patients will receive AZD2171 (cediranib maleate) at 30 mg by mouth once a day. Treatment may continue for as long as benefit is shown. Patients will undergo MRI and CT scan of the liver before beginning treatment, 3 days after the first dose of AZD2171, and after finishing course one. Patients will also undergo blood collection periodically for laboratory studies. Laboratory biomarker analysis, computed tomography, dynamic contrast-enhanced magnetic resonance imaging, and pharmacological study will be performed. cediranib maleate: Given orally laboratory biomarker analysis computed tomography dynamic contrast-enhanced magnetic resonance imaging pharmacological study | 5 | 17 | 17 | 17 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| pulmonary embolism | Vascular disorders | Systematic Assessment |
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| hyperbilirubinemia | Gastrointestinal disorders | Systematic Assessment |
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| left subdural hemorrhage | Nervous system disorders | Systematic Assessment | unwitnessed fall with mental status change and was found to have large left subdural hemorrhage and transtentorial herniation leading to death |
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| Fatigue | General disorders | Systematic Assessment |
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| AST-SGOT | Gastrointestinal disorders | Systematic Assessment |
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| Hyponatremia | General disorders | Systematic Assessment |
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| Alk. Phosphatemia | Hepatobiliary disorders | Systematic Assessment |
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| ALT-SGPT | Gastrointestinal disorders | Systematic Assessment |
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| Hypertension | Cardiac disorders | Systematic Assessment |
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| Hypophosphatemia | General disorders | Systematic Assessment |
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| Proteinuria | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | Systematic Assessment |
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| Hypothyroidism | Endocrine disorders | Systematic Assessment |
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| Cardiac Ischemia | Cardiac disorders | Systematic Assessment |
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| Hematemesis | Gastrointestinal disorders | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fatigue | General disorders | Systematic Assessment |
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| AST-SGOT | Gastrointestinal disorders | Systematic Assessment |
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| Hyponatremia | General disorders | Systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | Systematic Assessment |
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| Nausea | Immune system disorders | Systematic Assessment |
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| Alk.Phosphatemia | Hepatobiliary disorders | Systematic Assessment |
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| ALT-SGPT | Gastrointestinal disorders | Systematic Assessment |
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| Weight loss | General disorders | Systematic Assessment |
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| Anorexia | General disorders | Systematic Assessment |
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| Hyperbilirubinemia | Hepatobiliary disorders | Systematic Assessment |
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| Hypertension | Cardiac disorders | Systematic Assessment |
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| Hypophosphatemia | General disorders | Systematic Assessment |
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| Proteinuria | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Thrombocytopenia | Blood and lymphatic system disorders | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | Systematic Assessment |
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| Hypocalcemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Leukopenia | Investigations | Systematic Assessment |
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| Lymphopenia | Investigations | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Anemia | Blood and lymphatic system disorders | Systematic Assessment |
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| Hyperkalemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Rash/desquamation | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Fever w/o neutropenia | General disorders | Systematic Assessment |
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| Hypoglycemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Hypothyroidism | Endocrine disorders | Systematic Assessment |
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| Confusion | Psychiatric disorders | Systematic Assessment |
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| Creatinine | Investigations | Systematic Assessment |
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| Hand-foot skin reaction | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Hypokalemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Stomatitis | Gastrointestinal disorders | Systematic Assessment |
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| Headache | Nervous system disorders | Systematic Assessment |
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| Taste disturbance | Gastrointestinal disorders | Systematic Assessment |
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| Dysphonia | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Cardiac ischemia | Cardiac disorders | Systematic Assessment |
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| Hematemesis | Gastrointestinal disorders | Systematic Assessment |
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| Hypercalcemia | Metabolism and nutrition disorders | Systematic Assessment |
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| Epistaxis | Social circumstances | Systematic Assessment |
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Despite reaching the prespecified goal for the first stage of the trial, the study was stopped and did not proceed to the second stage after reviewing the development program of cediranib by AstraZeneca for reasons unrelated to this study.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Andrew X. Zhu, MD | Massachusetts General Hospital Cancer Center | 617-643-3415 | azhu@partners.org |
| ID | Term |
|---|---|
| D006528 | Carcinoma, Hepatocellular |
| ID | Term |
|---|---|
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008113 | Liver Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
| D008107 | Liver Diseases |
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| ID | Term |
|---|---|
| C500926 | cediranib |
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